How to Maintain Good Oral Health for Kids with Autism

National Children’s Dental Health Month falls in February, and if you’ve ever watched a child brush their teeth, you know how challenging it can be. This can be particularly stressful for children with autism spectrum disorders. In spite of this, dental hygiene shouldn’t be overlooked. Plaque, infections, and other serious health issues can result from poor oral health. We’ll talk about some tips to maintain proper oral health in children with autism to help prevent or ease some of the difficulties.

Challenges in Dental Hygiene for Kids with Autism

It can be challenging for any child to maintain good dental hygiene, but it is especially challenging for children with autism due to heightened sensitivities. The sensations associated with brushing their teeth can be gustatory, auditory, tactile, or all of these. A child with autism might not be able to communicate the pain in their teeth or gums, which makes things even more challenging for them. Stress and overwhelm can lead to behavioral problems escalating.

Tips for Good Dental Hygiene Habits in Kids

1. How to get used to a toothbrush

Learning to brush one’s teeth begins with being comfortable holding a toothbrush in one’s mouth. Get your child comfortable with allowing a toothbrush to go in their mouth. Then, they can tolerate the feeling of the toothbrush being pushed against their teeth if they are resistant to brushing. Reinforce their efforts by having the toothbrush in their mouth for a few seconds, then slowly increasing the amount of time. Use a timer to let your child know when it’s time to finish.

2. Bring fun to tooth brushing

Your child may not love brushing their teeth, but they can learn to accept it and may not oppose it in the long run. Turn it into a family activity to make it fun and inclusive for your child. Brush your own teeth while your child brushes theirs so they can watch and imitate. Consider a toothbrush that plays music or lights up. Timer features on toothbrushes often last for two minutes. It can also be fun if you have a positive attitude and are upbeat when brushing.

3. Identify the tasks to be completed

A task analysis breaks down a skill into smaller steps. You can use a task analysis for tooth brushing by breaking it down into smaller steps:

  1. Get out the toothbrush
  2. Open the toothpaste
  3. Put toothpaste on the toothbrush
  4. Brush each section of your teeth
  5. Rinse your mouth
  6. Clean the toothbrush

A detailed task analysis will depend on how much assistance your child needs to complete the task independently; for example, a child who needs a lot of help brushing their teeth would require a more detailed analysis.

Write down each step on a piece of paper to create a datasheet. This is an analysis of physical tasks. Record how well your child does on each step daily (or at least weekly) to see if they are improving.

4. Reduce the amount of help over time by prompt fading

Helping your child (when they need it) to be more successful at a specific task is known as prompting. You can physically help your child brush their teeth when providing prompts when brushing their teeth. To prevent your child from becoming more resistant to brushing their teeth, be selective with this type of prompting. Using your words can also be a verbal reminder to brush your child’s teeth. By using visual images, routines with visual prompts, such as pictures, can be created. To remind them to brush, you can set an alarm or use auditory prompts.

In order for prompting to be effective, you must fade out prompts that involve you helping your child over time. Focus on your child caring for their teeth independently, with less help from you.

5. Reinforce positive behavior with positive reinforcement

When an individual experiences something positive after completing a specific task, they are more likely to repeat the same task again in the future. Start by considering your child’s current ability to brush their teeth independently when teaching them to care for their teeth. It might be a positive reinforcer to put a toothbrush in their mouth with just water on it for 30 seconds if they are just learning this skill. As an alternative, if your child already brushes their teeth occasionally and can do it well on their own (but not every day, or multiple times a day), you can offer a reinforcer after each brushing.

6. Using a token system

Token systems are another way to reinforce positive behavior. Once they earn a certain number of points on the chart, they receive a prize. Each time they clean their teeth, they get a sticker or a checkmark. To increase the frequency of a behavior, a token system could set a goal of brushing their teeth 6 out of 7 days a week, then reward them when they reach it (based on a sticker system). Once the goal is met regularly, you can increase it to once a day for 7 days. Then, later on, you could set a goal for them to brush their teeth twice a day, and so on.

Visiting the Dentist

It is common for children with autism to have difficulty going to the dentist. Dentists and parents can use proactive strategies to help these children cope with dental visits.

Preparation for a dental visit:

  • Specialized pediatric dentists work with children with autism and other adaptive needs. Discover which office is the best fit for you and your family in your local community.
  • Educate the dentist about the child’s communication skills, sensory issues, and tips for keeping the child calm and relaxed before appointments.
  • Children should be well informed about what to expect at the dentist by their parents and dentists. Provide fun and supportive explanations of dental cleanings and procedures to your child.
  • Children should be gently informed about the instruments dentists use.
  • A field trip to the dentist’s office – one that does not involve the child getting any dental work – will help the child feel more comfortable with the dentist’s office and staff.
  • Bring items and activities your child likes. Be sure to check with your dentist on their preference before offering electronic devices or videos.
  • Consult your child’s dentist about the use of general anesthesia.
  • Dental equipment and other items should be kept out of reach of children.
  • Be sure to communicate your plan to the dentist and/or staff if your child engages in challenging behaviors.

It’s a team effort!

Brushing your child’s teeth and establishing good dental hygiene can be challenging. Almost all children and their families struggle to maintain ideal oral hygiene. You should tailor your approach to the unique needs and abilities of your child with autism.

Capozza LE, Bimstein E. Preferences of parents of children with autism spectrum disorders concerning oral health and dental treatment. Pediatr Dent J. 2012;34:480–4.

Hage, S., Lopes-Herrera, S. A., Santos, T. F., Defense-Netvral, D. A., Martins, A., Sawasaki, L. Y., & Fernandes, F. (2020). Oral hygiene and habits of children with autism spectrum disorders and their families. Journal of clinical and experimental dentistry12(8), e719–e724.

Lai B, Miano M, Roberts MW, Hooper SR. Unmet dental needs and barriers to dental care among children with autism spectrum disorders. J Autism Dev Disord. 2012;42:1294–303.

Stein LI, Polido JC, Najera SO, Cermak SA. Oral care experiences and challenges in children with autism spectrum disorders. Pediatr Dent J. 2012;34:387–91.

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