Going to the Dentist

Going to the dentist can be stressful and scary for any child or parent. Many parents of autistic children find themselves avoiding the dentist for a variety of reasons (e.g., sensory sensitivities, behavioral concerns, and long periods of time between visits; Faella et al., 2022). The American Academy of Pediatric Dentistry and the American Academy of Pediatrics recommend that children visit the dentist by the age of one, or within six months of their first tooth coming in. Having an infant check-up and continuing with checkups can help prevent many potential problems (AAPD, 2023).

Children with autism show worse oral health than their peers. They have an increased risk for cavities due to their preferred diet of soft, sticky, or sweet foods, packing and storing foods in their mouths, and difficulties with brushing their teeth on a regular basis. In addition to being at an increased risk for cavities, children with autism also often experience barriers to accessing dental services who are comfortable and confident providing services to autistic children, or children with disabilities broadly (Bien et al., 2011; Faella et al., 2022; Narzisi et al., 2020). 

As parents, there are several strategies you can use to support your child and their dental provider in having a successful and positive experience. First, it can be beneficial to seek out pediatric dentists who have experience in working with children with disabilities, have information related to special needs accommodations they can offer listed on their website, or when you call to make an appointment seem invested in listening to and implementing some of your recommendations that are effective with your child (Nazisi et al., 2020). Although not an extensive list, these two providers are located in the Ann Arbor area and meet these criteria. 

Ann Arbor Pediatric Dentistry:   https://www.annarborpediatricdentistry.com/ 

Blossom Pediatric Dentistry & Orthodontics: https://www.blossompediatricdental.com/

In preparation for your child’s dentist appointment, it can be helpful to organize potential helpful tips for the dentist. Things like your child’s sensitivity to loud noises, giving more praise and support when looking at the back teeth, taking breaks, speaking with simple kid-friendly terms, or giving regular reminders of the reward available at the end of the appointment can be helpful information for the dentist. It can also be beneficial to request if it is possible to visit the dentist’s office prior to the appointment to meet the staff and familiarize yourself and your child with the environment. Finally, reading stories about the dentist and providing your child with a brief explanation of what to expect can promote relaxation (Nazisi et al., 2020; Udhya et al., 2014).

Recommended books: Curious George Goes to the Dentist, Peppa Pig: Dentist Trip, Elmo Visits the Dentist, Show Me Your Smile!: A Visit to the Dentist (Dora the Explorer), Just Going to the Dentist (Little Critter), and The Berenstain Bears Visit the Dentist

While at your dental appointment, it can be helpful to provide your child with a visual schedule of what to expect (images, or with an app) that you review throughout your appointment. Support your child and dental provider by recommending the use of a show-do-tell method (e.g., show the tools that will be used, model (do) the action, and explain (tell) in simple terms what is happening) or even model procedures on you as a parent before your child. You can bring distractions such as preferred videos, comfort items, and music to play for your child. Another strategy that is recommended is the use of selfie mode on your device to allow your child to see the procedures being performed. This can promote relaxation for some but is also beneficial in developing skills related to keeping teeth clean. When challenging or disruptive behavior occurs do your best to ignore and give praise statements around all of the positive behaviors your child is engaging (e.g. ignoring yelling while giving praise towards bravery and being seated). Bringing your child’s alternative augmentative communication device to dental appointments allows for channels of communication between the provider and the child directly, enhancing their rapport and relationship. Finally, identifying a high-value reinforcement activity or object that can be provided at the end of the visit; it is helpful if the dental staff is able to provide this reward (Faella et al., 2022, Nazisi et al., 2020; Thomas et al., 2018; Weil et al., 2010). .

Visual Schedule Applications: ChoiceWorks 

Once you are home from your dentist appointment you can review the photos you captured of the appointment to celebrate the child’s success, and potentially use these to create an individual story that you can review regularly to prepare for future appointments (Faella et al., 2022).. To maintain good oral hygiene your child can use visual supports such as images, videos, or dental applications that break down steps to good teeth brushing. Finally, it is important to promote drinking water throughout the day and being conscientious of your child’s diet (Nazisi et al., 2020).

Applications for Oral Hygiene: Dental DJ, Children’s doctor: Dentist, Disney Magic Timer by Oral B, and Chomper Chums

References

Bien, L., Milano, M., Roberts, M.W., & Hooper., S.R. (2012). Unmet dental needs and barriers to dental care among children with autism spectrum disorder. Journal of Autism Developmental Disorders, 42, 1294 – 1303.

Fallea, A., Zuccarello, R., Roccella, M., Quatrosi, G., Donadio, S., Vetri, L., &Cali, F. (2022).  Sensory adapted dental environment for the treatment of patients with autism spectrum disorder. Children, 9, 393 – 400. 

Narzisi, A., et al., (2020). “Mom let’s go to the dentist!” Preliminary feasibility of tailored dental intervention for chidlren with autism spectrum disorder in the Italian public health service. Brain Science, 10, 444 – 463. 

Thomas, N., Blake, S., Morries, C., & Moles, D.R.  (2018). Autism and primary care dentistry: Parents’ experiences of taking children with autism or working diagnosis of autism for dental examinations. International Journal of Paediatric Dentistry, 28(2), 226 – 238

Udhya, J., Varadharaja, M.M., Parthiban, J., & Srinivasan, I. (2014). Autism disorder: An updated review for pediatric dentists. Journal of Clinical and Diagnostic Research 8(2), 275 – 279.  

Weil, T.N., Inglehart, M.R., & Habil, P. (2010). Dental education and dentists’ attitudes and behavior concerning patients with autism. Journal of Dental Education, 74(12), 1294 – 1307