DISCLOSURE: Noelle Copeland RDH is an Oral Care Specialist and Dental Consultant who provides content for Brilliant Oral Care and Baby Buddy.
Oral care needs for people with autism can be extreme, but they can also be pretty straightforward. It depends on the severity of the sensory complexes the autistic patient is dealing with daily, and there is usually some level of sensory aversion. Sight, taste, smell, auditory, and touch are all considered when planning oral care.
I would never try to compartmentalize oral care for autism down to any rigid set of tips or tricks. However, when providing home care or professional oral care, there are foundational considerations to know. It takes more than a specialty-designed “toothbrush for autism
” to succeed. Don’t get me wrong, I love some of the great autism toothbrushes out there, but they matter very little if you can’t get the brush into the mouth to brush the teeth. So, where should you start? If you are the caregiver, start early, as early as possible, with oral care, making it a familiar and comforting process.
When a routine is started early in infancy, a child comes to expect it and may often find comfort in its repetitiveness. Patients with autism might respond in this same way, but they typically have a much harder time starting a new routine, so keep oral care regular and as a comforting part of the schedule as soon as possible.
- Start wiping the mouth after meals with sterile mouth wipes.
- Use silicone toothbrushes to brush and rub their teeth and gums.
- Whenever the "First Tooth" erupts, introduce a soft bristle toothbrush. Never use a medium or hard-bristled toothbrush.
- Use pastes and gels with Fluoride and Xylitol to help protect the teeth.
- Be cautious of strong mint or cinnamon flavors. Plain versions are available.
- Floss their teeth for them.
- Train them to help with oral care, but plan to do all the toothbrushing to remove plaque and bacteria for effectiveness.
- Find a dentist early, as soon as possible. Plan to see a professional specializing in special needs oral care if needed.
- Use appropriately sized products, not too big, not too small, and something you, as the caregiver, are comfortable holding since you will most likely be doing all oral care.
- 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 into several mini sessions. But don’t push or rush oral care. Quick and rushed oral care is NOT adequate. If you can only get 30 seconds done, then do a different section of the mouth 3-4 times a day.
- Mouthguards may be necessary for some with more severe autism. 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 those who are prone to self-injury, have seizures or epilepsy, or other co-conditions that put teeth at risk of being fractured or broken.
- Diet and Nutrition are essential to oral health. I know how difficult food acceptance can be for autism 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 the desired food texture is soft, try applesauce and cheese before sugar-filled options like gummy bears or pudding.
- Never let them chew or gnaw on a toothbrush for sensory stimulation. This is dangerous and can cause painful mouth ulcers.
- Always rinse and wet a toothbrush with warm water before it is used. This softens the bristles and helps prevent toothbrush abrasion. Never use a dry brush in the mouth.
- Don’t use toothpaste smears as a replacement for toothbrushing.
- Avoid alcohol-based products as these are drying to the oral tissues.
- Use sunglasses, ear covers or headphones, and blankets to help soften the dental environment for professional oral care.
If you were looking for the best way to establish an effective home care routine, you’ve found the right place at Brilliant Oral Care. Our patented round head bristle toothbrush not only removes the plaque on teeth, it simultaneously cleans and removes the plaque and bacteria found on the cheeks, gums, teeth, and tongue. It’s the bristles that make all the difference in performing oral care for sensitive teeth and gums, being gentle yet effective. Don’t forget to #BRUSHBRILLIANT.
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