Brushing teeth and dentist visits

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hello my names terri and my son is dan, he is 4 and has only recently been dignoused wiv AS. We live in the UK. I have 2 problems. The 1st problem is that he has too bad coordination to brush so I'm supossed to brush his teeth 4 him but he won't let me so I need advice 4 that. Also dentist visits are a struggle and due to there being no pediatric dentists in the area and His teeth are suffering due to this. He won't even open his mouth at the dentists. I'd be grateful 4 any advice, thank you.
Terri

I bought a great book that helped my son a bit with dentist visits. It's called "Going to the Dentist: A Picture Social Skills Story Book" by Cindy A. Bailey. The pediatric dentist used it to show Dylan each step through the book by explaining and reading the book to him as he was working with him. Of course, Dylan is also another that makes it hard to brush his teeth. I had a little massage type brush called a Nuk Brush that the OT had use brush his gums and lips and all to try and desensitize and you might want to try to find out about Wilbarger Oral Program for Desensitizeation. You can read about it in "Building Bridges Through Sensory Integration" by Ellen Yack, Paula Aquilla and Shirley Sutton and is geared towards the Wilbarger Protocol for Brushing and all developped by Patricia Wilbarger. Those things might help a little. Most of Dylan's dental work is done in day surgery under general anaesthesia and I know how hard it is to deal with things, we can't normally sit with Dylan very long in the office before he starts getting anxious and all. We've already had to deal with 8 fillings and this was back when he was 4 yrs old.

I never thought of teeth brushing as a problem associated with AS. When I read your post It just jumped out at me. My son hates to brush his teeth, every time we go to the dentist they give me this big speach about brushing better.... its so annoying, anyway I feel like the toothbrush nazi. I have to stand right next to my son and time him and then check to see if he did a good job. For the dentist office visits I let my son take his gameboy... and we havent had a problem so far. When he was your sons age he needed several teeth worked on and they put him out for it. Good luck!

Yes, it's the same for us.

I do know that if I let him off without doing it I'll never get him to do it the next time.

When I was pregnant with him I couldn't put a toothbrush in my mouth without gagging. I still can't.

Mish is so right...it's a sensory issue for these kids with AS. I know you guys are probably sick of hearing me refer to this book but, MAN! , it's been a great book to have around for just these sorts of challenges. The book is "1001 Great Ideas for Teaching and Raising Children with Autism Spectrum Disorders" by Notbohm and Zysk.

Here are some tips they give in their book for the "resistant brusher":

Try different shaped and angled toothbrushes, heads and consistency of bristles (most kids prefer soft)

No brush at all. Use a piece of gauze or a washcloth wrapped around a finger (just the thought of this one makes me gag but it might work for someone with AS related sensory issues). Dip it in toothpaste, floride wash or just plain water if that's all your child will tolerate. You're still removing a large amount of bacteria.

A battery-operated toothbrush. Many children find the vibrating soothing altho some may find it irritating.

Try adaptive toothbrushes (like Mish mentioned earlier). They mention the Nuk toothbrush trainer or Nuk massage brush, or the Collis-curve Toothbrush (www.colliscurve.com). Also there is the 60-second TimeMachine Toothbrush available from Magical Toys and Products at www.magicaltoysandproducts.com, www.bestbabystore.com and others.

Brush with warm water rather than cool to reduce sensitivity.

Try different types of flavors of toothpaste. Paste may be too gritty but gel may be just right. If your child is sensitive to food dyes, artificial sweeteners, and other substances, be aware that many common brand toothpastes contain such ingredients. FDA doesn't require toothpaste to be labeled as such, but if the paste has stripes, blues specklies or a pink glow, you can bet it contains dye.

If brushing all of the teeth at the same time is too overwhelming, break it up. Start with the bottom, take a 2-minute break (or 5 or 10), then brush the top. Break down further as needed.

Sing a short song with each section as a way of letting your child know how long it will take (ex. Bingo, Old Mcdonald, Farmer in the Dell, Row, Row, Row Your Boat, etc.). Change the words up to fit the activity (see below).

Provide visual cues/charts showing each step of the tooth brushing process that can be hung up in the bathroom.

Stand behind rather than in front of your child to help, like the dentist does. Let him/her rest his head against you. Let him/her sit if it makes the process easier.

Follow-up tooth-brushing with a pleasant, anticipated activity (like reading together or listening to his/her favorite music, etc.).

EXAMPLE OF A TEETH-BRUSHING SONG (to the tune of Row, Row, Row Your Boat):

Brush, brush, brush your teeth,
'til they're shiny bright.
They'll be healthy, they'll be strong,
If you treat them right.

Brush, brush, brush your teeth,
keep them clean each day.
Then you'll have a pretty smile,
and healthy teeth all day.

Brush, brush, brush your teeth,
after every meal.
The more you brush,
the more you floss (or "brush" again),
the better you will feel.

You get the idea! Our AS son is a real music lover and making up songs to help learn a new habit and/or chore always works with him. Not only does he love to hear us make up songs about making his bed, brushing his teeth, taking a bath, etc. but he actually sings along or makes up his own lyrics!

As for the dentist visit, that's a hard one but I think Mish's idea about a book would be great! If you could find one that addresses visiting the dentist that would be awesome. We prepped our son for his first visit about a week in advance. We also made sure to make his older brother's apt. for the same day so that our AS son could watch him go thru it first. We also wrote up a contract with him beforehand about the type of behavior we wanted him to use at the dentist's office with a promise of a positive reinforcer of his choice afterward for incentive (ex. watching his favorite show with him, reading a book he enjoys a lot, going to McDonalds, etc.). After we wrote up the contract in simple language he could process, he "signed" it and we signed it. But, since your baby is only 4, this may not work as well.

Hope the ideas from the book for teeth-brushing at least help?

God bless you guys!

I'm generally fine when brushing my teeth. I use a normal one, as the electric ones do my bleedin' head in.

My son always complained about the mint flavors of toothpaste, he said "they make my mouth burn and make it hard to breathe". We finally found an orange flavored gel toothpaste (not gritty) that he can tolerate. But he still puts a tiny amount on the brush, but at least he's brushing now.

When it was time for my son to brush his teeth, we got him a musical disney toothbrush that played a tune when it was time to finish. I also let him watch me cleaning mine and then asked him to copy and seemed to do the trick. As for the dentist, we have got a really understanding dentist and told him about Aidan's problems and for a while he just came with me when I went and watched whilst I was seen to. Then the dentist would ask if he wanted to be seen, if he didn't he wouldn't pressure him and now he jumps in the chair before I have a chance to say anything and just opens his mouth. It also helped seeing the school dentist. Good Luck