FACE Website- Clinical Prospective- Dental Prospective
Dr. Yawen Peng, DMD
Part I- Home oral care
Daily home oral care is even more critical for individuals with ASD. The fact that a
dental visit is a much more challenging task, maintaining good oral hygiene on a daily
basis at home can prevent the development of oral diseases like cavity and gingivitis.
Here are a few tips to help you get started:
A.
Explain to your child the importance of practicing wide opens of the mouth
and cleaning the teeth with toothbrush and floss every day. You can tell a
SOCIAL STORY or show a VIDEO to help your child understands the
relationship between tooth germs and oral diseases (cavity, gingivitis,
toothache).
Here is an example of a social story video:
“Tooth brushing for kids: Crawford the cat- Educational”
http://www.youtube.com/watch?v=wdhptrhn2tM&feature=related
B.
Use DISCLOSING AGENT for visual demonstration of where the “germs” are.
Most of the individuals with ASD are visual learners. If they can “See”
where the germs are on their teeth, they can easily grasp the concepts of
where to position the toothbrush and floss. The disclosing agnet will stain
the plaque on the teeth and provide great visual effect of “germ” location.
The disclosing agent may come in solution or tablet.
Here is a photo showing the tooth germs are colored by the Red Disclosing
Solution.
C.
Use a VISUAL SCHEDULE to demonstrate the tooth brushing and flossing in
step-by-step. You can check-off each step as your child progressed. You can
also recommend this activity to the occupational therapist to incorporate it
into the training curriculum for daily-to-day tasks.
Here is an example of a visual schedule demonstrating the tooth brushing
activity:
Step 1:
Rinse your toothbrush head with water
Step 2:
Squeeze out pea-size toothpaste onto
toothbrush
Step 3:
Brush the outside of the front teeth left to
right for 10 times
Step 4:
Brush the inside of the front teeth left to
right for 10 times
Step 5- Part I:
Brush the top of the right bottom teeth
back and forth for 10 times
Step 5- Part II:
Brush the outside of the right bottom teeth
back and forth for 10 times
Step 5- Part III:
Brush the inside of the right bottom teeth
back and forth for 10 times
Step 6:
Repeat Step 5A-5C at the left bottom and
right/left upper teeth
D.
When helping your child with oral hygiene practice, it is easier to lay down
your child or stay behind your child. Ask your child to lift up the chin and
facing towards you. Not only will your child automatically opens the mouth
from the neck muscle pulling the chin down, you also have a direct visual
to all his/her teeth. If your child is taller than you, you can have the child sit
in a chair.
Lay down your child
E.
Stand behind your child
Choose the appropriate size and soft bristle of toothbrush. Consider
transitioning to a power toothbrush when your child demonstrates better
manual dexterity. There are a few advantages to use a power toothbrush:
i.
Power toothbrush usually comes in large ergonomic handle for easy
grip and better results.
ii.
Power toothbrush provides sensory stimulation to the oral
environment in children with ASD. When practice daily at home, their
mouth will be desensitized and transition easily to the teeth cleaning
at a dental office..
iii.
Research shows that power toothbrush removes more dental plaque
in the first 2 minutes than a manual one1. This is especially helpful for
children with ASD who have short attention span to maintain the oral
hygiene effectively.
F.
Choose the flavor of toothpaste that your child likes (preferable with
fluoride), and only use “pea-size” amount each time.
Some children dislike the taste of fluoride in the toothpaste. MI paste can
be an alternative to prevent cavity development. You can use either your
finger or a toothbrush to apply the paste on the teeth. The only
disadvantage of this product is that it is not an over-the counter toothpaste.
Therefore, you will need a prescription order from a dentist to purchase
the paste.
G.
Use a dental floss to clean your child’s teeth daily. It is the best to use a
regular floos. If you experience difficulty, you can also try with a handheld
flosser or waterflosser (by Waterpik). Research shows that adding
waterfloss to routine oral hygiene practice reduces the plaque biofilm,
gingivitis, bleeding, and pocket depth in patients with gum disease
(periodontal disease)2.
Handheld flosser
Waterflosser
References:
1.
2.
Van der Weijden GA, Timmerman MF, et al. A comparative study of electric
toothbrushes for the effectiveness of plaque removal in relation to
toothbrushing duration. Timer study. J Clinical Periodontology. Vol. 20, No. 7.
1993.
Cutler CW, Stanford TW, et al. Clinical benefits of oral irrigation for periodontitis
are related to reduction of pro-inflammatory cytokine levels and plaque. J Clin
Periodontol. 2000 Feb;27(2):134-43.