How does autism affect independent tooth-brushing routines?

PostedDecember 22, 2025

UpdatedDecember 22, 2025

ByMy Patient Advice

Author: Lucia Alvarez, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

For many autistic children and adults, maintaining a regular tooth-brushing routine can be challenging, not because of unwillingness, but because of sensory sensitivities, executive-function difficulties, and anxiety around daily tasks. According to NHS England’s 2023 clinical standard on oral healthcare for autistic children, personalised mouth-care plans and environmental adjustments make a meaningful difference in supporting independence.

Sensory challenges and routine barriers

Many autistic people experience sensory overload during tooth-brushing, certain flavours, foaming toothpaste, or the sound and feel of brushing can be overwhelming. King’s College Hospital NHS guidance (2024) recommends using flavourless or SLS-free toothpaste, playing calming music, and brushing when relaxed to reduce distress.

Autistic individuals are more likely to brush less frequently or need supervision. A 2025 PubMed study found that difficulties with fine-motor coordination, sensory overload, and anxiety contribute to less effective brushing habits, while caregiver involvement improves consistency.

BMJ findings (2024) also describe autistic children’s experiences of oral hygiene as “like an explosion in the mouth”, reinforcing the importance of sensory-aware adaptations and predictable routines.

Evidence-based strategies that help

Behavioural and occupational therapy approaches are shown to support independence in tooth-brushing. According to Esposito et al. (2024, PubMed), using pictograms, sequential teaching, and parental training helps children learn brushing steps gradually and confidently.

The NIH’s 2025 review highlights social stories, video modelling, and caregiver education as effective ways to build routine and reduce anxiety.

Meanwhile, NICE guidance on oral health promotion (2022–2025) emphasises the importance of regular dental visits and tailored advice for families, helping embed good oral hygiene habits over time.

Takeaway

Autistic individuals may face unique challenges with tooth-brushing, but structured, sensory-aware support can make a real difference. Consistent routines, visual aids, and compassionate guidance from parents, carers, and healthcare professionals help build independence, one small, supported step at a time.

Lucia Alvarez, MSc

Author

Lucia Alvarez is a clinical psychologist with a Master’s in Clinical Psychology and extensive experience providing evidence-based therapy and psychological assessment to children, adolescents, and adults. Skilled in CBT, DBT, and other therapeutic interventions, she has worked in hospital, community, and residential care settings. Her expertise includes grief counseling, anxiety management, and resilience-building, with a strong focus on creating safe, supportive environments to improve mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.