Personal experience. My own baby had oral defensiveness due to a myriad of birth defects and medical interventions. She hated having anything in her mouth and had a gag reflex that made brushing teeth an ordeal.
Dental consult and more frequent cleanings. The first thing I did was contact a pediatric dentist. Dr. G was like the Pied Piper of Hamelin -- and children did whatever he wanted. I really liked him. So did my daughter. The first thing he suggested was more frequent teeth cleaning than was ordinarily warranted. I agreed and she went in for teeth cleaning every three months. He encouraged her to brush her teeth twice daily and asked her about it. She would smile and nod or shake her head no as he talked, to signal her agreement or disagreement. The head fake for her was that he was putting things in her mouth the whole time and she became increasingly accustomed to it.
Transition song. Next, we sang brushing teeth songs twice a day, to introduce the idea that it was time to brush teeth. As we sang, we held hands or I carried her as we walked into the bathroom. She had no ability to sing or to create any sound, because she had a trach and damaged vocal chords.
"This is the way we brush our teeth,
brush our teeth, brush our teeth.
This is the way we brush our teeth
so early in the morning/ so late in the evening."
The ABCs. Once toothpaste was put on the toothbrushes, she picked up hers, I picked up mine, and we brushed our teeth together as I sang the ABCs. I told her that we would see how many letters we could sing so it became a game, and also allowed her to keep the toothbrush in her mouth longer than she really wanted it to be there. Each time I sang a letter was a stroke on a tooth, from the gum, to the tip of the tooth.
Celebrate when it's time, as a surprise. When she got to Z we had a toothbrush party and invited her father and brother to join us in celebration. We, as a family, brushed teeth together. With one sink, it was quite a funny challenge.
Toothpaste type: flavor, texture, bite. I should add that we used organic toothpaste/natural toothpaste so that the biting, intense experience of commercially available toothpastes would not be a reason for her to avoid brushing her teeth.
Outcome. As her ability to tolerate foreign object (toothbrush) and taste/sensation/texture (toothpaste) increased, her oral defensiveness declined. And by the time she was four years old, she and her brother were brushing their teeth side by side, and he was telling her what a good job she did, learning to brush her teeth!
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