When Ollie first started at The Forum School he did not brush his teeth. Ollie would hold his toothbrush but would pass it straight back to staff. He was reluctant to put the toothbrush near his mouth. Ollie is now brushing all of his teeth with toothpaste with adult support.
When Ollie first moved into Laurels, Adults worked on this area with Ollie recognising that this needed to be a positive experience for Ollie and to encourage playfulness and building his confidence in this area.
Adults gave encouragement and Ollie made slow progress but would put the toothbrush with no toothpaste on his lips but no further into his mouth. This was a quick tap and wanted to pass straight back to adults.
Occasionally he would let one adult brush his teeth, this was the same adult and was not consistent. There was no further progress being made and Ollie was still very reluctant to do this even with no toothpaste involved.
In January 2024 a teeth brushing plan was put in place. The first step was to give Ollie a choice of toothbrush. He chose his own tooth brush willingly.
He then chose from a range of toothpaste with adults informing him of the different flavours. He chose a fruity flavoured one.
In March 2024 Ollie was working on holding the toothbrush with no toothpaste on the brush on his lips for 5 seconds. This was with adults counting and giving lots of praise.
This was a really positive step and encouraged Ollie to do this and trust that this would done in his time and adults understanding that he found this difficult.
Ollie achieved this in April 2024 and then moved on to doing the same step, holding this to his lips for 5 seconds but with toothpaste on the brush. He achieved this in the same month of April 2024 and although not putting the toothpaste on his lips every time he was still using the toothbrush and toothpaste and putting it on his lips for 5 seconds.
Ollie then moved towards working on putting this on his teeth for 5 seconds. There was a plan in place to increase this at each step. Adults remained playful and encouraging with supporting Ollie to do this in his own time and continue to build on his progress positively.
The home introduced some teeth brushing toys. He had a giant toothbrush and big set of teeth that adults could play with him with. He could brush the teeth and adults could role model brushing all of the teeth.
Ollie’s key worker also created a laminated picture of a mouth in A4 size and had a ‘play’ toothbrush. They coloured in the teeth on the picture with a dry wipe marker and Ollie could use the play toothbrush to clean off all the marker helping him to learn to clean all of the teeth thoroughly.
Ollie played this with an adult and seemed to like cleaning it all of. Adults were playful and would do it alongside Ollie and clean all the marker off. This seemed a really good activity that seemed to really boost the progress at this time to brushing all of his teeth, seemingly improving his understanding of brushing all of his teeth.
Ollie achieved putting his toothbrush on his teeth for 5 seconds in April 2024 and then progressed to touching the toothbrush on his side teeth as well.
The next step for Ollie was to put the toothbrush in his mouth on his teeth with toothpaste on his toothbrush. He achieved this in May 2024 with some adults but was not doing consistently with all adults.
Adults worked on this continually and consistently. He started achieving this with more adults in Laurels consistently and he increased the time in 5 second intervals and with some hand over hand help from adults. Ollie willingly accepted the help and did this with adults.
Adults were given their own toothbrush so could role model alongside Ollie brushing their teeth.
Ollie then further achieved the next step in May 2024 moving the toothbrush around his mouth brushing his teeth needing some hand over hand support.
During June and July 2024 Ollie continued to play with the coloured in teeth and toothbrush, he increased the amount of time in 5 second intervals aiming and achieving to brush all of his teeth with hand over hand support.
Ollie then very quickly achieved brushing his teeth for 2 minutes with his choice of toothpaste. He still requires hand over hand help and wants adults to help him.
Ollie has continued to have a choice of toothbrush and he has chosen a battery powered one that had a cartoon on.
Ollie has chosen an electric toothbrush and his key worker also got him a choice of stickers so Ollie could choose which stickers he wanted and put these on his toothbrush to personalise it.
As of September 2024 the plan was complete and Ollie was now brushing all of his teeth with toothpaste.
Ollie has continued to have a target set as part of his outcomes to achieve further independence in this area.
At the end of January 2025 he has had a target set to reduce the amount of hand over hand help he needs and adults to encourage him to the last bit himself with verbal and gesture prompts.
He also went to the dentist on 3rd February 2025 he visited the dentist. Ollie was very playful in the dentist and the dentist was able to do a thorough examination. Ollie also let the dentist brush his teeth whilst at the appointment. This is a fantastic achievement as this was a thorough brush with an unfamiliar person doing this task for him.
The adults supporting Ollie said the dentist seemed to really understand Ollie’s playfulness and used Ollie holding the light and moving it away and then closer to him to interact with Ollie throughout the examination. The dentist did introduce the cleaning tools to Ollie however Ollie appeared to not like the sound of these when they were turned on so declined having these used on him by the dentist at this appointment.
Research informed practice for this plan and to ensure that we are working towards the recommendation set out for oral hygiene is form the following links:
Chapter 8: Oral hygiene - GOV.UK
PHE standard publication template
We are so proud of Ollie!
