Fine motor skills like brushing and flossing can be difficult for many individuals with ASD. If possible, have the patient brush in the operatory so the dental professional can visually assess what adjustments should be made. Creating an assistive brush can be as easy as putting a tennis ball on the brush handle to make a custom grip (Figures 20 & 21).
Some individuals may find the sensation of the bristles very uncomfortable. In several patients the author has found the Banana brush to be a useful transition tool (Figure 22). The toothbrush is made of silicone and marketed to very young children as a “safe toothbrush.” There are short bristles made of silicone on the brush that help desensitize the individual and help transition to a regular brush. The handles are also helpful with dexterity challenges.