In the Know for You to Know

As a parent, you know that preventing dental related issues is important, and you also know that this is not so simple to do when your child has Autism Spectrum Disorder (ASD).

Some children may be fearful of new surroundings or sensitive to light and sounds or smells and tastes and do not know how to express these feelings. You may or may not have already established a consistent way that comforts your child when introducing them to new experiences.

These last 3 weeks we’ve discussed the challenges and strategies to help you help your child achieve successful dental care in the office, as well as strategies for your at home toothbrushing routine, and strategies for your at home flossing routine.

Today we’re breaking down the basics on how to create your own dental social story.

Helping Your Child To Learn And Prepare For Going To The Dentist

Your approach needs to be tailored to your child’s individual needs.

For some children with ASD, it’s your calm reassuring voice talking with them about the Pediatric Dentist’s office, the people they’ll meet, the chair they’ll sit in, the toothpaste that’s used to brush their teeth.

While other children may like to read or look at books, some like to look at actual photos on your phone, or role play, and for some it’s your social story.

Which ever works best for your child, always stay positive and portray their dental care (whether in the office or at home) in small, repeatable steps.

Read A Social Story With Your Child About Taking Care Of Their Teeth

Social stories use simple, straight forward language to describe the sequence of events a child will experience. The stories usually have photos or pictures to help show the things they will see, hear, and do.

Before creating your own social story, a good resource for you to see examples of social stories is the website for the Pennsylvania Autism Services, Education, Resources, and Training Collaborative.

You’ll find social stories about going to the Dentist, having their teeth cleaned, having dental x-rays taken, and having a cavity filled.

Create Your Own Social Story About Going To The Dentist

Once you’ve made your child’s appointment it’s best to introduce this early on.

Before you do, consider taking pictures of the street the office is on, the parking lot, the outside of the building, the office’s front door with the Dentist’s name.

You might want to stop by and ask if you can take some pictures of the office to include in your social story.

This way you’re establishing what your child will be expecting step by step.

To go along next to the pictures you can include a description—

1. We’re going to the Dentist and we’ll be driving down this street,
2. Then we’ll park the car near the Dentist’s office,
3. After we park the car we’ll walk to the Dentist’s office,
4. The office is upstairs/downstairs/on the walk-in level so we may/may not need to take an elevator ride; or we may or may not take the stairs,
5. When we get to the Dentist’s office we’ll open the door and walk in,
6. There is a lady sitting behind a desk to say hello to us when we walk in,
7. After we say hello, we’ll tell her my name,
8. The lady behind the desk may ask us to sit down and watch a movie, or play one of the games until it’s my turn,
9. When it’s my turn the hygienist will call my name,
10. We’ll all walk together to a room with a few special chairs that look like Daddy’s recliner chair,
11. The hygienist will ask me to sit down in the chair,
12. The hygienist will tell me that this chair is special because it moves up and down and reclines back almost like a bed, but I don’t have to take a nap,
13. The hygienist will tell me that the chair moves back so she and the Dentist can look at all my teeth even my teeth all the way in the back,
14. The hygienist will also tell me that when I’m lying back on the chair I can hold my Mom’s hand and put my legs straight out in front of me,
15. The hygienist will ask me how big I can open my mouth, and we will count how long I can stay open wide,
16. The hygienist will show me the big light she and the Dentist use so they can see all my teeth,
17. Before she turns the light on, the hygienist will ask me if I want to wear sunglasses because the light is bright or if I want to close my eyes,
18. The hygienist will show my the special mirror she and the Dentist use to look at my teeth. She’ll let me touch the mirror will also show me what the mirror feels like on my lips and tongue and cheeks,
19. Then the hygienist will show me the tooth counter she and the Dentist use to count and check my teeth,
20. The hygienist will show me the special floss string she uses to clean in-between my teeth, she’ll let me touch the floss and she’ll show me how it feels in-between my fingers and then she’ll floss my teeth,
21. The hygienist will show me the special power toothbrush and special toothpaste she uses to clean my teeth, then she will let me touch this special toothbrush and she’ll show me what the brush feels like on my finger and then on my teeth; the best part is that the hygienist says I will get to pick the flavor of the toothpaste,
22. The Dentist may want to take special photos of my teeth, the hygienist explains that these photos are called x-rays and I get to wear a super special emoji apron to take the x-rays, and my Mom gets to watch me,
23. When I’m all finished the hygienist will give me a fun bag filled with a brand new toothbrush and toothpaste, and I’ll get to choose a super special prize.

What To Remember

Preparing your children with ASD for their Dentist’s appointment and dental care in advance can be helpful for having a calm and successful visit.

Ask your child’s Pediatric Dentist about scheduling a pre-visit introductory walk about, or if you can take pictures of the office to help you put together your own social story.

Your child’s needs always come first, so if you feel doing everything at one appointment is too much, ask about breaking up the visit into smaller steps and introduce the appointment more gradually. This way your child will become more familiar and feel more comfortable.

Most important, praise and reward your child and you for a job well done!

How did you prepare your child for their first dental appointment? How did it go? How have your subsequent dental visits been? Have you heard of social stories? Have your read social stories or created your own? Tell us, We’d really like to know! Send us an email at kidstoothhotline@proton.me Like Us or Chat with us on Facebook at facebook.com/kidstoothhotline

More tips? We have lots. We’re here just for kids!

In the Know for You to Know

Children’s oral health (aka dental health) is an extremely important part of healthy everyday life. As a parent, one of your first goals is to focus on prevention and at home oral hygiene routines.

However, for some children who have Autism Spectrum Disorder (ASD) following a brushing and flossing routine can be quite difficult. This makes establishing and maintaining these daily routines challenging.

For some children this may be due to sensory sensitivities, for some it’s due to taste and texture sensitivities, and for some it’s their inability to communicate which leads to everyone’s frustration.

Last week we discussed the challenges and strategies to help you help your child achieve successful dental care in the office.

Today we’re breaking down the basics on challenges and strategies for your at home tooth care routine.

Strategies For Your At Home Tooth Care Routine

Almost everyone thinks you need to brush teeth in the bathroom, it is not always the case.

A Few Ways For You To More Easily Brush Your Child’s Teeth

• Try brushing your child’s teeth with your child lying down on your bed, or
• With you sitting on a chair have your child sit down on the floor in front of you and lean back against your legs. Have them tip their head up so you can see inside their mouth, or
• Have your child lie down on the floor. You can either sit beside your child, or put a pillow on your lap and place your child’s head on the pillow, or
• Standing in the bathroom with your child standing in front of you, have them face the bathroom mirror with their head slightly tilted against your body. Place your hand gently over their hand so that you can help guide the toothbrush around their mouth.

What You Need To Get Started Brushing Your Child’s Teeth

• Soft-bristled toothbrush-choose your child’s favorite color or cartoon character
• Electric toothbrush
• Bubble gum or fruity flavored toothpaste
• Hand held Flossers in fun colors
• 2 Minute Timer-a traditional fun colored plastic timer and watch the sand as you brush teeth, play a favorite song, or sign up for the 2 Minute 2X A Day App
• Fluoride Rinse- which is available in several flavors

Parent Choices

• Electric toothbrush-some children like the feeling of the moving bristles in their mouth and some children do not
• Toothpaste- if you’re concerned about sodium lauryl sulfate (SLS) in your child’s toothpaste, there are toothpastes without SLS, you may want to consider the Hello brand or Tanner’s Tasty Paste (Disclaimer: I do not receive any endorsements and do not have any affiliations with any of the mentioned products).

Toothbrushing Steps

Start by showing your child their toothbrush and have them touch the brush handle and then the bristles with their fingers, then rub the bristles gently in small circles on the back of their hand.

You can then touch the toothbrush bristles to their lips. Ask them to open their mouth (as big as they can) and touch the bristles to one or two of their front teeth. Count together to see how long they can keep their mouth open.

Place a rice grain size (if your child is younger than 3 years old) or a small green pea size (if your child is older than 3 years old) amount of toothpaste on their toothbrush.

Next Comes Toothbrushing—

1. Brush the outside, inside and chewing surfaces of the top right back teeth five times,
2. Brush the outside, inside and biting edges of the top front teeth five times,
3. Brush the outside, inside and chewing surfaces of the top left back teeth five times,
4. Brush the inside, outside and chewing surfaces of the bottom left back teeth five times,
5. Brush the outside, inside and biting edges of the bottom front teeth five times,
6. Brush the bottom right back teeth outside, inside and chewing surfaces five times.

4 Important Tips To Remember When Brushing Your Child’s Teeth

1. always support your child’s head,
2. have good lighting so you can see inside their mouth as well as what you are doing,
3. be able to easily move their tooth brush around their mouth, and
4. always find the safest and most comfortable position for you and your child.

A Parent’s Experience Establishing A Daily Oral Hygiene Routine For Their Child With ASD

Remember the child we discussed last week? The child who took 4+ years to be able to accept dental care.

You know that agonizing, tearful, disappointing, painful and frustrating dental appointments are compounded at home when you try to brush your child’s teeth, let alone try to floss.

They read social stories and made step by step story boards. They coordinated their oral hygiene schedule with other parts of their daily AM and PM routines.

They involved anyone in the family they could. They tried distraction and demonstrated through role playing.

They came up with a calendar for their AM and PM routines, made this something fun to look forward to, and they included a rewards calendar.

The hardest part was staying positive and motivated no matter how frustrated or defeated they felt.

Then one day out of the blue it came together after more than 4 years in the making. Yes this may seem amazing, but it can happen because each child is on their own time line.

What To Remember

It takes time to establish a routine, and it may take multiple revisions and repeats. Try incorporating oral care into your daily life to become part of what you do everyday.

Consider talking with your child’s teacher, principal or the school district about adding daily oral hygiene to to your child’s Individualized Education 
Plan (IEP).

It’s important to take this one step at a time, reward your child’s successes and acknowledge that somethings may need to be tweaked.

2 of the most important things to remember—
When you get to where you want your child’s oral hygiene routine to be it will be so worth it!
Reward yourself for a job well done!!

Stay Tuned — We’re looking forward to seeing you next week when we continue discussing Strategies For Your At Home Care Routine with tips for creating your own storyboard.

Does your child have ASD? What are your at home care challenges? How is your routine going? What are your successes? What have you learned works for your child? Tell us, We’d really like to know! Send us an email at kidstoothhotline@proton.me Like Us or Chat with us on Facebook at facebook.com/kidstoothhotline

More tips? We have lots. We’re here just for kids!