Some children fight brushing and flossing as a part of their normal developmental stages. For others, it may be due to other underlying causes, such as sensory sensitivities. These kiddos get to experience life differently because of the ways their brains process the information gathered by their senses but, for many, these differences can cause a child to resist brushing and flossing.
How do sensory sensitivities impact brushing and flossing?
You may have heard of sensory processing disorder and autism, both of which are associated with being highly sensitive to certain types of stimuli. However, being highly sensitive to one or more types of sensory input is also very common in people without either of these diagnoses and for people, children in particular, to have strong reactions when exposed to the overwhelming sensory input. It is even common for successful adults to avoid brushing and flossing so they don’t have to endure the “unpleasant” sensations!
Interestingly, touch and taste are not the only things that could make your child dislike the process. It could be the temperature of the bathroom or water on the toothbrush, the way the room looks or how bright the lights are, or even the sound of water running through the pipes!
When it comes to dental health, the most important thing is to discover the specific sensations that cause your child to resist brushing and flossing. Some children may be able to communicate this information to you. For many kiddos, it will be difficult to pinpoint, and you may need to use trial and error, or watch to see what other types of things cause a strong reaction. Do they dislike loud noises? Maybe it’s the sound of brushing. Sensitivity to strong scents or different tastes and textures could mean that the toothpaste flavor or bubbles are the culprit. Once you discover the cause, you can develop strategies to help them move past the cause of their dislike so they can develop good habits to keep their teeth healthy.
That is what we are here for! We want to help your child develop a pattern of caring for their teeth so they can enjoy a lifetime of dental health. Ideally, we would also like to help you do this in a way that allows brushing and flossing to become a stress-free part of your family’s daily routine. With that goal in mind, we are providing different ideas that you can try.
A Note on Motor Skills
For some children, the overwhelming sensory stimuli can be combined with a lack of the necessary fine motor skills to brush and floss properly. This further complicates the process and may require additional time and strategies to bring a child to the point where they can brush and floss on their own.
Just so you know, it is completely normal for kids to take years to develop the motor skills necessary to do a sufficient job brushing and flossing. That is why we recommend that a parent also brush and floss for the child until they are at least 7 or 8 years old - or older - then continue supervising until the child can do a good enough job on their own.
Techniques to Help Your Child Become Comfortable with Brushing Their Teeth
Before we dive into the tips, it is important to note that every child is unique and brushing and flossing may always be a struggle for some. For others, what works for one will lead to meltdowns in another. So, we are providing a wide range of ideas that are recommended by experts and that parents have found to be helpful. You can try them out and see what works for you. Hopefully, we can help make dental care for your child - and by extension your life - a little easier and smoother with these ideas!
Setting the Stage
First off, remember that you are key to success! If a child’s caregiver is calm, patient, and consistent it will greatly improve the chances of successfully incorporating a dental hygiene routine into your child’s day.
Be sure to be very positive throughout the process, giving plenty of praise and encouragement throughout the process, especially for any type of success.
Start small. For some, it may be a huge accomplishment just to let you touch their mouth one day, put the toothbrush on their lip the next, then brush one tooth the following day. Move along at a pace they can handle, offering plenty of encouragement along the way.
A very important step is to let your child know what to expect and, if possible, get them to agree to the process. Show what will happen in each step while explaining it. Some kids may find it helpful to read books or watch videos of the process. Others may find it helpful to be in the bathroom with you and watch while you brush for a few days before attempting it. This has the added benefit of making the bathroom feel more comfortable as a place to brush their teeth. If your child responds well to charts, create a chart of the process. Or, if you are building up to brushing, make a calendar of what step they are progressing to each day.
It may help to simply explain why we need to brush our teeth – without making it seem scary or threatening. You can start by simply saying that it is bad for our teeth when we don’t brush, and it can make our breath smell bad. Please do not threaten your child with a trip to the dentist or needing to get fillings. That will create more problems in the long run.
You can try role-playing, letting your child brush your teeth, or a doll or stuffed animal’s teeth.
Where brushing and flossing happens may be a huge deal to your child. If they are used to watching you brush in one bathroom, it may not be a good idea to expect them to brush in a different bathroom. Some kiddos may find it easier to brush in the bathtub or shower and others may need to be in a completely different room where they feel safe.
Observe the room that you decide (or your child picks) is the one for brushing and flossing. Are there any stimuli that you know will be difficult for your child? Is it too bright, too cold, the floor too hard or soft, too noisy, too strongly scented, or are the colors ones they can’t handle? Any number of things could cause your child to feel uncomfortable.
Create a daily routine for brushing and flossing. It will help if the same set of activities happen in the same sequence at the same time every day. For example, in the morning: wake up, eat, brush teeth, wash face, get dressed. Eventually, it will become a familiar part of the routine and hopefully meet with less resistance.
Brushing and Flossing
Some kiddos will respond well to having you gently but firmly hold their chin or stand behind them and gently tip their head back.
Some children may prefer to watch in the mirror as you brush their teeth. This allows them to see what to expect.
You can try letting your child sit on a chair or the floor - or lean against you.
Find the right toothbrush. The toothbrush head should be the right size for their mouth and soft bristles are optimal. Silicone bristles are another option. A broader handle may be easier to hold. It may help to allow your child to pick out the color or style. There are multiple head toothbrushes that let you clean multiple surfaces at one time.
Let them become familiar with the toothbrush before they are expected to put it in their mouth. (This may be necessary every time the toothbrush needs to be replaced as well.)
Your child may surprise you and prefer an electric toothbrush, so it is worth a try. We definitely recommend letting them run it first, before it gets anywhere near their mouth so they can hear the noise and maybe even feel the sensation against a different, less sensitive part of their body. Electric toothbrushes have the benefit of doing a much more thorough job of cleaning in a shorter amount of time.
If they cannot tolerate a toothbrush, you can try wiping the teeth with a damp washcloth, using a finger toothbrush, or Nuk brush.
Be sure the water isn’t too cold or too hot. Slightly warm water on the toothbrush and for rinsing may work best.
If your child is extremely sensitive to touch, it may help to build up their tolerance by slowly building up to toothbrushing. During the time in the routine that is scheduled for brushing do a little something to progress toward brushing. Move along each of the following steps when your child becomes comfortable with the current step. You can start by putting firm but gentle pressure on their chin or tap along their gums, then move to the lips. Then introduce a warm, damp washcloth to their lips and encourage them to allow the washcloth to touch their teeth. It may be fun for them to bite down while you try to pull the washcloth away, and this also gets them used to a rubbing sensation. Gently rub their teeth with the washcloth. Introduce a damp finger toothbrush or silicone bristle brush. Next, try a soft bristle toothbrush. Finally, try introducing toothpaste. It is a good idea to let them find a toothpaste that they like the look, taste, and smell of, before trying to brush with it.
Let your child try many different flavors of toothpaste to see what they like best. Keep in mind that not all brands are equal. Strawberry flavor in one brand can taste very different in another, especially to a sensory sensitive kid.
If bubbles are a problem, try using a bit less toothpaste. Toddlers only need a rice sized amount and ages 3 and up only need a pea sized amount anyways. There are different brands that produce fewer bubbles. Sodium Lauryl Sulfate creates the foamy bubbles, so look for a toothpaste without it.
You can also try letting your child spit out the toothpaste after each section of teeth is complete.
If your child has a tough time spitting out the toothpaste, be sure to keep using fluoride-free toothpaste until they have the technique down. A tiny bit of fluoride won’t hurt, but you don’t want your child to be swallowing a bunch twice a day, every day. Find a toothpaste with xylitol until they are good at spitting it out.
If your child absolutely cannot tolerate the taste or feel of any toothpaste, use a wet toothbrush and try again at a different time.
Once you’ve found an acceptable toothbrush and toothpaste, find the best floss. You can try waxed or unwaxed (they create very different sensations) and various flavors or unflavored. You can try floss picks as well. Be sure to get the right size for your child’s mouth and let them choose the style/color.
Try using a timer. It may help your child to be able to see how much longer they have. You can also use a timer to slowly increase the length of time they are brushing.
It may help some children to listen to a short song or a countdown. Not only do they know that they are done brushing when the song or countdown is over, it could also distract them from the sounds/sensations.
If sound is a problem, try noise cancelling headphones.
Offer rewards for reaching set goals – even if the goal is as simple as putting the toothbrush in their mouth or brushing for 15 seconds!
You can also try to make a game of it and brush away the “germ bugs” (or “germies” if they would freak out at the idea of bugs in their mouth)! You could also incorporate a countdown and try to brush away a set number of germ bugs.
We hope this information helps you and your child. If you have any specific questions, we are happy to help. Please feel free to contact us. We look forward to hearing from you and seeing your incredible child at their next appointment!
At Jungle Roots Children’s Dentistry & Orthodontics, we strive to provide the highest comprehensive pediatric and orthodontic dental care in a unique, fun-filled environment staffed by a team of caring, energetic professionals. We believe the establishment of a “dental home” at an early age is the key to a lifetime of positive visits to the dentist.