Toothbrushing 1-2-3©
For some children, toothbrushing is an uncomfortable, and even scary sensory experience. It, therefore, becomes uncomfortable for parents trying hard to care for those teeth. To follow recommendations from the dentist to keep teeth clean, many parents have had to resort holding the child’s head still and quickly brushing teeth while the child cries and wiggles to get away. This is not fun for child or parent, and does not help the sensitive child to learn to enjoy the mouth for eating.
We utilize the “Toothbrushing 1-2-3” approach that understands the child’s caution and gives the child more control while building trust, and eventual enjoyment of toothbrushing. Many children become stressed at the sight or touch of the toothbrush. When the toothbrushing starts, they may become more and more stressed, more and more uncomfortable with the sensations of the toothbrushing as they have NO IDEA when the discomfort will STOP. It becomes a worsening cycle.
We need to find a way to prepare the child for what is about to happen, and break the task down into little steps that are more comfortable for the child. There needs to be a predictable beginning and end so the child is clearly aware when the toothbrush will be out of the mouth! The steps needed for each child to be comfortable differ depending on each child’s stress level. We move forward at the rate each child can trust.
Make a change
If you want to change the child’s behavior around the toothbrushing, CHANGE the way it is done! What change could help the overall activity? Brushing teeth in a different place? Different toothbrush? Music playing?* Change of toothbrush?
There are lots of different toothbrushes that can be novel and interesting for children and provide a distraction from the brushing. There are spinning, and vibrating toothbrushes, big and small, theme, and finger toothbrushes. Some children need to be offered a soft washcloth or spongette until they regain some confidence in toothbrushing. Consider taking your child with you when shopping to pick out the toothbrush.
* Change of toothpaste?
Sometimes it helps to just use water ad gradually add toothpaste little by little as the child let’s you know it is okay. As the child increases comfort with the brushing activity, toothpaste can be added.
* Change where to start?
For many children the anticipation of a toothbrush approaching the mouth is too stressful. Perhaps you can start on the hand and work up the arm in a playful way. As you start approaching a “worryzone”, then back down the arm to a comfortable area and then again work up towards the mouth. Some children are comfortable with games with a toothbrush at the cheek that is moved playfully, rhythmically towards the lips. Other children like the toothbrush to play at the lips until they find a comfort level allowing them to open the mouth exposing their teeth.
Helping the child anticipate
Children who are sensitive need to know what to expect. We show them the toothbrush, and playfully work towards their mouths. We begin the process of “1-2-3”. We touch the area closest to the mouth where they have comfort and we say ” 1-2-3”. At “three” we remove the toothbrush and then approach again with “1-2-3”. We work closer and closer to the mouth, and then say “1-2-3” on their lips, even if they are closed. The anticipatory playful game is one of approach and retreat and the child knows they only need to deal with the toothbrush until they hear “three” and then they get a break. If the game of “1-2-3” is exciting enough, most children will gradually part their lips and your “1-2-3” is on the front teeth. As the child begins to trust, they relax lips so “1-2-3” is said while moving up and down on top and bottom front teeth and eventually to the side and back teeth. To stretch how long the child allows the toothbrush in the mouth, you can start your “1-2-3’s” very rapidly and gradually draw them out with “one………….two…………………………. threeeeeeeeeeeeeee!”. But you NEVER go to FOUR!!, The child MUST trust that you are trustworthy and that there is a beginning and an end to a sensory experiences that is not the favorite.
“1-2-3” Variations
You do not have to say “1-2-3”. It can be “Do-Re-Mi” or “La Di Dah”, or ANY song or tune or phrase or silly sound that distracts the child but has a clear beginning and end.
“Big Back Teeth”
Some older children learn about their “Big Back Teeth”. Identifying these teeth in the mirror and in parents’ mouths, tickling them with fingers and then a toothbrush can be a way to help prepare a child who is gaggy or worried about the toothbrush moving from front teeth to back teeth.
If children do not like toothbrushing approach, it is OUR responsibility to try another way to help them find a comfortable way to accept toothbrushing. It is a challenge, but children with sensory sensitivities will appreciate the effort.©Marsha Dunn Klein 2008
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