Ask the expert: Our boy bristles at the thought of a toothbrush
The battle of the brush: the problem with washing teeth could stem from a sensory experience that the child finds challenging. Photograph: Getty Images
Q My son, who is just six years old, has always resisted us brushing his teeth. Each wash becomes a battle that we often lose. I really don’t want him to have tooth decay. Is there anything we can do to make things go better, and to help him accept that his teeth have to be washed? A friend of mine suggested he might have a sensory problem with things in his mouth and that he might be tactile defensive. Is there any truth in this? How do we go about getting help for him? He is also an extremely fussy eater and hates change to his routines.
A Lots of young children have specific sensory preferences and sensitivities, and this is often a helpful way to understand their behaviour.
Frequently, at the bottom of certain perceived misbehaviours is a sensory experience that the child finds challenging. For example, some children resist getting dressed because they hate the feel of certain clothes or are particularly sensitive to the touch of labels, seams and belts. Or some younger children might be sensitive to excessive noise and so could be easily overwhelmed by busy playgrounds, and act up as a result.
In your situation, it could well be that your son is very sensitive to touch in the mouth area and thus finds the process of brushing teeth very uncomfortable.
Professionals often use the term “tactile defensiveness” or, more specifically, “oral defensiveness” to describe such problems, which can be either the result of hypo-sensitivity (reduced sensation and awareness in the mouth area causing anxiety about brushing teeth) or hypersensitivity (being overconscious of oral sensation, making even the slightest touch uncomfortable or even painful).
Before looking at strategies to help your son, it is a good idea to first take him to a dentist to rule out any dental or gum problems that might underpin his behaviour and contribute to his sensitivity.
Getting your son’s co-operation
First, it is important to first try to get your son’s co-operation about overcoming his sensitivity and getting used to brushing teeth.
Even though he might find it hard at the moment, help him to understand the importance of brushing teeth and dental hygiene.
Seek out some children’s booklets that explain this in a child-centred way that you can read together. Try to give him as many choices about brushing teeth to increase his co-operation. For example, involve him in choosing the toothbrush and toothpaste: he may be more likely to give things a go if he likes the flavour of the toothpaste, or if the toothbrush has a picture of his favourite TV character.
In addition, be careful to choose an extra-sensitive toothbrush such as those recommended in the online resources below.
In introducing the toothbrush, it might work best to proceed gradually and to build up over time. Maybe start with the part of his mouth that is least sensitive, for example his front teeth, and just start with washing these successfully before moving on.