Toothbrushing isn’t always easy—especially for individuals with intellectual and developmental disabilities (IDD) or Autism, who may experience sensory sensitivities, communication differences, anxiety, or past negative dental experiences. If you are a caregiver of someone who resists brushing, you’re not alone—and you’re not doing anything wrong. 

The most important thing to remember is this: 

You are brushing with them, not for them. 

These strategies are designed to support individuals with IDD or Autism by reducing stress, honoring choice, and building trust. There will be smooth moments and challenging ones. Progress may be slow—and that’s okay. Every small success matters. 

Start With Yourself 

Before you begin, take a moment for you. 

• Take a deep breath 

• Stay calm—your tone and body language help build trust 

• Be patient and kind 

A calm helper helps create a calm experience. 

Offer Choices Whenever Possible 

Choices give a sense of control and reduce resistance. Even small decisions can make a big difference. 

Try offering options like: 

• Toothbrush: green or blue 

• Type: small manual, electric, or 3-sided 

• Toothpaste: mint or bubblegum 

Letting them choose helps turn brushing into a shared activity instead of a power struggle. 

If They Push You Away 

If resistance escalates, pause. 

• Stop brushing—don’t force it 

• Step back and take a breath together 

• Try again later that day when things feel calmer 

Stopping doesn’t mean failing. It means you’re listening. 

Try a New Location 

Sometimes the bathroom itself is the problem. Changing the environment can help. 

Consider brushing: 

• In a bedroom chair 

• On the couch while watching TV 

• In the kitchen or even the bathtub 

Flexibility can turn a tough routine into a manageable one. 

Use Distractions 

Distractions can help shift focus and reduce anxiety. 

Helpful options include: 

• A short video or favorite song 

• A fidget or comfort item 

Keep distractions brief so brushing stays the main activity—but fun, too. 

Create a Calm Setting 

A soothing environment sets the tone. 

• Play soft music or a favorite song 

• Speak slowly and gently 

• Keep lights low if possible 

• Use the same helper when you can—consistency builds trust 

Predictability can be incredibly reassuring. 

Change Your Approach 

If brushing head-on feels uncomfortable, try a different angle. 

• Brush from the side or from behind 

• Use a mirror so they can see what’s happening 

Sometimes a small change in positioning makes a big difference. 

If They Bite or Won’t Open 

Safety matters—for both of you. 

• Use a foam mouth rest to protect fingers 

• Pair brushing with calming talk, music, or gentle touch 

Go slow and stop if stress increases. 

If They Gag Easily 

Gagging can be uncomfortable and discouraging, but there are ways to help. 

• Start with the front teeth only 

• Lean forward so saliva can drain 

• Take breaks and encourage slow, deep breaths 

• If gagging continues, talk with a dentist 

Even brushing a few teeth is still progress. 

Praise Every Success—No Matter How Small 

Positive reinforcement goes a long way. 

• Say “Good job!” even if only a few teeth were brushed 

• Offer a small reward like a favorite song, sticker, or short show 

Success doesn’t have to be perfect—it just has to be positive. 

Keep Going 

Toothbrushing may never look the same from day to day—and that’s okay. What matters most is building trust, reducing stress, and supporting oral health in a way that respects the person’s needs. 

You’re doing important work. Every calm attempt counts. Visit Pathways to Oral Health to check out our resources and videos on strategies to support good oral hygiene habits. You can also print these strategies here.