Sensory Processing: Tooth Brushing!
Poor tolerance of tooth brushing can be a common challenge for individuals of all ages. Some may experience sensory sensitivities that make the feeling of a toothbrush bristle against their teeth and gums uncomfortable or even painful. Others may have difficulty with the motor skills required to manipulate the toothbrush effectively. Additionally, individuals with oral aversions or sensory processing disorders may struggle with the taste or texture of toothpaste, leading to resistance or refusal to engage in this essential oral hygiene task. It is crucial for occupational therapists to address poor tolerance of tooth brushing and develop individualized strategies to improve oral care routines while promoting overall oral health. There are a few recommendations that may help you or your child, but it is always recommended to consult a professional to develop a plan for you or your family’s specific needs.
So what may poor tolerance look like? Your child may gag when a toothbrush is introduced or they may refuse to brush their teeth altogether. If your child is considered a ‘picky eater’ there is a good chance that the refusal is sensory-related. Starting with the broadest recommendations, remember, not everyone likes/prefers the same toothbrush! Try a different firmness; if you’ve been using a soft bristle brush, try an extra soft bristle brush. Also, let the child pick out the color and get excited about it! Sometimes our excitement can rub off on our children. You can also try using an electric toothbrush. Now, as an OT, I have seen both preferences. I have seen refusals to use electric toothbrushes because the vibration is overstimulating, and I have seen the vibration promote calm. So, this one is really up to the individual child. Trial different toothpaste flavors, as well. Maybe mint or bubblegum isn’t the most tolerated flavor for your child. You can also play around with how much toothpaste you use, if any. Maybe the best starting point is to not use toothpaste right now to build up tolerance. You can also trial different water temperatures and warm water is typically more tolerable.
If you have tried all of these general recommendations, I have a few more tricks! If a toothbrush is absolutely refused, try using a warm, damp washcloth to gently rub the teeth. This pressure would be firmer than a toothbrush, and a toothbrush may be giving the child a more ‘tickly’ feeling. Just rubbing the teeth would not provide the best oral hygiene, so this is not a long-term solution. I would also start with a face and gum massage using a washcloth. Starting on the face, use firm and predictable patterns, and I would verbalize exactly what I was going to do. If there is already anxiety around toothbrushing, then narrating the task may help. After the face is washed, try also rubbing the inside of the child’s cheeks and gums. You can also have them bite down on the washcloth and gently tug it to provide deep and resistive pressure. This recommendation should only be used if the child can follow directions and you are confident they will not try to swallow or eat the washcloth. Lastly, model tooth brushing! Allow the child to watch you through the mirror and encourage them to follow along with the pattern you’re using. Modeling the behavior we want to see is helpful in a variety of situations. Children not only need to see HOW we do something, but they are always watching our REACTIONS. If something seems unpleasant to an adult, a cautious child will be less likely to attempt the task.
Here are some tooth brush recommendations for a variety of ages. Again, consulting your pediatrician or occupational therapist is always recommended before trialing these items.
Source: Toolstogrowot.com
