Son with Asperger's needs a brace but not interested

[Esty]

My son is 12 and recently diagnosed with Asperger's. Our latest dilemma is that he needs a brace on his teeth (not just a little wonky, he only has one central incisor at the top as his other one didn't come down). Two years ago he had an operation to remove an extra tooth that was lodged in his gum and he coped with that really well. However he refuses to brush his teeth daily (we're lucky if he does it twice a week - ugh!) so the dentist is obviously reluctant to put a brace on in case food gets stuck and rots his teeth. We've tried all kinds of things to get him to brush his teeth (rewards and explaining clearly why he should eg doesn't want painful ugly rotten teeth), but it's as if he can't possibly imagine that scenario as it's not happening now. He has had problems with not liking the taste of toothpaste so he uses a milk teeth one, not perfect but better than nothing. He's seen people with bad teeth and even commented on it himself but doesn't put two and two together and see that could be him- as if it's so far in the future it doesn't matter. I realise it's all part of his Asperger's and not being able to imagine/ visualise but don't know what to do next. He's the same over having baths and wearing clean clothes. Clearly we can't force him to have a brace but he's a good looking lad and we don't want him regretting this when he's older. His incisor is now off centre and the gap getting too small for the other tooth to come through naturally. He looks like he's had a fight and had it knocked out! Having Asperger's, he cares very little for his appearance but still manages to pull off looking cool somehow.

He has always gone to his orthodontist appointments reluctantly (with bribes, basically ) and now is refusing to go at all (he has one tomorrow). I don't want to get into a situation where I'm offering him big bribes to go to the orthodontist as if he doesn't brush his teeth it will amount to nothing anyway. He also refused to go to his last appointment with our family dentist. He's not needed treatment apart from his operation so doesn't have a fear of the dentist - he just doesn't see the point.

Should I just give up on this one? It totally doesn't bother him having mad teeth!

[purplehaze]

Hi, my 15 yr old son is the same and often tells me he doesn't want his teeth. I've tried different flavoured toothpastes, electric tooth brushes etc but he says it hurts when he brushes them and hates the taste of the pastes. I have tried so many different brushes but last week I bought another and he said it feels better in his mouth and has been cleaning them more (not everyday but better). He has been like this all of his life but luckly I managed to get him in the dentist chair a few weeks ago and he doesn't need any treatment!

 

I haven't the right answer but just wanted to say your not alone-good luck X

 

 

[bid]

Not trying to be a doom-goblin or anything, but just some thoughts based on our experience of braces.

 

My DS was fitted with the removable braces prior to having 'train tracks' fitted. He lasted one evening, as he was so acutely distressed as he had upper and bottom braces, which pulled his lower jaw forwards, changing the shape of his face. He had been so brave at the orthodontist, but sat their in tears, dribbling and unable to speak as well as in pain.

 

I decided it really wasn't worth so much distress, as it was for a slight over-bite. I guess I would have perservered if it had been for really serious dental reasons, as with your son.

 

As I said, I'm not trying to be all doom and gloom, but it had never occurred to me that firstly the braces he had would alter the shape of his face, and secondly that he would find that so distressing. If you are going to go for the braces, I think it would probably be good to do loads and loads of visual preparation, etc. We definitely didn't do enough preparation.

 

Good luck, and I really do sympathise.

 

Bid

Edited August 10, 2009 by bid

[Teresa]

Hi

T had 4 teeth out to make way for other teeth that were coming through, then she had 4 braces fixed 1under her tongue 1 fixed to her bottom teeth 1 fixed to the roof of her mouth 1 fixed to her top teeth, all though she said it was painful at first and suffered with ulcers she got use to it, also she was kinda of lucky as they were the in thing at the time, braces were trendy with pop/tv stars wearing them, so very little name calling at school. 2plus years later straight teeth she is pleased that she had it done although she wasn't at the time.

 

Sorry no adivce just to say I hope your son makes the right choice for him.

 

Teresa

 

[Mandapanda]

My son is 12 and recently diagnosed with Asperger's. Our latest dilemma is that he needs a brace on his teeth (not just a little wonky, he only has one central incisor at the top as his other one didn't come down). Two years ago he had an operation to remove an extra tooth that was lodged in his gum and he coped with that really well. However he refuses to brush his teeth daily (we're lucky if he does it twice a week - ugh!) so the dentist is obviously reluctant to put a brace on in case food gets stuck and rots his teeth. We've tried all kinds of things to get him to brush his teeth (rewards and explaining clearly why he should eg doesn't want painful ugly rotten teeth), but it's as if he can't possibly imagine that scenario as it's not happening now. He has had problems with not liking the taste of toothpaste so he uses a milk teeth one, not perfect but better than nothing. He's seen people with bad teeth and even commented on it himself but doesn't put two and two together and see that could be him- as if it's so far in the future it doesn't matter. I realise it's all part of his Asperger's and not being able to imagine/ visualise but don't know what to do next. He's the same over having baths and wearing clean clothes. Clearly we can't force him to have a brace but he's a good looking lad and we don't want him regretting this when he's older. His incisor is now off centre and the gap getting too small for the other tooth to come through naturally. He looks like he's had a fight and had it knocked out! Having Asperger's, he cares very little for his appearance but still manages to pull off looking cool somehow.

He has always gone to his orthodontist appointments reluctantly (with bribes, basically ) and now is refusing to go at all (he has one tomorrow). I don't want to get into a situation where I'm offering him big bribes to go to the orthodontist as if he doesn't brush his teeth it will amount to nothing anyway. He also refused to go to his last appointment with our family dentist. He's not needed treatment apart from his operation so doesn't have a fear of the dentist - he just doesn't see the point.

Should I just give up on this one? It totally doesn't bother him having mad teeth!

 

Hi Esty

 

Join the club!

 

My eldest has always been good at cleaning his teeth but at 14 after having 2 teeth out so 2 adult ones had room to grow, he needed 2 more out but refused to have it done. It was the injections that were so traumatic for him. He also needed a brace but I knew that was a non-starter. We had a lovely orthodontist who was very understanding and explained that if he was willing to put up with the 'less regular' appearance of his teeth then they would leave well alone, and he could have something done later on if he decided to. He hates showering and washing his hair and does it once a week very reluctantly, though I don't think any soap or shampoo is involved!

 

My youngest will wash (occasionally) but hates toothpaste and used to tolerate the milk teeth toothpaste. Since they changed their range he has to use the 0-3 one, even though he is now 13, as it is the only one like their old version. My dentist said the only difference between that and adult toothpaste is the taste, so I don't think there is a problem.

 

We have tried many different toothpastes to no avail. I even tried Fennel toothpaste (yeuch!), as my son hates mint. Recently I have discovered a whitish gel toothpaste which I myself much prefer to ordinary toothpaste as it is not 'pasty', IYKWIM!! However, most toothpastes including the gel ones all seem to slightly 'burn' my son's mouth. He would use a non-burning cheese flavoured toothpaste if there was one . I think there is a gaping niche in the market here !!!!

 

 

[oxgirl]

We are in a bad teeth situation too. My lad is nearly 16 and, although he goes to the dentist, he hasn't had more than a quick squirt with the cleaning thingy. He can't tolerate being touched and messed with and has never had any treatment, not that he's needed any so far, thank heavens. Our problem now is that his teeth are extremely wonky and at odd angles. He desperately needs a brace and the orthodontist has said it will be a big, complicated job involving extractions, etc. Trouble is, Jay won't be able to cope with extractions, he can hardly tolerate being touched at all. He'd never cope with or even consider having a brace and would find it so distressing that it would seriously impact on his life all the time the brace was in place. We're at a loss what to do. The dentist has said they wouldn't consider removing the teeth under anaesthetic as they don't consider putting a child at risk for the sake of appearances good enough reason, so we don't know what to do. His teeth do look awful. He cleans them, but they are so wonky. He hardly ever looks in the mirror at himself, but when he does he does say he doesn't like the look of his teeth, but he can't bring himself to put himself through the trauma (and it WOULD be trauma) of going through extractions and braces.

 

~ Mel ~

[Mandapanda]

'Other people' have no idea what we have to cope with as parents, do they?!!!

[Esty]

Thanks so much for these replies - it is so helpful to know we are not alone with this one! Until recently he has been ok about going to the dentist (though hates the feel of the rubber gloves ) but now he sees everything as leading towards (a) making him brush his teeth more and ( getting a brace so he's done what he always does when he feels he's going down a path with a certain goal - he's put the total mockers on it by stopping it in its tracks.

We can get him to have a bath (not shower) twice a week only by saying his friend can't come into the house unless he does so but we can't use his poor mate as bartering power for everything! Often J will get the bath but refuse to wash his hair - and he's going through a 'don't want my hair cut' phase so his hair is quite long. His thing at the moment is that he doesn't like his hair to be wet but won't let me dry it with a hair drier as he doesn't like the feel of that either! We've just got back from holiday at a surf mecca in Anglesey and he totally fitted in there with his hippy hairdo and wetsuit Bizarre how he doesn't like clean bath water on his hair but can bodyboard in salt water?! - Tho he did need a long wetsuit as he hated the feel of the seaweed on his legs. Honestly

I've cancelled this afternoon's appointment as I choose my battles with J and this one isn't worth fighting if the ortho won't put a brace on him anyway. It's hard to let stuff go though, isn't it, as you feel it's just another situation where he got his own way...although from what people have said he wouldn't cope with the physical side of a brace anyway. Let's hope they invent something else or he can pay for his own 'invisalign' braces when he's older!

 

BTW Expect to see me on Dragon's Den soon with Cheese Flavoured Toothpaste for Kids with Asperger's! That is GENIUS, Manda! Except all the kids would fight over whether it was Primula or Dairylea haha.

[Mandapanda]

It's hard to let stuff go though, isn't it, as you feel it's just another situation where he got his own way...

 

Ahhh, that's what 'other people' (and Baddad) would say. I would say we are bending the rules, er.. I mean.. being flexible, so that they can cope with life.

[Karen A]

Hi.I have a few thoughts that might be helpful.We have J who is 13 [NT] very mature and capable.J has had a brace for a year now.It has been an absolute pain to cope with.It is uncomfortable and he spends twenty minutes twice a day keeping up the oral hygiene routine needed.We have worked our way through various products to stop the brace rubbing.In the last few weeks we went on holiday.First a bracket broke on the brace the J realised he had no wax with him to stop rubbing......he improvised with chewing gum.I will stop moaning now.However I thing Ben [AS] age 11 with numerous sensory issues and very little frustration tolerance will live for a while longer with imperfect teeth.I need some time to build up my resolve before attempting braces with him.

I thought I would add that before the orthodontist would fit braces for J I needed to sign a form stating that J would follow specific guidance on hygiene and not eating particular things.I do not think I would be able to sign a form stating that I would be able to ensure Ben followed the routine either.If the braces are broken the parent may be charged.Karen.

Edited August 19, 2009 by Karen A

[NobbyNobbs]

The dentist has said they wouldn't consider removing the teeth under anaesthetic as they don't consider putting a child at risk for the sake of appearances good enough reason

wow. that must be a regional thing. here, childhood extractions are often done under general anaesthetic as they prefer to do that than make the child afraid of the dentist forever. this would be especially pertinant in a disabled child.

 

our local hospital dentist now do 'autism kits' which include different types of gloves so the child can decide which ones they like, sunglasses to stop the lights hurting, a toy and some other stuff i can't remember which they give out to ASD kids before their appointment. i'd have loved that as a kid. i absolutely hate the taste of the gloves in my mouth, they make me feel sick.

 

on the braces front i was in the dentist the other day and saw a sign about a new kind of brace which is moulded plastic, but used instead of train tracks. its removable, more or less invisible and is said to reduce the risk of cavity damage because theres no chance of food getting stuck against the teeth (i believe you take it out to eat). might be worth looking at if you feel he really needs to have a brace.

 

 

[bid]

In my area we have a Special Needs dentist...not sure if this is true everywhere. If you are interested, you could start by asking your Health Visitor or SN HV.

 

Bid

Edited August 20, 2009 by bid

[Mumble]

They have special needs dentists (for both children and adults) where I am in London and seem to accept referrals from a very wide area. When we were growing up, my brother saw a special needs dentist at the local hospital.

 

[rag31]

I really struggle to brush ds2's teeth. He cries 'ow ow' all the way through and says it hurts, so although he is younger - I hear you!

 

I had braces as a young teen for two and a half years and they were really quite painful. They caused lots of ulcers due to bits sticking out and rubbing the mouth, and ached for days every month when the orthodontist tightened them. I wouldn't force my child to go through it if they were not keen and it was only a minor problem. (having said that, I'm pleased I did put up with it - my sister refused to have them and has regretted it ever since!).

 

hmm, not a particularly useful post I'm afraid!

 

Becky

[Paula]

My son is 15 and hates brushing his teeth refuses to do it cant stand the toothpaste in his mouth weve tried alsorts.

 

 

My son now attends the communtiy dentist hed to be refered there by his own dentist.The community dentist deals with special needs kids and adults and its great.They realy understand his needs.For the past year hes been going every two weeks for the hygenist there to clean his teeth .............hell allow her to do it but refuses to do it himself or let me.........and she also coats them with a special stuff that hardens the enamal............it means that even though his teeth dont get brushed at home he hasnt any rotton teeth or fillings............its a paine taking him every couple of weeks but worth it.

 

If i were you or anyone else whos as kids hate tooth paste and stuff see if theres a specialist service or commun tiy dentist in youre area...............

[sandyn]

Just a thought, would you son use a mouthwash? There are a few flavours (although mostly mint). That might be better than nothing at all?

[lsw146]

Our DD hates to brush her teeth but loves to eat sweets last thing at night. we try our best to monitor but she's 15 and we are trying to get her there on her own. Now she has one tooth which is more filling than tooth although the dentist said it started out as a developmental problem her dental health has not helped. we just keep on about the consequences of loosing a tooth. She wants to dance and perform and we tell her she wont look good if she looses a tooth.

[caci]

A lot of children with ASD seem to hate the taste/feeling of mint.

 

Our 11 yr old will tolerate toothpaste that is berry/fruit flavour and you can buy it in places like Superdrug and Lidls. I haven't been able to find any in Sainsburys or Morrisons for a couple of years, so if you do find some, I advise stocking up. Also with mouthwash, there is a children's one that is pink and not mint flavour (Johnsons I think).

 

 

 

[Wildkat]

I can very rarely get S to brush her teeth, but never with the rest of my kids as she says she can taste the smell of thier tooth paste.

She will only do it in the evening. Her teacher, last year started a tooth brushing programme in school along with her whole class, but her new teacher just doesn't seem to have the time. Her TA takes her out every morning to do it, but she hates it as she feels like everyone is watching her leave the classroom. She could do with a brace, but until she's brushing regularly there is no point.

[Tantaz]

My son is 12 and recently diagnosed with Asperger's. Our latest dilemma is that he needs a brace on his teeth (not just a little wonky, he only has one central incisor at the top as his other one didn't come down). Two years ago he had an operation to remove an extra tooth that was lodged in his gum and he coped with that really well. However he refuses to brush his teeth daily (we're lucky if he does it twice a week - ugh!) so the dentist is obviously reluctant to put a brace on in case food gets stuck and rots his teeth. We've tried all kinds of things to get him to brush his teeth (rewards and explaining clearly why he should eg doesn't want painful ugly rotten teeth), but it's as if he can't possibly imagine that scenario as it's not happening now. He has had problems with not liking the taste of toothpaste so he uses a milk teeth one, not perfect but better than nothing. He's seen people with bad teeth and even commented on it himself but doesn't put two and two together and see that could be him- as if it's so far in the future it doesn't matter. I realise it's all part of his Asperger's and not being able to imagine/ visualise but don't know what to do next. He's the same over having baths and wearing clean clothes. Clearly we can't force him to have a brace but he's a good looking lad and we don't want him regretting this when he's older. His incisor is now off centre and the gap getting too small for the other tooth to come through naturally. He looks like he's had a fight and had it knocked out! Having Asperger's, he cares very little for his appearance but still manages to pull off looking cool somehow.

He has always gone to his orthodontist appointments reluctantly (with bribes, basically ) and now is refusing to go at all (he has one tomorrow). I don't want to get into a situation where I'm offering him big bribes to go to the orthodontist as if he doesn't brush his teeth it will amount to nothing anyway. He also refused to go to his last appointment with our family dentist. He's not needed treatment apart from his operation so doesn't have a fear of the dentist - he just doesn't see the point.

Should I just give up on this one? It totally doesn't bother him having mad teeth!

 

My son is exactly the same, he never wants to brush his teeth! My consultant at Birmingham Childrens Hospital suggested getting him to use a mouthwash, not a major thing I know but at least if he can swizz around his mouth with mouthwash it may protect his teeth a little. Also get some disclsoing tablets from the chemist - these are the ones that when you suck them the colour highlights where all the plaque is in the mouth - maybe that would encourage your son to brush more if he see's how much food is stuck on his teeth - good luck!

 

Tania

[Babylicious]

Paris is another who refuses to brush her teeth and they are now badly yellow, it's gross. I think she just hates the feel of the bristles of the toothbrush

[peaches]

Just read this and it rang bells.

 

My daughter, now 23, has always needed reminding or persuading about teeth brushing. Now she lives semi independently she often doesnt bother and has absolutely chronic halitosis. There isnt a deal you can do about it. I keep hoping the boyfriend will shame her into it. She doesnt see the need to go to a dentist. She isnt frightened, just cant see the need.

 

She went with me and her brother when she was younger and had braces and it was a nightmare getting her to keep her teeth properly clean. Her bro also had braces and now has lovely teeth but he really looks after them.

 

If its any consolation, its never too late to have braces, I had them when I was in my late 20s after having my second child. It was painful, gruelling, and when I first had them put in I thought I would never eat a proper meal again. But Im soo sooo glad I had it done.

[peaches]

BTW sainsbury's still does a pink berry flavour toothpaste for kids, own brand, and its the only one our little boy will tolerate. There are other berry flavoured ones, but it has to be this one!

 

Also, DGS age 6 had bad front teeth due to his mum neglecting them when he was a toddler, although he started brushing them reluctantly when he came to live with me. The dental hospital were unable to treat him, sent him to the children's, and under anaesthetic they removed his bad front teeth and put metal caps on the back ones whilst he was under.

Edited October 15, 2009 by peaches

[JsMum]

I feel when a child doesnt like their teeth brushed its down to sensory issues, and I am wondering if a referral for a Occupational Therapist who specialise in sensory intregration disorder may be able to help him, there is some specially designed toothbrushes for sensory intregration issues, look into special needs toothbrushes too, it maybe he needs a course in sensory intregration to get him use to the tastes/sensations, also reward chart, some of the ideas Ive read on the internet are to provide distractions when there brushing their teeth such as playing music, or dancing!!!

 

It may there is days when its just too Hypersensitive and maybe to leave it those days, as long as he is brushing some of the time.

 

Have a visual display of what you do when brushing your teeth, a very detailed spersific diagram of how to brush may also help to aid them.

 

J has been having access to a disability nurse and was introduced to all equiptment before he had treatment and took baby steps, from just looking into the room, to then looking at the equiptment, to then some of the equiptment in his mouth, and eventually he could handle things in his mouth, amazingly he had fillings without anestetic because for some reason he was fine with having it done without it.

 

J goes throw stages where he will brush them every day to then not doing it for a few days, Ive recognised this is when he is hypersensitive, and when he is less anxious will revert to his brushing his teeth again, he also some how tolerates mouthwash now too.

 

Anyway I recommend a OT that has knowledge of sensory intregration disorder.

 

JsMumxxxxx

Edited October 15, 2009 by JsMum

[trekster]

I can very rarely get S to brush her teeth, but never with the rest of my kids as she says she can taste the smell of thier tooth paste.

She will only do it in the evening. Her teacher, last year started a tooth brushing programme in school along with her whole class, but her new teacher just doesn't seem to have the time. Her TA takes her out every morning to do it, but she hates it as she feels like everyone is watching her leave the classroom. She could do with a brace, but until she's brushing regularly there is no point.

 

Could the TA do it during breaktime or before school instead? Might take some of the embarrassment away from your daughter.

[trekster]

Just read this and it rang bells.

 

My daughter, now 23, has always needed reminding or persuading about teeth brushing. Now she lives semi independently she often doesnt bother and has absolutely chronic halitosis. There isnt a deal you can do about it. I keep hoping the boyfriend will shame her into it. She doesnt see the need to go to a dentist. She isnt frightened, just cant see the need.

 

Somehow i think if he attempts to shame her into attending the dentist then it will likely make things worse. i avoided my dentist for 14 years because i felt i couldn't trust him. He wanted to scale and polish my teeth but wouldn't tell me if it would hurt or not so i refused treatment. i then found another dentist when i moved out (on my own without any pushing or encouragement) and i go there every 3 months now. If shes very angry most of the time or depressed that could be her way of saying "im not happy". i tend to self neglect when im severely depressed. Her chronic halitosis could be caused by gluten and milk addictions, mine were. Does she shower? Or bathe? or wash herself without lots of persuasion? Im not able to do those things either. In fact only music will eventually get me relaxed enough to shower. Also she could be taking the "an apple a day keeps the dentist away" saying too literally.

She went with me and her brother when she was younger and had braces and it was a nightmare getting her to keep her teeth properly clean. Her bro also had braces and now has lovely teeth but he really looks after them.

 

If its any consolation, its never too late to have braces, I had them when I was in my late 20s after having my second child. It was painful, gruelling, and when I first had them put in I thought I would never eat a proper meal again. But Im soo sooo glad I had it done.

 

What about a social story about why we need to brush our teeth? Only a book from the chemist (in plain english) that mentioned "endocarditis" was enough to get me to start attending the dentists. Mint toothpaste stings my eyes, electrical toothbrushes can be too loud for some autistic kids, sight of blood could frighten them. I started by using very warm water then progressed to "kingfisher fennel toothpaste". i also found the in between the teeth brushes hard to get used to at 1st.

 

i don't think she knows when and how to look after them. Since there isnt literally a time of day where "everyone in the world brushes their teeth" ie an absolute she doesn't understand why or that she has to brush her teeth. The NAS information applies to autistic children and adults see

http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=1064&a=7844 for details.

 

Thanks to all who contributed to this discussion, i have just managed to brush my teeth tonight

 

[trekster]

i agree that OTs have experience of sensory issues. i hope they can help your kids.

 

Alexis