DISCLOSURE: Noelle Copeland RDH is an Oral Care Specialist and Dental Consultant who provides content for Brilliant Oral Care and Baby Buddy.
Performing oral care for a child can be daunting at times. To be honest, sometimes it feels insignificant compared to other pressures and challenges going on. I get it; I've been there; I've felt that; I'm a mom of three, a licensed dental professional, and I have a child that has a rare disease. Oral care for my own family has been challenging and came with its own set of anomalies.
I certainly don't think I have seen it all, but I sure have seen a lot, and what I know for sure is that caring for someone else's oral health can be tricky. Add in any extenuating circumstances like Autism Spectrum Disorder (ASD) on top of the typical “in's and out's” of oral care, and it can be downright overwhelming.
Studies in Applied Behavior Analysis (ABA) have proven there are tried and true ways to create positive dental experiences for children with autism. If you have a child with ASD and struggle with routines like personal hygiene practice, I recommend considering ABA therapy for your family.
Applied Behavior Analysis Therapy
- System of treatment that is different for every patient.
- Utilizes positive reinforcement, accolades, and rewards for planned activities.
- Encompasses an understood (based on the patient's ability) explanation of consequences.
- Communication between the parent/specialist and the child is fine-tuned during therapy and vital to the process.
- The parents, ABA therapist, and Dentist should all be on the same page when treating the child.
- A clear understanding of autism is essential for any caretaker. A willingness to be patient, calm, and helpful can positively address a child's dental care needs.
According to ABA, when a "desired behavior" is performed and backed up by something that the individual values, it is more likely to be repeated. This encourages positive behavior change over time that helps people work on tasks and skills that provide more independence and success.
ABA Therapy Techniques for Oral Care
Discrete Trial Training: The ABA Therapist will provide a cue, ask for the desired behavior, and reward the behavior with positive reinforcement. Discrete trial training can help ASD patients to develop social and behavioral skills. This is an excellent method for encouraging independent brushing at home. The cue can be music or something else that is sensory attentive for the individual.
Modeling: The modeling technique is one of my favorites for oral care. I recommend it to parents when they are toothbrush training their children. This method involves demonstrating the desired behavior by personally doing it or providing a video/audio example of what needs to be done.
Reinforcement Systems: Reinforcement systems teach individuals about some of the negative consequences of underperforming behaviors. For example; If the individual doesn't engage in the demonstrated behavior, like toothbrushing, prompt them again. If they continue to resist, withhold reinforcement until the behavior is performed. Reinforcement for children can be coins or tokens collected and exchanged for toys and special privileges. I encourage my parents not to use food as reinforcement since most food rewards are sugar-filled treats that tend to be sticky, gummy, or chewy.
ABA Therapy Techniques for Visiting the Dental Office
- Explain the planned treatment.
- Describe what will happen.
- Clarify expectations during the treatment.
- Outline the steps of the treatment.
- Show pictures of each step.
- Allow the use of headphones to lessen noise and sunglasses to reduce the glare of operatory lights.
- Visit and talk to the dentist and staff to get to know them before the appointment.
Oral Care Advice From the Very Beginning
Start Oral Care Early
1. Start wiping your infant's mouth after feedings.
2. Use silicone toothbrushes to brush and rub their gums starting at three months old.
3. Whenever the "First Tooth" erupts, introduce a soft bristle toothbrush.
4. Use pastes and gels with fluoride and xylitol to help protect the teeth.
5. Be cautious of strong mint or cinnamon flavors.
6. Floss their teeth for them.
7. Train them to help with oral care, but plan to be the one doing all the toothbrushing to remove plaque and bacteria.
8. Find a pediatric dentist early, before age 1. Plan to see a professional that has advanced training in special needs oral care if needed.
Make Oral Care a Familiar Process
- Use appropriately sized products.
- Keep it "simple" as much as possible. Of course, if you are struggling and need whatever tool has all the bells and whistles that make a task or routine easier, then, by all means, do whatever you need to. But start simple and go from there.
- One step at a time. If you can't get toothbrushing done in one session, split it up into several mini sessions.
- Tell-Show-Do. Sometimes this involves you, as the parent, too. I've had great success in instructing parents to allow their ASD child to brush their adult teeth; at the same time, they are brushing their child's teeth.
- Use language they understand and accept. Now, this is the exception to keeping it simple. If your ASD child LOVES something specific, then utilize that in speech or drama for cooperation. This could be a song or tune that you sing or play on your phone.
Provide Oral Care Protection
- Use fluoride and xylitol to protect the teeth. Introduce flavors slowly and ask for plain versions whenever they are available.
- Mouthguards may be possible for some ASD children. This can be tricky to determine and maneuver, so it must be prescribed by a dental professional and custom-made from a dental office/lab. Mouthguards, night guards, or sports guards can be very helpful for children with ASD. Individuals prone to self-injurious behavior, those with seizures or epilepsy, or other co-conditions that put teeth at risk of being fractured or broken should be evaluated.
- Diet and Nutrition are paramount in oral health. I know how difficult food acceptance can be for ASD children and the best advice I can give is to leave sugar and highly refined carbs out of their diet as long as possible. Nothing feeds the pathogenic bacteria in the mouth faster and easier than processed sugar and carbs. If crunchy is the desired food texture, try apples and carrots before giving them crackers or cookies. If soft is the desired food texture, try applesauce before sugar-filled options like gummy bears or pudding.
If you were looking for effective and healthy ways to establish oral care routines with your family, you found the right place. If you want to try the best electric toothbrush for kids, look no further than Brilliant Oral Care. https://www.brilliantoralcare.com/collections/sonic-toothbrushes
Be sure to check out our selection of toothbrushes for individuals with special needs. This includes our silicone toothbrushes that make oral care easy to start. Our DINOSAUR, PENGUIN, and DUCK character sonic toothbrushes make oral care fun; and are the closest option for a baby electric toothbrush. And our special soft toothbrush with our most extensive bristle count and the softest texture brush we offer.
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