Toddler Teeth, continued...

In my last tooth-focused blog entry, I listed some of the dental considerations that may need to be made for children with Down syndrome.

One thing I didn't know at the time was a piece of good news.  Children with Down syndrome experience only 1/3 the number of cavities as their typical siblings.  This may be due to a variety of factors...later appearance of actual teeth...more space between teeth (less room for plaque to grow...)...whatever the reason, it's nice to have a bit of positive to cling to.

But that piece of positive DID have me questioning why children with Down syndrome were more prone to other dental problems...specifically periodontal disease. 

Through research and picking the brains of pediatric dentists, one response seemed to be the common culprit.

Children with Down syndrome often have more significant dental problems because, as dental patients, they are categorized as among the most difficult to professionally treat.

Simply put, it isn't easy to clean or repair the teeth of a kiddo with Down syndrome.  While typical children may share the same fears and anxiety that children with Down syndrome experience, it is far more difficult to discuss and alleviate these fears with a child who has Down syndrome.

While that reasoning may sound a bit stereotypical, I must admit I don't know of anyone who has won a debate with a person who has Down syndrome.  I have worked extensively with children and young adults with Down syndrome and have yet to score any personal wins.  If a child with Down syndrome decides that the dentist is dangerous and they're NOT getting dental work performed, it's a rare dentist who wins that battle.

 image source

So, here is the dental hygiene routine we've come up with for now...

1.  We brush twice a day using a consistent, predictable routine.
After breakfast and bedtime snack, when the squibs are in their feeding seats, we do brushing.  Flossing is also recommended, but right now we're focusing on the brushing experience being successful and positive before we introduce another element into that activity.

Each squib has their own, electric toothbrush.  Before brushing begins, we sign "brush teeth" and find our teeth and mouths.  Then, we put happy music on the CD player and play with our toothbrushes in off mode for a minute or two. 

Neither of the squibs are fans of their toothbrushes in "on" mode, due to the noise each one makes and the sensations they bring into their mouths.  However, dental tools are often both noisy and implement vibrating and spinning motions, so I think it will be to their benefit to grow comfortable with using the brushes when the brushes are turned on.

For now, we're easing into it by signing "GO!" and turning each brush on.  Then, I allow the squibs to explore the brushes with their arms...fingers...etc.  I place the brush on their cheeks and faces and let them place the brush against their tray and play with them in "on" mode for a bit.

(Biggs, of course, is a fan of the toothbrush tummy tickle...)

After a few minutes of play with our toothbrushes, it's time for the brushing to begin.

Teeth are brushed with the squibs at table height, laying on their backs.
This is done to simulate the dental visit experience as much as possible.  Luckily, our feeding seats will fully recline, so it's easy to tip each squib into "ready position" when it's their turn to brush.

It's okay to simply use a damp toothbrush, sans toothpaste until the child is up to 3.  Toothpaste with fluoride isn't recommended until age 3-4, anyway. 
We DO use toothpaste, simply because the squibs LIKE the flavor and it adds to the appeal of the brushing.  If you DO use it, keep in mind the swallowing strength of your child and the fact that they're on their back.  A minimal amount of paste will do.

We brush from behind our squibs.
Since that's the stance a dentist would normally take, we come at the squibs' teeth from the top of their head, so they're used to the experience of an adult approaching from that route.

Each squib has a brushing theme song, of course.
This has been the most positive addition to our routine.  We chose a song, approximately 1 minute long, for each of our squibs and play the SAME song each time we brush.  When the music starts, brushing starts.  When the music stops, brushing stops.  EVEN IF WE DIDN'T FEEL WE HAD SUCCESSFULLY REACHED ALL THE TEETH.  It's important that they understand the activity has a start and a stop.  By knowing the song, they can anticipate where we're at in the brushing process.  As we lengthen the brushing time, we'll simply choose longer, familiar songs to play as we brush.

If you'd like to employ the same strategy, I'd advise searching for television theme songs on iTunes.  LC brushes to the Mickey Mouse Clubhouse theme (0:57) and Jace brushes to the Backyardigans theme song (0:58).  The Raffi song "Brush Your Teeth" is a great one and is 1:16.  You can also go to your iTunes library, if you have one, and sort your songs by length.  Then, you can compile a playlist of songs that last for approximately 1 minute.  It will be a great go-to album for LOTS of your routines...picking up toys, loading a diaper bag, dancing before bed, etc. 

  After we're done brushing, we celebrate ourselves and then immediately head into a fun activity...usually going to the playroom or dancing to the Biebs. 

So far, our dental routine is proving successful and positive, but if you have additional tips and tricks, we'd love to hear them!