Pediatric Oral Care at Home and at the Dentist: How to prepare your child with SPD

Feb 7, 2022 | Occupational Therapy, Pediatric

Many parents of children who have Sensory Processing Disorder (SPD) know how hard it is to manage their child’s unique sensory sensitivities and intolerances. A very common challenge for these children, and parents, to overcome is brushing their child’s teeth and/or taking them to the dentist. As Occupational Therapy Practitioners, we commonly have parents express how difficult this daily task can be and the stress it presents at home and when preparing to go to the dentist. February is Children’s Dental Health Awareness Month and P.T. Services’ very own Ashley Childress, COTA/L, and Heidi Smalley, COTA/L provided the following tips to hopefully ease these challenging tasks.

Tips for getting started at home:

  • Toothbrush selectionAllow your child to pick out their own toothbrush and toothpaste. A child-sized toothbrush with soft bristles is the best for beginners. Some sensory-seeking children may also enjoy the vibration from electric toothbrushes. Nuk brushes are also a great alternative for beginners with over sensitivity to bristles.
  • If your child is able to make choices, allow them to help make their daily routine. Once the routine is made, stick with it so they know when and what to expect. Example: “do you want to brush your teeth before or after you put on your pajamas” or “do you want to brush your teeth before or after you eat your breakfast”.
  • Model proper tooth brushing by brushing your teeth with your child. You can make fun games by seeing who can brush their teeth longer or allow your child to brush your teeth while you brush their teeth.
  • Some kids do not like certain flavors and/or textures. You can try toddler toothpaste that does not foam or no toothpaste at all. The friction from the toothbrush is actually what cleans the teeth, so if your child cannot handle the flavor, try just a dry brush or run it under water first. This is also a great first step for getting your child to allow the toothbrush in their mouth without giving them too much sensory overload.
  • Always have a mirror so your child can see what is happening in their mouth. Sometimes fear comes from not being able to see what is going on. A mirror and/or your demonstration will help your child overcome this hurdle.
  • Try to incorporate a healthy diet into your child’s life and avoid excessive sticky and sugary foods to ease the amount of decay and build-up on your child’s teeth.

How to prepare your child before starting:

  • Start by getting your child into the bathroom with a calm and positive transition. If your child transitions best with a fidget or comfort item, allow them to have that with them during the transition. If your child does not do well with toileting and bathing, making the bathroom an uncomfortable place, allow them to brush their teeth at the kitchen sink. Sometimes children are more willing to allow the toothbrush in their mouth while in the kitchen since this is where food and mealtimes occur.
  • Have your child in front of the mirror and start with facial rubbing on the cheeks and jawline while they watch or participate. You can use your hands in circular motions, use a washcloth for texture, or an electric toothbrush to provide vibration on the cheeks.
  • Have them turn the water on and adjust the temperature to their liking. The more you allow your child to be in control and assist, the less aversive they will be.
  • You can have them start by putting water in a cup and taking small drinks or rinsing it around in their mouth and spitting it in the sink.

How to incorporate the utensil:

  • You will want to allow your child to attempt brushing independently if they are able. If they are in control of the utensil entering their mouth, the calmer they will be.
  • Have them place the toothbrush on their lips first and then start by brushing the front teeth and gradually working their way to the back.
  • Allow them to take the toothbrush out as often as needed to rinse with water and allow them to spit.
  • Give lots of praise and encouragement and always make this a positive experience.
  • To encourage proper length of time, try playing a short song and/or have a visual timer or auditory timer.
  • Try to avoid touching the tongue and/or the back of the tongue to decrease the risk of gagging.
  • If all else fails, try allowing your child to chew on a wet washcloth after meals to get friction on the teeth to assist with cleaning.

Preparing for the dentist:

  • Start by finding a pediatric dentist with a child-friendly waiting room and someone who is experienced with sensory processing difficulties. Prepare the dentist with information about your child’s needs before scheduling.
  • Remember that many children and adults have difficulties with going to the dentist. So don’t expect perfect behavior.
  • Make sure you acknowledge your child’s feelings and fears and try to comfort them.
  • Take time to consider your child’s sensory needs before arriving at the dentist. They may need to listen to music throughout the appointment, wear sunglasses, use a weighted blanket or lap pad, keep the door closed to limit noise, be placed in a room with the least amount of traffic or distractions, have the staff cover unnecessary screens, etc.
  • Prepare your child before going to the dentist by watching kid videos about the dentist, reading a book about the dentist, or even playing dentist at home!
  • Try to start going to the dentist when your child is young. This typically starts when getting their first few teeth. Try to go every 6 months. Starting at this young age, helps children to become familiar with the process.
  • Call your dentist’s office when you are leaving the house to ensure they are running on time to alleviate a long wait which can increase anxiety in your child.
  • Schedule appointments with an extra time length if possible to avoid rushing and to allow the child to explore and learn his/her environment. This could be less overwhelming and less stressful for your child.
  • Allow your child to bring their comfort item with them.
  • Before leaving for the visit, do the desensitizing facial rubbing techniques that you do at home.
  • If your child uses a chewy, allow them to have it in the car on the way to prep the inside of their mouth.
  • Practice playing dentist at home with your child laying back and using flashlights. This will simulate their appointment and prep them.
  • For kids who do not like unpredictable changes with movement, the raising and reclining of the chair can be scary. If your child is small enough, having them sit on your lap could be comforting.
  • An award is always acceptable, even if your child had a hard time with the visit. They deserve something special.

We hope that you find these strategies and suggestions helpful for both you and your child. We strive to help create independence with daily living tasks and ease the stress on both the patient and guardians. If you have additional questions or concerns, reach out to your child’s physician to discuss your specific needs. Your child may benefit from a referral to Occupational Therapy where an Occupational Therapist can evaluate your child’s needs and create an individualized plan.

Ashley Childress COTA/L
Heidi Smalley COTA/L