Toothbrushing

 

Many parents and carers find toothbrushing challenging. It may be difficult to keep the mouth open wide enough to brush the back teeth, the sensation could be uncomfortable, the child may not like the taste. If the difficulty is related to the sensation or taste, desensitisation by starting in small steps may be helpful. If it does not get easier over a period, seeking advice from an occupational therapist may be worthwhile as maintaining good oral hygiene is a very important part of ensuring good oral health and general health. 

 

There are many types of toothbrushes available. In general, one with a small head and soft bristles is preferable. There are other manual toothbrushes with larger handle for better grip. Some children like using an electric toothbrush and may find the vibration soothing. Every child is different so you would need to try a few different types of toothbrushes before you find one that is most suitable and easy for you or your child to use. Most children require assistance by an adult with toothbrushing. A rule-of-thumb is if a child can tie up their own shoelaces, they may have adequate co-oridnation skills to brush their own teeth properly. Otherwise, help is required for proper brushing.

 

Take one step at a time. You may need to get your child to practice 'open wide' first, or show them how you brush your teeth. If they are orally defensive, try brushing their lips first or just the cheek of the mouth. A visual aid may be helpful for some children and you may find it helpful to follow as well. We have included an example of visual aid here you can modify. This series of photos demonstrate where one needs to focus on when brushing the teeth and although the visual aid may not be suitable for all children with special needs, it may still be valuable for the parents/carers to look through. 

 

Some toothpaste has stronger flavour than others. If the child does not like the strong minty taste of toothpaste, there are other mild-mint or fruity flavour ones available. Toothpaste with fluoride is recommended for prevention of dental decay. You can also try brushing the teeth with a smear of toothpaste on a dry toothbrush. This reduces the amount of foaming up and may be more acceptable to some children. Some toothpaste do not contain foaming agent - sodium lauryl sulphate - and do not foam up as much.  

 

 

Toothbrushing tips

 

If you are brushing your child's teeth

• Stand behind your child and use one head to support their head or chin and the hand hand for toothbrushing

• If your child tend to bite or chew onto the toothbrush, give them an old toothbrush to bite on and use another one for brushing

• If your child is not comfortable with the standing position, try lying them on the sofa/lounge, bean bag, on the floor between your legs to keep them comfortable that way

• Distraction like brushing in front of the tv, having music on may make things easier for some children

• Flexiliby (with time of brushing, place, position) is important

• Use the non-brushing hand's fingers to retract the lip and cheek away to allow better access for the toothbrush and focus brushing around the gum line (where most of the plaque accumulate)

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• Other tips

• Some children may prefer setting time limits for each task. Using a timer could be suitable so the child will know when the brushing will finish

• Set the number of strokes for each side of the teeth (for example, brush five times on the outside top left side of the teeth) 

• Use a visual aid (example provided here) - can be in form of a series of photos, flash cards, poster, App, digital photo frame

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

• Flossing - consider using Flossettes (floss in small holder) - allow easy access even between back teeth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What you can do to prevent dental decay/caries

• Attend the dentist regularly

• Toothbrushing with fluoride toothpaste at least twice a day

• Healthy diet and drink only water wherever possible. Avoid food that is high in sugar or hidden sugar

• Check your child's teeth routinely, for example, by lifting their lips to check for white/brown spots or cavities

 

 

The BALANCE

Dental decay is a balance between preventive (for example, brushing with fluoride toothpaste) and risk (e.g. snacking on sugary snacks throughout the day, drinking soft drinks) factors. As long as the balance is tip towards 'preventive', then dental caries will not occur. That means if you cannot control some of the preventive or risk factors (e.g not able to change the type of drink your child prefers), then you would need to work  harder on the preventive side of things to ensure the balance won't be tipped towards the risk factors side and dental decay will occur. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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