Improving Sensory Tolerance for Brushing Teeth

Children with special needs often have unique sensory issues, including sensory preferences, oral aversion and oral pain. These can significantly impact your child’s ability to tolerate an invasive process such as teeth brushing. Identifying your child’s sensory likes and dislikes can help you select the equipment and strategies that will best help your child succeed.

  • For sensory seekers.
    Children who are moving all day and are hard to calm, as well as children who frequently are mouthing items or grinding their teeth, are usually characterized as sensory seeking. These children use sensory input to calm their bodies during stressful situations or changes in their environment. One strategy for your child who seeks sensation is to use a vibrating, rotary or wide brush toothbrush. Another tactic is to sing songs and move around while brushing teeth. Using a timer can help your child spend an appropriate amount of time and effort on brushing.
  • For sensory defensiveness.
    Children who have feeding needs, including children who do not actively participate in the activity of eating and children who tolerate only a limited range of foods, typically have sensory defensiveness. These children often have particular oral sensory needs that can make the simple act of brushing teeth unpleasant or unbearable.

You can help your child become more comfortable with a toothbrush in his or her mouth through a series of activities that slowly encourage increased participation.

  1. Provide deep, calming pressure to the back of your child’s head. Use both of your hands and make firm contact for a count of five, and repeat this step three times. Perform this activity three to five times per day. It is helpful to always perform this routine in the same area of the home (such as by the sink in the bathroom or kitchen) each time you do it.
  2. Once your child is able to tolerate it, start adding other areas of his or her head and face to the routine. Provide deep pressure to the area below the ear and lower cheek bone with your hands. Then, using calm strokes and consistent pressure, make deep, sweeping motions from the ears to the chin. Finally, add deep pressure to the lower lip, upper lip and upper cheek bones.
  3. When you have reached the lips, repeat the previous steps using a warm wash cloth.
  4. Once your child accepts the warm wash cloth on the lips, focus on the child accepting the wash cloth into his or her mouth. Make this step fun to encourage your child to mouth, chew and lick the wash cloth by engaging in playful pulling or biting of the wash cloth.
  5. When your child can tolerate you touching his or her front and side teeth with the wash cloth, introduce a toothbrush. Start by following the same steps you used to introduce your child to the wash cloth. Again, use slow steps that encourage your child to actively participate in the new sensory experience. Do not use toothpaste at first.
  6. A variety of toothbrushes and toothpastes are available to encourage and enhance your child’s ability to accept and actively participate in daily teeth brushing routines (see related tip sheet). Consult with your occupational therapist, speech therapist, dentist or pediatrician for additional approaches and ideas. Disclaimer: This information is provided for reference only. Consult your dentist before engaging in any procedures, practices, or treatments.

Disclaimer: This information is provided for reference only. Consult your dentist before engaging in any procedures, practices, or treatments.