Kids are often lax about oral hygiene. Many really dislike the sensation of the toothbrush and the strong flavour of toothpaste. This can get a lot worse during burnout. Your young person may be completely unable to clean their teeth due to the sensory challenges it poses.
This is even more concerning if their diet is restricted to “safe foods”. Often these are sticky or sugary, such as sweets and crisps.
As a parent, you imagine your child’s future filled with toothaches, black teeth, and expensive trips to the dentist. Your concerns deepen with worry over whether they will ever be able to cope with dental work, injections or fillings.
During burnout, your young person may find the demands of oral hygiene are just too great. Pushing them to brush their teeth may cause extreme distress and dysregulation, or alternatively cause them to become unresponsive and shut down. Sometimes, you have to let these things slide, at least for a while. Lowering demands as far as possible is essential to burnout recovery, especially when your youngster is in the deepest phase of chronic burnout.
Once they are less overwhelmed, you may be able to experiment with new products or alternatives to traditional toothbrushing. These can be surprisingly effective and may help ease some of your fears about your child’s long-term oral health.
Oral hygiene ideas to try
There’s a variety of oral hygiene products and techniques you can try (but probably not all at once – introduce them slowly). They are not a substitute for regular brushing, flossing or dental check-ups, but can be beneficial for fighting bacteria during burnout when thorough dental care may not be accessible.
If mint, aniseed or fruit-flavoured toothpastes cause your young person sensory distress, unflavoured toothpaste may be the answer.
Example brand: Oranurse
These toothbrushes have hundreds of delicate bristles, which are much softer than those of a standard toothbrush. This softness can lessen irritation for those with sensitive mouths, making brushing more tolerable.
Example brand: NanoBrush Pro
Multi-headed toothbrushes offer maximum brushing in minimum time. They clean the entire surface of each tooth at once, reducing brushing time and making the process quicker and easier.
Example brand: Dr Barman’s Superbrush
Often used as a first toothbrush for young children, these silicone brushes feature a wraparound shape that gently cleans many teeth at once. U-shaped toothbrushes are available in manual and electric versions, and sizes for older children, young people, and adults are available from specialist suppliers.
Example brand: Sensory Shine 360° U-shaped electric toothbrush
This soft silicone brush fits over the tip of a finger and is easy to use, while being gentle on teeth and gums.
If you have a dog, you may already be familiar with finger toothbrushes, which are often recommended by vets as tooth-cleaning tools for our furry friends.
Example brand: Sensory Shine Densitisation Finger Toothbrush
If your child hates the feeling of toothbrush bristles, you can avoid physical brushing by using an electric water-flosser. While not as thorough as tooth brushing, the water jets do blast plaque off and from between the teeth. It’s an odd but not unpleasant sensation and can be made into a game.
Example brand: Waterpik
Chewing gum for 20 minutes releases saliva, which washes away bacteria and removes food particles from around the teeth. Saliva contains calcium and phosphate that help remineralise enamel, strengthening teeth and even reversing early tooth decay. Opt for gum that contains xylitol, a natural sweetener that inhibits bacterial growth and supports tooth health when brushing is limited.
However, be careful to keep sugar-free gum (or sweets) away from dogs because xylitol is highly toxic to our canine friends, even in small amounts.
Carrots, celery, and cucumbers act as mild abrasives, helping polish teeth. Similarly, crunchy nuts such as almonds and walnuts can help scrub teeth and stimulate saliva.
Leafy greens such as lettuce and spinach are also great at scrubbing plaque off your teeth as you eat them.
Cheddar is rich in calcium and phosphate, which help strengthen enamel and neutralise plaque acids. Drinking milk can also help protect teeth in a similar way.
In Britain, we joke that a cup of tea is the solution to all our problems. Well, tea really can help with oral hygiene. There’s evidence that drinking 1 to 3 cups of unsweetened black or green tea per day kills harmful bacteria in the mouth.
As if you needed an excuse to put the kettle on!
Rinsing with mouthwash helps to remove food particles from around and between the teeth. Most mouthwashes have antibacterial or antiseptic properties, helping to kill or inhibit bacterial growth. Many flavours are available, and some brands contain fluoride to help strengthen tooth enamel.
When brushing isn’t possible, rinsing with mouthwash or even plain water can still help maintain some level of oral cleanliness.
Rubbing teeth and gums in a circular motion mimics the action of a toothbrush and helps physically remove some plaque and debris. If toothpaste is tolerated, you can rub the usual amount around the mouth and spit out the excess.
Disposable teeth-whitening finger wipes are available specifically for this purpose.
Example brand:
BeringMall Mint-Flavoured Teeth Whitening Finger Wipes (Amazon)
Who says toothbrushing has to happen in the bathroom? Some kids love to mix it up and brush their teeth in the garden, while watching TV, at the park, or even in the car. All you need is a toothbrush, toothpaste and a lidded cup to spit in.
They may enjoy ‘breaking the rules’ and experiencing the freedom of brushing their teeth in unconventional places and at unusual times.
Community Dentists
Many areas of the U.K. have specialist dental teams that provide dental care for children and adults who cannot visit a general dental practice due to specific needs. You will need to be referred by a general dental practitioner, GP or other health care professional.
Don’t be afraid to ask for a referral. Community dentists are trained to understand that oral hygiene can be challenging. They work with people who struggle to look after their teeth for many reasons and who may be highly anxious about treatment.
Best practice tips
Obviously, you can ignore these if you need to. Don’t let perfect be the enemy of good!
- Brush twice a day: or don’t. It’s better to brush reliably once a day than fight to brush twice a day and fail.
- Brush for 2 minutes: or 30 seconds. Brushing a few teeth is better than brushing no teeth at all.
- Brush last thing at night: unless the stress of this stops your child from going to sleep, in which case, brush whenever works for them.
- Use fluoride toothpaste: it’s hard to argue with this one. In fact, the community dentist may be able to prescribe extra-strong fluoride toothpaste if your young person would benefit from it.
- “Spit, don’t rinse”: the fluoride in toothpaste needs time to soak into the teeth to be most effective. Of course, if your kid can’t stand the taste or texture, rinse with water or mouthwash.
- Clean between teeth: flossing, interdental brushes or water flossing are great for teeth but may be out of reach during burnout.
- Brush your tongue: scraping your tongue on your front teeth can be quite effective too.
- Use an electric toothbrush: some young people enjoy the vibration, but others can’t stand the noise or sensation. Use whatever brush or tool they like best.
- Replace toothbrush regularly: at least every three months, or sooner if the bristles are frayed.
- Regular dental check-ups: even if every six months isn’t possible, do your best when you can.
Additional Resources
https://www.autismtoothcare.com/
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Autistic Burnout - Family Stories 
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