The Hidden Struggles of Dental Hygiene: Neurodivergent Voices on Dental Care
Through listening to our neurodivergent members who are part of the Thinking Differently campaign’s Advisory Group, the NFWI has identified an overlap between our Dental Health Matters and Thinking Differently campaigns. In this blog, we highlight the difficulties neurodivergent members face when it comes to dental healthcare and the strategies they use to alleviate their challenges.
What’s the Problem?
For many of our neurodivergent members, maintaining dental health isn’t a simple daily habit, but a complex, overwhelming task which can cause sensory sensitivities, executive dysfunction, and emotional fatigue:
“It causes a problem every day in some way. Sensory overload 101 [is] brushing and flossing [my] teeth. Mouthwash hurts. Toothpaste feels weird and overpowering.”
“It wakes me up too much if done in the evening, it's overstimulating.”
”I carry on until the brush has virtually dug out the roots... More blood... The taste of iron... Overload!”
“If I do brush my teeth at night, my mouth is more likely to feel furry and overwhelming the next morning, so it feels like a punishment for doing the right thing.”
“My mouth is so full of ulcers every day, month after month. It's relentless.”
“I have dental instruments in all shapes and sizes so that I could remove the metalwork of a broken brace because facing a trip to the dentist felt too difficult.”
“There's no chance of brushing my teeth if I've got a headache. There's too much sensory information happening in a small space.”
“It needs to be the first of the month to start a new streak of trying. Heaven help me if the first goes past by mistake and it's another full month that passes before starting again.”
“For many years, I avoided attending a dentist altogether due to my phobia.”
Attending Dental Practices
Clearly, maintaining dental health at home is difficult for many neurodivergent members, but they also highlight how a visit to the dentist is a challenging and often highly distressing experience filled with sensory overwhelm, miscommunication, and a lack of understanding from professionals who are often unprepared to meet their needs. It is clear that neurodivergent dental patients face unique challenges when it comes to experiencing a supportive and comfortable visit to the dentist, and many members have shared their stories of experiencing significant hardship:
“When at the dentist having a check-up or cleaning, the overwhelm with noise and someone in my mouth and the pain make it a very unpleasant experience.”
“Dental work needed to be done under sedation due to my anxiety and panic attacks, particularly when someone is close to my face. Unfortunately, this had to be carried out privately, as my NHS dentist doesn’t offer sedation, so the costs are proving to be substantial.”
“The new dentist may have sensed my differences, but seemed to assume I was of low intelligence. She talked to me as if I were a five-year-old. She said I had to clean my teeth twice a day (but didn't like me saying I'd been doing that since long before she was born.).”
“When [my dentist] asked if my medical history had changed, I told her I'd had an autism diagnosis. I had paperwork in my hands. She turned to the computer, typed something in, didn't ask how she could support me and then talked to me loudly for the rest of the appointment, as if I'd said I'd developed a hearing impairment.”
“Dentists don't seem to understand issues with taste, texture, large things in the mouth, eye contact and small-talk. They seem way behind other medical professionals. I'm dreading my next appointment and trying to work out what I can take to explain my diagnosis, needs and the recommendations from my assessment.”
Strategies of Coping
Maintaining good dental hygiene can be a challenge for many neurodivergent individuals, making a simple daily task feel daunting. However, through creativity, supportive healthcare professionals, and personal adaptations, many have found strategies that work for them. Members are testing different toothbrushes, toothpastes, water temperatures, brushing in the shower, and setting reminders, all to try to alleviate the challenges they face.
“As an autistic, I never liked the minty taste of toothpaste, though of course I did use it. My dentist introduced me to Orenurse, a flavourless toothpaste. Made all the difference.”
“I had a brilliant dentist for years, who really seemed to understand me. She only ever used mint toothpaste, as she knew I couldn't cope with the orange one. She let me take out X-ray plates as soon as the X-ray had been done. She always explained what she was doing.”
“I get offered the very scratched protective glasses, which are great, as I can't see the dentist's eyes.”
“It took decades to realise it was easier to manage the overwhelm by brushing my teeth in the shower with an electric toothbrush.”
“I have so many reminders and goal charts to remind me to brush my teeth.”
“I have tiny disposable toothbrushes in every bag I own for when I forget to brush my teeth or I am too overwhelmed by the feeling before leaving the house. I feel bad for the environmental waste this causes, but at times it’s the only way I can brush my teeth in a day.”
One member also discussed utilising specialist dental services through their legal right to reasonable adjustments. You can visit the Scope website to learn more.
Members are finding strategies to improve their oral health despite the difficulties they face. However, this blog raises a broader question of accessible dental care and the dependency of the individual to find solutions, rather than there being an accessible NHS dental healthcare service. This is made more difficult by the NHS dental healthcare crisis, which the recent NFWI campaign report highlights has several gendered impacts.
Many neurodivergent members of the public may not have the financial means to afford privatised inclusive dental healthcare, or feel overwhelmed and therefore unable to consider solutions to support themselves. By acknowledging the diverse needs of neurodivergent individuals and promoting accessible solutions, we can all help ensure that everyone has the opportunity to maintain their oral health in a way that works for them.