Tackling Toothbrushing

Spiky therapy cushion for standing on...

Having found toothbrushing to be a problem for as long as J has had teeth (since he was 4 months old)... we have amassed quite a few tips, techniques and tricks to get us through this important daily care task.  It seems we are not alone in finding things challenging when addressing the tantrum inducing time that is toothbrushing.  So, here goes - if you recognise this as a difficult task to undertake, see what we've done and perhaps there's something that may work for you (for a while, at least!)

J says that it is unpleasant brushing his teeth and he doesn't like the sensations he gets.  This is a little odd, given that he is always mouthing objects and uses chewy tubes for deep sensory input.  However, as child with Sensory Processing Disorder,  we have found it's not unusual for him to be a sensory seeker and avoider in the same area!  What matters is to try to get the messages he is receiving to be positive ones for the activity being undertaken.  

So, techniques and methods used for toothbrushing have been:-

• Swaddling will sometimes work - the deep pressure sensation provides a feeling of security and calmness.  This is still a good option (even at 11 years old) after a shower when wrapped in a huge bath sheet as tiredness means he needs to be relaxed... he props himself against the wall and is cocooned.
• Different types of toothbrush and varied flavours of toothpaste - J chooses the brush/paste combination for tooth brushing.  He prefers a dry brush and a low foam toothpaste but also likes a minty taste.
• Firm touching around the mouth area and along the jaw bone prior to beginning the brushing has been encouraged. This is something J does for himself now.
• Positive tactile sensations -  J selects an item to stand on or play with (in his non brushing hand).  He likes a spiky therapy cushion some days, others he will choose a small spiky ball to squeeze in his hand.

This small spiky hand toy can help.

• Deep pressure on his shoulders whilst he is brushing - this used to be a favourite "only Mum can do it right" solution but it was good whilst it worked!
• Humming/singing along to the noise of the electric toothbrush - this seems a good distraction technique but works best when not too tired.
• Doing it together - J likes to mirror what someone else is doing whilst brushing... it helps him realise where/what/how he should be brushing.
• Using an app - there are some good apps to accompany brushing that indicate time and which teeth to brush.  Points are earned and this engaged J for a while - he prefers one called Teeth Timer.
• Visual sand timer countdown as to how long is left of the toothbrushing - allows J to realise there is an end in sight!
• Tick chart - this is completed morning and evening and a reward for a full week of ticks (two misses, not on the same day, are allowed). J chooses at the start of the week the reward he is cleaning towards.

Son's TEETH chart

All of the above have been a success at one time or another.  Many are used in combination.  There is no simple answer in this household and the surest thing we know about toothbrushing is that it's not the 2 minute task that many others have... we have to allow about 30 minutes.  During this time there is much discussion, briefing, kajoling and insistence.  It's not a straightforward task and it takes a great deal of patience, which I do not always have in sufficient amounts, so it is a pretty stressful way to start and finish each day.  

ADVANCE WARNING: We are aiming to cover handwriting in the next blog entry... although it will, doubtless, require more than one post as it's a BIG topic here.