Monday, March 2, 2015

Dentist's Tip: Keep helping kids brush!

credit: Envato
Dear Melissa,
I have a 4 year old son with a diagnosis of Autism. He has extreme defensiveness to touch, food textures and he gags easily. This oral sensitivity also makes brushing teeth a nightmare! He refuses to let me brush his teeth and refuses to brush them himself. I'm hoping that not brushing or flossing will be OK because he just has baby teeth. 

In responding to this question I have already addressed: 1) The importance of caring for baby teeth in the "Baby Teeth...Big Concern!" post; 2) The challenges of oral care in the "Help, my child refuses to brush!" post. Finally, 3) I address the all important topic of when and how children should begin to independently care for their own teeth at home. I'm again joining forces with Dr. Karen Green, a Board Certified Pediatric Dentist at Pediatric Dental Associates & Orthodontics. 

 Melissa:  Until what age should the parent still help the child brush his/her teeth?
Dr. Green: A child should be allowed and encouraged to brush their teeth, but until the child is at least 8 years old (and often older depending on how effective brushing is) an adult should be helping the child brush.  

Melissa: I think some parents might be surprised by how much they need to still help a child who seemingly brushes independently?
Dr. Green: Think of it this way: Would you allow your 4 year old to wash your dishes and then expect that they have been thoroughly cleaned? The same goes for his/her teeth. At a young age, their manual dexterity is not sufficient to do a thorough job. 

 Melissa: I just got a mental picture of my 4 year old daughter washing the dishes, and then the family eating dinner on them. Not pretty! I am officially helping her brush her teeth more! 
Dr. Green: If you start this practice early, the child will be more receptive. As soon as the first tooth cuts through the gums, the parent or guardian should be brushing the child's tooth/teeth twice a day. Even before the first tooth erupts, a baby's gums can be massaged with a baby toothbrush or a soft dampened washcloth.  

 Melissa: For older kids a good compromise might be for the child to brush his teeth first, and then the parent provides a thorough, but gentle, scrubbing after the child is “finished”. How often should a child (and parent helper) brush his/her teeth?
Dr. Green: Brushing should be done at least twice a day, preferably after breakfast, and before bedtime. Flossing should be done once daily.

 Melissa: Do all children need to floss?
Dr. Green: Most kids do need to floss. A toothbrush cannot reach between the teeth like floss can. If your child's teeth are crowded, flossing is really important. Look inside your child's mouth and if you can see space between all of their teeth, then flossing is not necessary at this point, but practicing and getting into the habit of daily flossing is always a good thing.

 Thank you Dr. Green for your expert advice! Over the years I have helped many children with Autism and Sensory Processing Disorder learn to brush up their pearly whites. So, there is hope! I know it can be done. From my perspective as a Pediatric Occupational Therapist, here are just a few of the many components of brushing and flossing:
  • overcoming sensory defensiveness, 
  • developing body awareness,
  • "fine tuning" fine motor skills, 
  • working on sequencing skills, 
  • focusing attention on the task.
If your child finds any of these components difficult, COMMUNICATE! Talk to your dentist, occupational therapist, or speech therapist. Oral care can become a painless and simply part of your daily routine, but developing the foundational skills to make that happen may require consultation with professionals. Do a bit of research to find out which dentist in your community works best with children who are orally defensive. In Northwest Arkansas, don't hesitate to reach out to the Pediatric Dental Associates. I think they do a wonderful job with children who have challenges with sensory defensiveness.  

 A special thanks to Dr. Karen Green for participating in this week’s blog!
front office area at Pediatric Dental Associates and Orthodontics
What has worked with your little ones to create a healthy home oral care routine?  
I would love your tips!  Please share! share@childrenstherapyteam.com
References:
"Dentist visits for kids with sensory defensiveness", Children's Therapy TEAM Dear Melissa Blog for Parents (February, 2015)
"Baby Teeth...Big Problem!", Children's Therapy TEAM Dear Melissa Blog for Parents (February, 2015)
"Help, my child refuses to brush his teeth!", Children's Therapy TEAM Dear Melissa Blog for Parents (February, 2015) 
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