Feeding Issues and Toothbrushing
Picky eating and difficulties with daily self care activities are common childhood behaviors that do not always resolve with age and frequent exposure. What happens when behaviors with eating and daily activities like toothbrushing persist despite best efforts by parents and caretakers? These two activities have more in common than you may realize. Children who struggle with these activities may be experiencing sensory processing issues.
“Sensory processing refers to how the nervous system organizes and manages incoming environmental information via seven sensory systems: vestibular, proprioceptive, tactile, visual, auditory, gustatory, and olfactory” (www.asha.org). Sensory processing issues are difficulties with organizing and responding to information that comes in through these senses.
Kids can be overly sensitive (hypersensitive) to sensory input, under sensitive (hyposensitive), or both. These issues, sometimes called sensory processing disorder or sensory integration disorder, can greatly affect learning and everyday life. There are two types of sensory processing challenges, and sometimes kids may experience a mix of the two. Children who are hypersensitive may avoid sensory input because it can feel overwhelming to them. Children who are hyposensitive may seek more sensory stimulation.
How does all of this affect feeding?
Food related sensory issues involve our ability to understand smells, tastes, touch, and sights. Although most of us process this information in similar ways, it is completely unique to every child. As adults, we have been desensitized to smells, flavors, and textures of food over time, but many children have not. Many times, children who are extremely picky eaters negatively process the smell, taste, and touch of a food, which can result in a limited list of favorite foods and sometimes food refusals during mealtimes.
It is also common for children with sensory processing issues to resist tooth-brushing which leave many parents feeling helpless or frustrated. Resistance to tooth-brushing is common in children with a history of negative oral experiences or sensory issues affecting their feeding. Stimulation in the mouth can be overwhelming, negative, and may even lead to gagging. Children that can tolerate stimulation in their mouth, such as through toothbrushing, are generally able to handle manipulating foods in their mouth more than children who cannot tolerate toothbrushing.
Toothbrushing is an essential component of a child’s general health. It additionally supports feeding development; when children can tolerate toothbrushing, they are often ready to participate in accepting new foods and textures. Toothbrushing reduces oral hypersensitivity and helps to move the gag reflex further back in the mouth. It provides stimulation and input to the biting and chewing surfaces as well as the lips and tongue. These are the same structures that are used during eating.
You may be thinking “Ok, this makes sense, but what now?” You can start by just having the toothbrush around so it becomes familiar. The same goes for food. Exposure to new foods will help them to become more familiar and less resistant. Below are some more strategies that you can try at home to help with tooth brushing and feeding!
For older kids, allow them to choose their own toothbrush and eating utensils/plates with a favorite theme.
Brush your teeth alongside your child. The same goes for eating together and even cooking together! You are their best model!
YouTube has many videos about toothbrushing and even videos about eating your food. They can be great reinforcers and offer a fun and different teaching opportunity.
Brushing the teeth on dolls and stuffed animals and using play food and a kitchen are fun ways to increase exposure and opportunity!
If brushing is improving, a vibrating toothbrush is an effective tool to help desensitize the mouth for new food textures while keeping those teeth clean!
Sensory play is a great way to desensitize, it doesn’t have to all be about the mouth! Sand play, water play, playdoh, and even using cookie cutters with brown sugar are great sensory activities!
Allow your child to hold the toothbrush and have control.
Be patient and take small steps! Think about making small changes to the foods your child already likes to help build a bridge to new foods in a way that is comfortable. The same can be said for the toothbrushing process. A toothbrush in the mouth for a few seconds or a small bite of a new food are all progress!
When your child is struggling with daily activities that we find to be second nature, it is easy to become frustrated and upset. Please remember, you are not alone! We are here to help you. Contact Talk Time Speech and Language Therapy for more information!