By: Dr. Tengku Nurfarhana Nadirah Tengku Hamzah
Autism spectrum disorder (ASD) significantly affects children’s social communication, behaviours, and daily routines. According to the National Autism Society of Malaysia (NASOM), approximately one in 68 newborns, totalling around 9,000 babies annually, are diagnosed with ASD in the country. This developmental disorder presents specific challenges, even in seemingly routine tasks like brushing teeth. Consequently, a majority of ASD children experience dental caries due to the complexities they encounter during oral hygiene routines.
The process of brushing teeth can be particularly challenging for children with ASD, often resulting in tantrums and resistance. These difficulties, if unaddressed, significantly impact their oral hygiene, leading to dental caries and gum diseases. Establishing consistent routines therefore is crucial, offering a pathway to decrease their anxiety and enable more effective interaction and care for them.
Several strategies may help to improve oral hygiene care at home among ASD children. Firstly, visual aids in the form of pictures and videos can be used to demonstrate proper brushing techniques. By providing visual modelling, ASD children can easily grasp the steps involved in oral care routines and improve their ability to perform these tasks independently compared to verbal instructions.
Secondly, it’s important to consider using toothpaste and toothbrushes that are sensory-friendly. If your child has sensory sensitivities related to taste and texture, you can explore various options, such as different flavours, non-flavoured, or non-foaming toothpaste. Opting for a toothpaste that is free of sodium lauryl sulfate (SLS) can be a beneficial choice, as it doesn’t produce a foamy texture and can be less overwhelming for children with sensitivity issues.
For children with ASD who may have limited tolerance for extended brushing time, manual toothbrushes with triple heads that allow simultaneous brushing of the occlusal, buccal, lingual, and palatal aspects of the teeth can be helpful. Start with a short brushing time that the child can comfortably tolerate, even if it’s just a few seconds, and then gradually increase the duration after each successful session.
Some parents or caregivers may consider introducing electric toothbrushes to help children with ASD to maintain their daily oral hygiene routines. However, it’s important to be mindful of the potential challenges of these devices may pose. The vibration and noise generated by electric toothbrushes can be overwhelming for some ASD children. Therefore, it’s advisable to make a gradual transition to an electric toothbrush once the child has become comfortable with a manual toothbrush and has developed good brushing habits. As the child grows older, parents or caregivers can employ a physical prompting technique, such as hand-over-hand assistance, to assist with the toothbrushing task. This approach can help the child gradually acquire independent brushing skills.
Lastly, incorporating a reward system that includes verbal praises and the occasional small treat, alongside maintaining schedules to monitor progress after each successful toothbrushing session, can serve as a highly effective positive reinforcement strategy in encouraging the development of good oral hygiene habits in children with ASD. The use of such positive reinforcement can create a sense of accomplishment and motivation in these children.
As we commemorate the International Day of Persons with Disabilities on 3rd December, it’s crucial to actively support and implement strategies that facilitate oral hygiene for children with ASD. These approaches can significantly ease the challenges faced by these children. By fostering an environment that embraces and accommodates the unique needs of individuals with ASD, we can ensure that every child, irrespective of their abilities, receives the essential oral care they deserve.
Let us all be that bit more inclusive and supportive, as espoused by the MADANI narrative.
The author is a Paediatric Dental Specialist at the Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya. She may be reached at firstname.lastname@example.org