Molar Mayhem

[conuly]

Dear Annie: Recently, I stayed with my niece and nephew while my brother and his wife took a trip. This seems like a trivial problem, but I know it can lead to serious health issues in the long run. Neither of my brother's teenaged kids brushed their teeth regularly. I reminded them often, but they found ways to wiggle out of it. One was even running the electric toothbrush outside of his mouth -- so I would think he was brushing his teeth. When I went into the bathroom afterward, the electric toothbrush was bone dry. His sister later told me about that trick.

I asked my brother about this, and he said they've tried for years to get the kids to brush their teeth more consistently. They gave them excellent electric toothbrushes and set a great example of brushing at least twice a day themselves. If they try to watch the kids brushing, it turns into a huge fight every time. They've spent hundreds of dollars on dental care as a result. They're at a loss as to what to do. The kids understand it's important but just don't care enough to change their habits. Of course, they do not realize the long-term damage they may be doing, including dangers of infection and disease.

Anything I can do to help them? We're very close, so my brother and his wife would not see it as butting in. They'd welcome a solution. -- Brushless in Baton Rouge

Dear Brushless: While this may seem like a molehill of a problem now, a mountain of plaque buildup on your niece's and nephew's teeth is a huge problem. This is a fight worth fighting. Since they are teenagers, explain to them the diseases and long-term damage that they are at risk of if they fail to brush their teeth. Showing them actual pictures of decayed teeth, while disturbing to look at, could be powerful motivators. Being upfront about the cost of the dental work, and what their family could have spent money on instead -- vacation, shopping, extracurricular activities -- might have them see the impact of their poor dental hygiene in a new way, too.

Perhaps your brother and his wife could try incentives or rewards for completed brushings. It takes roughly two months to form a good habit. So, when setting the reward, have that goal in mind. When they do brush their teeth or get a good cleaning, take a moment to point out just how good it feels to be clean and taking care of your body. Naturally, as humans, we like to be clean.

Also, continue to have their dentist talk to your niece and nephew about the importance of dental hygiene.

Comments

[conuly]

I kinda think that if the kids, who are teenagers, are at the point where they fight with their parents about toothbrushing and fake brushing their teeth then the problem is bigger than can be cured with more lectures. How about you ask them why they don't brush their teeth, listen to the answer, and then try to find a cure?

(My guess is sensory issues, in which case I'd recommend the kids be evaluated to see if occupational therapy can help. Alternatively, google can get you started with suggestions while you try to wrangle insurance to cover this.)

Also, all the commenters at Arcamax are framing this as "the kids are disrespectful, they need to learn to obey, you should punish them in some painful or embarrassing way until they shape up" which is not a solution to this problem. God, I'd like to smack all those people with a dead fish until they shape up.

[laurajv]

Yes! Does Annie imagine that in all the things the parents have tried, and all the dental work the kids have had to have as a result of not brushing, no one has told the kids why brushing is important? Something else is going on.

[minoanmiss]

Exactly this. I was thinking the whole time, "Did anyone ask why they don't want to?"

[eva_rosen]

Tell their parents to take the dentist's fee from their allowance. They'll brush.

[conuly]

Not if brushing is more painful than having no walking around cash.

I just don't think that punishment (or any form of consequencing) is the answer here.

[eva_rosen]

One would think, but if it is teenagers they're talking about. I know one who refused (violently) to shower to the point of getting skin problems, which didn't disuade her. Her parents had her tested for alergies (no), mental issues (neither) a counselour (the school complained). Taking her material stuff did the trick (her mother feared her tantrums, she got sent to her father's house, who's a dick). Of course one should check the other options first.

[melannen]

That could also be sensory issues, tbh. I was also a teenager who hated showers, and I'm pretty sure it was based around sensory issues. It's not something that tends to get accounted for unless the kid already has an ASD diagnosis, and often not even then.

(Also, I am wondering about a teenager who has violent tantrums to the point that her mother is afraid of her who gets assessed as having "no mental issues". That... seems wrong. Normal teenagers should not be having frighteningly violent tantrums at their parents.)

"Making their life so miserable that they treat you as a jailer" (which is often what 'taking material stuff away' comes down to these days, especially since the first 'material thing' somehow always seems to translate to 'ability to communicate with friends') can fix things like that in the short-term, because it changes the scale they measure misery on, but it doesn't tend to help long-term.

[eva_rosen]

Sadly, the kid (my cousin) was also a jerk. She would hit her mother, because my aunt was a wet blanket, but act meek and never raise her voice around anyone else. My mother also thought sending her with her asshole dad was a horrible thing to do, but he wasn't abusive, just indifferent. When she screamed at him and he shrugged and left she turned normal overnight.

[redbird]

That seems unlikely, given that these are teens who dislike brushing their teeth enough that they will put up with dental visits, likely involving local anesthesia and drilling, even though they know that not brushing will mean another round of dental unpleasantness.

I realize dentistry is less unpleasant now than when I was in my teens, but I am fairly sure the teenagers don't want to be going to the dentist. If conuly is right, right now they're putting up with the sensory unpleasantness of a dental drill and tooth filling rather than the daily unpleasantness of brushing their teeth. "And we'll take away your allowance" seems likely to lead to the kids avoiding dentists altogether as soon as possible.

[eva_rosen]

That's sensible advise; also they might be old enough to decide how much the unpleasantness is worth future dire consecuences in those exact terms (my oldest has a crippling phobia of needles, as I do, but of course vaccination is unavoidable, so we have spoken clearly about both almost preferring to lost a limb instead of getting a shot, but having to put up with that, for us, trauma in order to prevent getting, or worse, spreading a preventable disease).

[lemonsharks]

I also jumped to sensory issues because dang that looks like sensory issues. (I did not like the taste of toothpaste growing up or how it got all foamy.)

[mommy]

It's worth asking the teens why they don't want to brush their teeth. If it's something as simple as hating the tingly taste/feel of mint toothpaste, then switching to a cinnamon flavored or baking soda based toothpaste might fix the problem.

[melannen]

Yep. I reached a ridiculously high age before it occurred to me that maybe most people don't find tooth brushing actively painful and otherwise unpleasant, and maybe it was sensory issues and I could fix it and regular brushing suddenly got a lot easier.

For me the fix was actually changing when I brushed, because right after or right before meals set off the sensory issues extra bad, and doing it before bed sent enough of a jolt through me that I couldn't get to sleep afterward. (Also: I had to wait until I was out of braces long enough to associate my teeth with anything other than pain and discomfort, ever.)

And of course all my family's efforts were around enforcing a routine at one of the times that made it worse, and it never occurred to me that I had options other than "follow the family routine" or "never brush your teeth ever". So maybe try working with them around timing and other options (like non-mint or tablet toothpaste or other kinds of brushes.)

(There's also been science lately that shows that things like 'brush after every meal' that have been common knowledge maybe aren't as good ideas as we thought they were, so be flexible - 'brush sometimes' ought to be the first goal.)

...that said if they've made it to teenagerhood and you're at the "they fake it to make people stop trying to force them" stage, you may just be better off backing off and waiting until there's been less conflict for awhile. That is the age at which they know that nothing you suggest will work, because nothing you have suggested has ever worked before, so why would it work now. And not brushing isn't something that will kill them tomorrow. They have time to learn.

[eleanorjane]

Also, I'm pretty sure that 'showing them the consequences' isn't going to make a lick of difference, because (most) teenagers will intellectually accept that X behaviour can lead to Y consequence, but not that it will happen to them personally. Teenagers know they're bulletproof.

[rosefox]

That's an unfortunate choice of phrasing... I think a lot of teenagers in the U.S. these days are very, very aware that they are not in fact bulletproof.

I don't bring that up just to poke; I think parents of present-day teens have no idea how immensely stressful and scary it is to be a teenager right now, and I really believe that has to be factored into any conversation about "My teen is acting weird, what's up with that?". When I was a teenager (in the early 90s) I went a while without brushing my teeth as a way of demonstrating that I had control over my body and time, a thing that teens tend to feel intensely about under any circumstances. I can only imagine that the need to feel that sense of control becomes far more desperate for teens in the era of school shootings, social media, climate change, and wage stagnation.

I do agree that the very last thing these kids need is a lecture on how actions have consequences, but that's because they probably have bigger things on their mind than tooth decay, not because they think they're going to live forever. Compassion might go a lot further.

[terrio]

The first thing that came to my mind is that it's not about the tooth-brushing at all, but a way to assert some degree of control over their lives. I wonder what the family dynamic is outside this one issue?

[lavendertook]

That was my thought, too. With as extreme a solution as wasting the same amount of time as brushing standing around holding a buzzing toothbrush just to rebel, I imagine asking them what the problem is will not get results. One may have sensory issues, but it is not likely both do. There's more serious problems going on with the family dysfunction.

[conuly]

One may have sensory issues, but it is not likely both do.

Given that this sort of neurological weirdness is genetic and highly heritable, I think it's plenty likely.

It's more surprising if only one child in a family has sensory issues, or ADHD, or whatever.

[minoanmiss]

I'm with you, not least because the siblings I'm helping raise do both have sensory issues in remarkably intersecting patterns.

[conuly]

That also came to mind as a possibility, but a less easily solvable problem than sensory issues.

[lilysea]

The first thing that came to my mind is that it's not about the tooth-brushing at all, but a way to assert some degree of control over their lives. I wonder what the family dynamic is outside this one issue?

Yes. When I was a child, I used to use my toothbrush and toothpaste to brush the bathroom bench instead of my teeth, because not-tooth-brushing was one of the only ways I got to exert control over my life. [My parents were emotionally abusive; verbally abusive; and physically abusive.]

[ambyr]

They gave them excellent electric toothbrushes and set a great example of brushing at least twice a day themselves.

My immediate reaction to this--as someone who finds the sound of electric toothbrushes agonizing--is, "Has anyone tried giving them normal boring toothbrushes instead?"

[neotoma]

As someone who finds vibrations unpleasant enough that I don't own a hairdryer, an electric toothbrush is quite possibly repellent on that point alone.

[conuly]

I would've thought that, but oddly, all the advice tips for kids with sensory avoidance suggest trying a vibrating toothbrush. (They also suggest trying gum massage. I mean, hey, if it works.)

[chiasmata]

For all those suggesting ‘just ask why they won’t brush’, that’s... not how teenagers work. Sure, ask away, but I’d be surprised if you got a useful answer.

[conuly]

Pretending to brush their teeth is sufficiently odd behavior for this age group that I think the results might surprise you, provided you come at it with an honest attempt at inquiry rather than an transparent attempt to lecture them when you don't like the answer.

[likeaduck]

If folks are finding they don't get useful answers when they ask teenagers questions I have a lot of questions about how they're going about asking and listening to the answers.