Daily Oral Hygiene for the Child with Autism

Description: This two-page document offers guidance for families and caregivers in maintaining daily oral hygiene.

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DAILY ORAL HYGIENE FOR THE CHILD WITH AUTISM

As a parent or caregiver, you recognize the challenges and day-to-day struggles of maintaining proper oral health for a child with autism. Although every child is different, this guide will offer you some tips and guidance for maintaining daily oral hygiene.

  • Parents and caregivers are KEY to the success of a child’s good oral health.

  • Establish a consistent daily routine for brushing and flossing.

  • Be patient - the child may be sensitive to having their mouth touched.

  • Approach in a calm, slow manner.

  • Holding a favorite toy or item may be calming for the child.

Toothbrush

  • Choose a soft bristled toothbrush that is the right size for the child’s mouth.

  • Multiple-head toothbrushes are available and clean several surfaces of the teeth at one time.

  • Consider a power toothbrush which may make brushing easier. Try a less expensive model first, such

    as battery operated brush.

Toothpaste

  • Toothpaste comes in a variety of flavors and textures.

  • A small amount of fluoride toothpaste is recommended.

  • Some children do not tolerate the use of toothpaste (plaque can be removed by using a wet

    toothbrush).

Positioning Tips

  • Find a comfortable and relaxing location which addresses the child’s sensory needs (light, sound, etc.) It doesn’t have to be the bathroom – a different room may be more appropriate.

  • Allow the child to stand, sit or lie down for comfort.

  • If standing or sitting, approach from behind and gently tip the child’s head back.

  • When reclining, have the child’s head placed in your lap.

Tell-Show-Do (Preparation)

  • Explain and demonstrate each step.

  • Consider using a picture schedule.

  • Allow the child time to become at ease with the toothbrush in his/her hand

  • Guide the child’s hand to the outside of the mouth and gently touch the lips.

Brushing Tips

  • Brush at least twice a day, especially before bedtime.

  • Assist the child in brushing all three sides of the teeth (outside, inside, and chewing surfaces)

  • Brush along the gumline using a gentle, circular motion.

Flossing Tips

  • Flossing can be difficult and challenging for everyone.

  • There are many types of floss – waxed, unwaxed and flavored. Waxed floss may slide through easier

    without fraying or breaking.

  • Ease the floss gently between two teeth until it reaches the gumline.

  • Wrap the floss in a “C” shape and move it up and down.

  • Flossers or holders may make flossing easier.

Tips for Success

  • Give praise and encouragement for each step.

  • Transition – slowly let the child take over each brushing and flossing step. Offer help if the child is

    having difficulties.

  • The child may not be able to complete all the steps. This process may take days, weeks, or months.

  • Use a timer so the child can see when the task will be over.

  • Offer rewards for completed tasks such as stickers or tokens.

Resources

National Museum of Dentistry - http://dentaletc.umaryland.edu/odar/health_smiles_for_autism.pdf

Autism Speaks - https://www.autismspeaks.org/sites/default/files/documents/dentalguide.pdf

Dental Social Story

Description: This one-page document provides a description and example of a social story for visiting the dentist.

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Dental Social Story

Social stories are a concept devised by Carol Gray to help teach social skills to individuals with autism spectrum disorders. They are short descriptions of a particular situation or activity and emphasize the significant social cues. Appropriate responses and behaviors are given in the story. A social story may improve the individual’s understanding of the activity and the expectations. Below is an example of a social story which can be read before going to the dentist.

Going to the Dentist

Adapted from Betsy Morse in Carol Gray’s The Original Social Story Book

Soon I will be going to the dentist so that my dentist can look at my teeth. My dentist knows how to clean teeth and keep them healthy. It is very important that I keep my teeth clean and the dentist can help me do that.

When I get to the dentist’s office, I will try to walk into the office quietly. I will sit in a chair and wait until it is my turn to see the dentist.

When it is my turn, I will follow the dentist or the dentist’s helper into a special room. I will sit in another chair. The dentist likes it if I sit quietly.

I will try to open my mouth wide when the dentist asks me to. The dentist uses a special toothbrush to clean my teeth. It is different from the toothbrush that I use at home. It makes a loud sound. Sometimes I get to choose what flavor toothpaste I want. Sometimes the flavor tastes like bubble gum. The flavor might taste like strawberry. The dentist will put a special straw in my mouth to get all of the toothpaste out.

The dentist might put a special piece of cardboard in my mouth to hold between my teeth. The dentist takes a picture of my teeth with a special camera. This is called an X-ray.

The dentist might use an instrument to check my teeth. I will try to do what the dentist asks me to do. After the dentist is done, my teeth will be cleaner. When I smile, people will see my clean teeth.

I will try to leave the dentist’s office quietly. The dentist and the dentist’s helpers will be happy that I did such a good job to help them out.

Dental Visits

Description:This one-page document offers parents suggestions on establishing a dental home and tips for having a positive dental experience.

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Dental Visits

Establishing a dental home and receiving regular preventive care are key elements in maintaining a lifetime of healthy smiles. Here are some tips for establishing a dental home and having positive dental visits for a child with autism.

Finding a Dental Home

  • It is important to find a dentist that has experience in caring for children with autism.

  • Pediatric dentists receive specialized training in treating children with special health care needs.

  • Ask to speak with the dentist. Share your concerns and special accommodations that may be needed.

  • Describe any challenges that may present during the dental visit.

  • Let the dentist know what time of day is best for your child.

Getting Ready for the Dental Visit

  • Ask if the practice has any photographs of the office and dental staff available.

  • Explain to your child who the people are and what they will do during the visit.

  • Consider making a picture schedule with office photographs or line drawings.

  • Read a social story about going to the dentist. Social stories will let your child know what will happen

    during the visit and how they should behave.

  • Role play a visit to the dentist. Practice sitting in a reclining chair, opening and closing the mouth,

    counting the teeth and taking x-rays.

  • Consider buying props at the drugstore such as a dental mouth mirror, small flashlight, and gloves to

    use during the role play. Your dentist may be able to give you some of the props.

  • Visit the dental office before the dental appointment to help your child become familiar with the office

    staff and equipment. This may take several visits.

  • Give verbal praise and reinforcement throughout the activities.

At the Dental Office

  • Bring a favorite item or toy for your child to hold during the appointment.

  • Sit with your child throughout the appointment.

  • Communicate his or her comfort level and concerns to the dental team.

  • Stay calm and talk with your child in a soothing voice.

  • It may take more than one visit to complete the examination.

  • Give verbal praise for each step of the visit.

Visiting the Dentist Picture Schedule

Description: This one-page document and three-pages of photographs will assist families in making a picture schedule for a visit to the dental office.

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"Visiting the Dentist" Picture Schedule

Individuals on the autism spectrum often benefit from the use of picture schedules and visual cues. Picture schedules utilize the individual’s visual strengths and lets them know what is going to happen next. This often reduces anxiety and improves outcomes.

Picture schedules contain a series of pictures that depict the elements of an activity in chronological order. Some individuals find photographs easier to recognize while others do better with line drawings. Photographs from the Pediatric Dentistry Clinic at the Center for Disabilities and Development are included in this section. Families are welcome to print the pictures and create a schedule for their child. The photographs can be cut out, laminated and Velcro can be used to attach each picture to a schedule board.

Included at the end, are optional photographs which some individuals may find over stimulating. A papoose board photograph is included for individuals who may feel more comfortable and relaxed in that position. Tailor the picture schedule for the individual’s needs.

Steps in Using a Picture Schedule

  • Place the pictures in order on the board for the immediate routine (4 to 6 pictures).

  • Tell the individual that there are lots of things to do, see and understand at the dentist.

  • Review the schedule by pointing to all the sequenced pictures, quickly describing the

    activity ending with “then we are done.”

  • Before beginning the procedure, point with the individual and focus on the first picture

    saying “first we are doing this.”

  • Put the picture board down within close reach and complete the activity.

  • Bring the board back to the individual and have them take off the picture, place it in the

    finished box and say “done.”

  • Point to the “next” picture and repeat the steps above.

  • Consider giving a reward or trinket for completing the procedure.

Other Resources