Dental offices can be scary for children, with its unfamiliar sounds and smells and tastes. A first dental visit might challenge all five senses with unfamiliarity.
It is overwhelming for a child who has autism spectrum disorder (or many other kinds of special needs, like Down syndrome). For the parent of the child with autism, it might seem impossible.
How can you expect this of your child? How can you prepare? How do you manage expectations?
Time in the dental chair is part of good oral health for any person. The benefits to your child are worth it to get through that first visit and beyond —from preventing tooth decay to setting them up for a lifetime of dental health.
What makes dental visits hard with ASD?
The dentist’s office can be alarming to anyone (it’s one of the most common forms of anxiety), but the sensory experience in a dental office is particularly hard for kids with ASD.
For instance, the idea of having someone touch the inside of your mouth can cross many lines your child may not be comfortable with.
The bright lights can be disorienting.
The procedures may cause pain or sensitivity, which can create a poor mental picture of a dental team in a child’s mind.
This is a lot, but you can do it. With a few preparations, you can plan on happy and successful dental visits with your child. Be thoughtful about your child and their unique needs. Here is a list of ideas to get you started:
1. Choose the right dental office.
This might seem obvious, but don’t overlook its importance: choose the place.
Visit several. Get a feel for the office.
Is it friendly? Can you hear other appointments in the exam rooms? Do they have TVs for patients to watch during the visit? Can the TV be turned off? You will know a lot about a place as soon as you walk through the door.
The best pediatric dentistry offices for children with autism are those who advertise specifically for special needs patients. General dentists are capable of providing the right dental treatment, but many of them are simply not prepared to thoughtfully care for children with developmental disabilities like ASD.
2. Choose the right dentist.
You want a dentist who will work with you to provide the best dental care and overall experience.
Ask to meet the dentist before you schedule a dental appointment. Ask about their experience with children who have sensory sensitivities due to developmental disorders. Ask about their plans to make this work.
Ask anything you want to ask.
More than information, this visit will give you a sense of their openness to making the experience a positive experience for your child. You will know as soon as you start asking questions if they resent the questions.
If they resent being asked to provide extraordinary care, move on.
3. Ask questions — don’t just trust the buzzwords.
Look for the buzzwords, but don’t assume that they translate well.
Some dental practices advertise that they specialize in care for scared patients or patients who hate the dentist. Some say they are kid-friendly. Some say they treat patients like family.
It all sounds good, but push back a little.
Does “specialty care for scared patients” mean that they sedate patients using general anesthesia or other methods? Does “kid-friendly” mean TVs are blaring in every room?
There is nothing wrong with sedation or TV distraction, but neither will help your child to have a good overall impression of the place.
Much more important are features of the dental office such as a desensitization tour or the willingness to examine your child in the waiting room.
4. Prepare your child for what will happen at the visit.
Once you find the perfect place, start prepping your kid.
Start talking about all the things in a dental office long before you bring them. Give them a chance to get used to dentistry.
Talk about their five senses. What will they see? What will they smell and hear? What will they taste? What will they feel?
Get specific. “When the dentist looks at your teeth, she may want to count them. She will wear a glove and use her finger to touch inside your mouth.” You can show your child what this will look and feel like.
Consider asking the dentist for a glove (not all medical gloves feel the same). Using the exact gloves that they use in the dental practice is one way to avoid unnecessary surprises.
Ask if you can make a video in the office before your child visits. It doesn’t have to be fancy — what you’re looking for is a short video walk-through. Give your child a way to familiarize the look of the place without sounds, smells, and taste.
Specialty dental offices may offer samples of products you can use with your child at home that he or she will see and feel during the visit.
5. Don’t force anything.
When you finally get there with your child, don’t force anything. If your child wants to leave immediately after arrival, just stay long enough to say hello and spread some joy.
You want the office to be a pleasure.
Maybe buy stickers for him to distribute. Mostly, this is a tool for him to meet the dental professionals on his terms, in his way, at his speed. Maybe let him pick his exam room for next time. It’s going to be easier next time if this time was low pressure and fun.
Don’t stress about getting the actual exam. It’s ok if it doesn’t happen!
Not all dentists will, but it’s worth asking if your dentist will consider doing the exam in the waiting room.
Some offices offer desensitization tours, in which your child can tour the office, choose his/her preferred treatment room, experience the sights and sounds, and meet the staff without an actual procedure or treatment.
From Mark Burhenne, DDS: This, I find, works best! I even had the whole family come after hours and hang out while I was doing paperwork. Unstructured play in the office for these wonderful kids seems to really work best.
You may also want to look for an office that uses a sensory-adapted environment. In some cases, this is known as the Snoezelen method. Gentle music, dimmed lights, and sensory-conscious techniques are used to reduce the senses overload.
Talk to your dentist about training good oral hygiene habits with your child, such as toothbrushing, how to floss, what toothpaste to use, and other ways to practice good oral care.
6. Accessorize with familiarity.
Bring his favorite headphones. Noise-canceling? Overhead or earbuds? Bring his sunglasses. Does he use a fidget? Bring it.
Other items to consider bringing:
- Blankets
- Stuffed animals
- Pets
- Pillows
- Favorite toy
- Friends
Dr. Burhenne once had a patient bring their pet snake, which comforted him to hold during a filling!
Bringing a child who has autism to the dentist is likely to be a challenge. It doesn’t have to be impossible.
Take your time. Plan. Give your child space and time. Set him up for success by facing each sensory concern directly and specifically. Aim for happiness and expect success.
7. Practice Cavity Prevention at Home
Ultimately, procedures to fix cavities and other oral disease will always be more uncomfortable than prevention strategies, such as routine cleanings.
Teach your child how to brush his/her teeth, address mouth breathing with their healthcare team, and do your best to watch dietary habits that may lead to cavities.
One additional technique to assist your child going to the dentist is by using social stories. Social Stories are proven to be an excellent tool for helping children on the spectrum deal with new or unfamiliar social events.
You’ve got this!
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