Extreme oral hypersensitivity is a common occurrence with children who have speech, language and feeding concerns. I have experienced many parents and caregivers explain the daily battle of the wills. “Mom gains two points by holding her child’s feet, dad gains a point and loads the brush, and spit, child wins! Tooth brushing fails yet again; the toothpaste is rasberried all over the bathroom mirror. Both parents and their child are left feeling exhausted, hurt and fearful of this daily task.” When you and your child are fearing tooth brushing it does not go away on its own, in fact it can get worse if left un-treated. Continued oral sensitivity and fear makes feeding and speech therapy extremely difficult. While it may be difficult to fix your toothbrushing routine it is NOT impossible to change, especially if you start right now. Find out why tooth brushing may be so difficult and what you can do about it today to help your child gain independence and begin repairing their trust with their mouth.
Why is tooth brushing so difficult?
#1 Pain
The mouth is considered by some people to be the most sensitive part of the body. When the toothbrush enters, your child may flinch in pain. The pain begins to radiate through their whole body. Your child may have a cavity, an open sore, or extreme oral sensitivity. When touch is processed differently; tooth brushing is a very unenjoyable, sometimes painful and a seemingly never ending task.
What You Can Do
Visit a pediatric dentist immediately and follow their recommendations. You also need to create a routine around tooth brushing and stick with it.
A routine has a beginning and most importantly it has an end. Your child needs to know that tooth brushing does not last forever. They need to know when it will start and when it will end. Older children do well with visual timers and schedules. Young infants and toddlers may need a quicker timer/routine, such as singing “this is the way we brush our teeth”. Singing the song quickly and ending the routine quickly is a good way to begin a positive tooth brushing routine. As your child begins to trust the tooth brushing routine you can begin slowly building up the length of the song. Remember when the song is over its over, if every tooth does not get brushed each time that is okay. You can help brush the missed tooth; later in the day. If your child is experiencing pain a new soft bristle toothbrush may help, your pediatric dentist can help determine what to do next.
#2 Mounting Anxiety
Just saying the word toothbrush creates stress and anxiety. The stress escalates all the way down the hall and into the bathroom. The bathroom, the room this child has began fearing.
What You Can Do
Brush your child’s teeth in the livingroom, outside, in the garage, in the bath, in the high chair. Have your child help brush your teeth! Make this a fun and exciting time to be together. Brush their dolls teeth, or their toy cars teeth (get creative). Toothbrushing does not have to happen in the bathroom. When your child shows extreme fear over the toothbrush try using a different toothbrush with tastes and foods he or she enjoys like pudding, applesauce etc. Don’t do this for too long, quickly get back to toothpaste or just water.
#3 Power
Your child wants to brush their teeth themselves. They fuss when you brush their teeth for them or even worse they refuse to open their mouth and you have to force the brush between pursed lips and hope they don’t bite down too hard. Your child may be independent in a variety of areas and toothbrushing is one area they want to do
on their own.
What You Can Do
Provide your child a toothbrush they get to use while you brush with another toothbrush. Their toothbrush does not need to have toothpaste. You can also try a vibrating toothbrush that is only “moms”, your child may allow you to finish up with the vibrating brush if they like it. Finally try taking turns. Let your child brush their own teeth while you brush your teeth then switch. You will see what it feels like to have someone else brush your teeth! You might be a little more open to supporting your child’s ability to brush their own teeth once you feel how uncomfortable it is having someone brush yours.
#4 Sensitivity To Touch
Your child has sensitive teeth or a sensitive mouth and the Dentist has told you they need to brush better. The pressure has been on and you are doing all you can to get your child’s teeth clean enough but they just wont sit still long enough! 30 seconds is all you get.
What You Can Do
Invest in a different toothbrush, a 2 headed or 3 headed toothbrush such as the one picture that can be found on amazon. Distract your child, make it a game or create a routine with how you go around with the brush in their mouth. "First we get the back, back, back then we get the front, front, front, front". Elmo has a fun song the toothbrushing song can be found on youtube and could be a fun timer for brushing.
Extreme oral aversion can be difficult to overcome and often takes the help of a therapist that specializes in feeding. A feeding therapist can work on desensitization using behavioral and oral motor therapy approaches to improve your child’s acceptance of items in their mouth. Feeding therapists may be Occupational Therapists or Speech Language Pathologists who have specialized training in feeding.