Going to the Dentist

Good regular oral care is the best way to keep and maintain oral health. It is known that children and adults are at increased risk of cavities if they have a preference for soft, sticky, sugary foods. Furthermore, sensory aversions common are common for individuals on the spectrum which may interfere with regular tooth brushing and dental care. Some individuals on the autism spectrum have habits such as teeth grinding, clenching, tongue thrusting, licking and/or biting lips, pica, gum picking, and even head banging that make oral health a priority. Additionally, seizure medications and other medications prescribed to help control behaviors may have side effects that affect the mouth and oral cavity. Sometimes a newly begun behavior, such as head banging, may be evidence of a dental problem. For example, there are cases of individuals on the spectrum who have started head banging in an attempt to relieve pain caused by a tooth abscess. Attention to dental health is extremely important!

As in any service for individuals on the autism spectrum, the key to a positive experience is preparation. Often dentists will suggest a pre-visit to the dental office to familiarize the individual with the waiting room, the office, and the various staff who are there, and to anticipate what to expect. Pre-visits are very short and non-demanding, and the patient should leave the office with a good feeling about the experience. Social Stories™ about going to the dentist office can also be used to review and help the individual anticipate and become comfortable with what is to come. Perhaps your dentist will allow you to photograph his or her office and staff to make your own Social Story about your upcoming visit.

Whenever possible, your child's first visit to the dentist should occur between the ages of 2 and 3. Beginning early, when there are fewer teeth to clean and check will help to give your child a positive first impression of the dentist office.

When it is time for the individual to have a check-up or dental procedure, it is sometimes best if the visit can be chopped up into multiple visits. Many individuals on the autism spectrum better tolerate multiple short visits, rather than one longer one. Of course, this needs to be determined on an individual, case by case basis. Parents and caregivers know their children best, and their opinions play an important role in making up this part of the dental plan.

Pediatric dentists and special needs dentists use many techniques to help individuals know and understand what is happening during the dental appointment. These include "tell-show-do," whereby the dentist first tells the patient what he or she will do, then goes on to show the patient what he or she will do, including allowing the individual to hold and handle the instruments, before conducting that part of the examination or procedure. Dentists may allow the individual on the autism spectrum to manipulate the tools or maneuver the chair, thus allowing the patient to become more comfortable in the environment. Some individuals on the spectrum find the dental chair frightening and instead choose to sit in the operator's stool or in another chair instead.

Some dentist offices (particularly special needs dentists) are willing to alter the dentistry environment by making the exam room environment as inviting as possible, including having the individual's favorite show or movie playing, a preferred level of lighting and sound, and reduced dental odors, thereby encouraging positive associations with the visit to the dental office. Other individuals on the autism spectrum may prefer a completely quiet and low light environment or something else entirely. Once again, information from the patient's parent is most important to determine what is best.

The visit to the dentist will be most successful if the patient:

• is able to follow directions
• can sit still
• can cooperate with the dentist
• enjoys rewards

You can help to motivate your child to cooperate by providing whatever reinforcement is most rewarding to your child (for example, allowing the child to watch a favorite video on a phone or portable DVD player, high fives, shouts of hurray, stickers, or a small preferred toy).

Sometimes it helps if the individual brings a comfort item, such as a stuffed animal or a blanket into the office. A parent or caregiver sitting nearby or holding the patient's hand may be helpful. Frequent breaks for hugs might also help get through a visit to the dentist.

Those dental offices with staff who are willing to be flexible and listen to parents suggestions are usually the best offices to care for children with special needs. These are the best indicators for a successful dental visit and good oral health for children.

Every child will have a different requirement for preparation for a visit to the dentist. It's best to use the type of instruction that works best for you and your child. Family members know the individual on the spectrum well, they know his/her likes, dislikes, what is exciting, what is disturbing. They understand the best ways to approach the individual and must be part of the plan that will evaluate and treat the dental patient. Making the caregiver part of the treatment team is the best way to ensure success!

Recommended Link:

• CAR Resource Directory (Search For Dentists)

Additional Resources:

• Applied Behavior Analysis: Behavior Management Of Children With Autism Spectrum Disorders In Dental Environments
• Practical Oral Care For People With Autism, From The National Institute Of Dental And Cranio-Facial Research
• Dental Tool Kit, From Autism Speaks®
• Healthy Smiles For Autism, From The National Museum Of Dentistry
• American Academy Of Pediatric Dentists Website
• American Dental Association Website
• Mouth Healthy Website
• Going To The Dentist: A Social Story For Aspergers And Autistic Children (Video)
• Child's First Trip To The Dentist (Video)