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Why Children with Autism Dislike Brushing Their Teeth

Children with autism often resist brushing their teeth, which is a common challenge for many parents. Understanding the underlying reasons and implementing effective behavioural treatment strategies can help children overcome this obstacle. This article will explore why children with autism dislike brushing their teeth and what measures parents can take to help them better adapt to this essential daily hygiene task.


Analysis of the Reasons

There are several potential reasons why children with autism may resist brushing their teeth, including sensory sensitivity, behavioural rigidity, and communication challenges. Here are some common factors:


Sensory Sensitivity: Children with autism are often highly sensitive to sensory stimuli, particularly touch and taste. For example, the sensation of a toothbrush in the mouth might cause discomfort or even pain, which they experience more intensely than neurotypical children, making the task of brushing teeth exceptionally challenging. Specifically, the friction from the toothbrush bristles might feel like sharp pain or discomfort; the taste of toothpaste—whether mint, strawberry, or any other flavour—might be perceived as overwhelming or nauseating; and even the foam and sound generated during brushing might trigger significant discomfort. These sensory issues lead to an instinctive aversion to the entire brushing process.


Behavioral Rigidity: Children with autism often have fixed behavioral patterns and preferences and may feel uneasy about new experiences or changes. They prefer consistency in their daily routines, and any disruption can provoke strong resistance. Brushing teeth, as a routine task that requires compliance, might be perceived as an uncontrollable change, leading to heightened anxiety. This is particularly true when parents force them to brush their teeth, which amplifies their discomfort and creates a vicious cycle. For these children, brushing their teeth is not just a health habit; it’s a challenge to their sense of control over their environment.


Communication Challenges: Children with autism typically struggle with language expression and communication, which may prevent them from accurately conveying their feelings or discomfort during brushing. This communication barrier makes it difficult for parents to understand the true reasons behind their child's resistance to brushing. For example, a child might feel uncomfortable due to the texture of the toothbrush or the taste of the toothpaste, but their inability to articulate this feeling means that parents might not take appropriate steps to alleviate the discomfort. Additionally, due to their limited expressive abilities, children might resort to non-verbal cues like crying, avoiding, or other forms of resistance, which further complicates communication between the parent and child. When parents fail to correctly interpret the child’s needs, they often resort to forceful measures, exacerbating the child’s aversion to brushing.


Behavioural Treatment Strategies:

Once the reasons behind a child's resistance to brushing their teeth are understood, parents can implement the following behavioural strategies to help the child gradually adapt to the process:


1. Create a Brushing Routine with Visual Cues:

  • Visual Schedules: Use a visual schedule with pictures or icons showing each step of the brushing process (e.g., pick up a toothbrush, apply toothpaste, brush top teeth, rinse). Place this schedule in the bathroom at the child's eye level.

  • Timer: Use a visual timer or an app that counts down the time to help the child know how long to brush. Start with shorter durations, gradually increasing as the child becomes more comfortable.


2. Use Sensory-Friendly Tools:

  • Soft Toothbrush: Select a toothbrush with extra-soft bristles designed specifically for children with sensory sensitivities. Electric toothbrushes with gentle vibrations may also be helpful if introduced slowly.

  • Flavorless Toothpaste: Offer a variety of toothpaste options, including flavorless or mild flavors, to find one the child can tolerate. Some toothpaste brands cater to sensory sensitivities by offering less foaming or less intense flavours.

  • Water-Only Brushing: Initially, allow the child to brush with water only if they strongly dislike toothpaste. Gradually introduce small amounts of toothpaste over time.


3. Desensitization Techniques:

  • Start Slowly: Begin by letting the child handle the toothbrush without brushing. Allow them to explore it, brush their toys’ teeth, or simply hold it during bath time to become familiar with the object.

  • Touch Desensitization: Before brushing, gently touch the child’s mouth, lips, and gums with a clean finger or a soft cloth. Gradually introduce the toothbrush, allowing the child to get used to the sensation.

  • Brushing Practice: Allow the child to practice brushing on your teeth, a doll's teeth, or a toy. This can make the activity seem less intimidating and more like a game.


4. Positive Reinforcement and Rewards:

  • Immediate Rewards: After successful brushing, offer immediate rewards such as a favorite small toy, a sticker on a chart, or extra playtime. The reward should be something that the child finds motivating.

  • Brushing Chart: Create a chart where the child earns a sticker for each brushing session. After collecting a certain number of stickers, they can choose a larger reward, such as a trip to the park or a special treat.

  • Verbal Praise: Offer consistent verbal praise for any attempt the child makes to brush, even if it’s brief or incomplete. Positive reinforcement can encourage them to try again.


5. Model and Practice:

  • Demonstrate Brushing: Brush your teeth alongside the child to model the behavior. Make it a fun, shared activity, and show excitement about brushing your teeth.

  • Mirror Practice: Let the child watch themselves in the mirror while they brush. This helps them see what they’re doing and can be reassuring.


6. Comfort Items:

  • Sensory Comfort: Allow the child to hold a favorite comfort item, like a blanket or stuffed animal, while brushing. This can provide a sense of security and distraction.

  • Calming Environment: Ensure the bathroom environment is calming—consider using dim lighting, playing soft music, or using a white noise machine if the child is sensitive to noise.


7. Professional Guidance:

  • Consult an Occupational Therapist: If brushing continues to be challenging, consult an occupational therapist who specializes in working with children with autism. They can provide personalized strategies tailored to your child’s specific needs.

  • Regular Dental Visits: Establish a relationship with a dentist who understands the needs of children with autism. Regular visits, starting with just getting used to the dental office environment, can help desensitize the child to oral care.


While there are various reasons why children with autism may resist brushing their teeth, understanding their specific needs and applying the right behavioural strategies can make a significant difference. With patience and persistence, parents can help their children gradually adapt to this crucial daily hygiene routine. If you’re still facing challenges with your child’s brushing habits, don’t hesitate to contact us for professional support. We're here to help you every step of the way.

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