How to Prepare Children with Autism for Their First Visit to a Dentist or Specialist
Let’s look at how to prepare children with autism for their first visit. As we grow as a society and become more inclusive, more compassionate, health care providers like me are also recognizing the shortcomings of our training. A 2013 study indicated that around 60% of dentists don’t feel prepared to treat patients with additional needs. Much of that can be traced to inadequate educations. For now, perhaps the best we can do is strive to empathize with each and every one of our patients until more considerate protocols carve new paths for treatment.
Here on the eve of Autism Awareness Month, I thought I’d embrace the occasion by discussing how we—dental specialists and parents alike—can better prepare for a child’s first visit when they’re diagnosed with autism spectrum disorder, a segment of our society that’s all too often ostracized because we’re ill-equipped to communicate with them.
Lots of children, but especially those with autism spectrum disorder, experience a great deal of anxiety about visiting a dentist or a specialist, often because they have difficulty communicating their feelings. But the source of their anxiety can also be as simple as fearing the unknown.
For a child with autism spectrum disorder, or other developmental disabilities, feeling anxious is generally only one part of what can be an overwhelming experience that exposes their difficulty with sensory stimuli, communicating their wants and needs, understanding expectations, and cooperating.
Parents, already acutely aware of each of those vulnerabilities, tend to suffer under the strain of their own anxiety about the scenario—to the extent that they’ll avoid it as long as they can, understandably. Among parents of autism spectrum disorder, almost half describe their child’s dental health as fair or poor, according to a study in the journal Pediatric Dentistry.
The best solution for making all involved more comfortable is for the parent, child, and dentist or specialist to meet ahead of the visit. It’ll give the doctor an opportunity to become aware of the child’s needs and aids. The parent can identify potential stumbling blocks. And for the child, some of the unfamiliarity with the masked adult and the whole process can begin to be diffused. It’s a small step, but it’s a step in the right direction.
Potential dental concerns
Historically, patients with autism spectrum disorder have been reported to have lower rates of cavities than typical patients. They may, however, be at a higher risk than typical patients for developing some other dental concerns as a result of behavioral difficulties that make oral hygiene at home a challenge, a diet that runs high in sugar, or a manifestation of their symptoms. These concerns include:
- Bruxism (the habit of constantly grinding their teeth)
- An overgrowth of gum tissue around the teeth
- Severe, early periodontal disease
- Tooth anomalies related to the size, shape, and the number of teeth present in the mouth
- Accelerated, inconsistent, and/or delayed eruption of one of more teeth
Each of these concerns can escalate quickly, largely because of the patient’s difficulty in communicating their pain. Which underscores the importance of having your child examined by a dentist or specialist early on in their lives and on a consistent basis, daunting as that idea may sound.
Preparing for the first visit
As I mentioned, meeting before the first visit is a crucial step. Aside from what’ll be explicitly discussed, it’s also an opportunity for the parent to get to know some of the support staff around the office. While much of the attention will be devoted to accommodating the child’s needs, the parent shouldn’t be ignored in the process. Seeing how everyone’s working together should help stem any embarrassment that may creep up later on.
After the meeting, the doctor’s going to put a few things in motion ahead of the first visit. First, the parent will be emailed an initial intake form. By completing the form at home, it’ll minimize any downtime at the office later on.
The doctor will also obtain the child’s medical records so that she or he can begin planning how to accommodate any co-occurring medical or physical issues and then review those procedures with the hygienist who will be assisting with the exam.
For the parent’s part, try to discuss anything your child may have observed during the meeting. The more often those things are rehashed over the coming days, the more familiar they’ll become. Make the process as predictable as possible. Children consistently do better with a clear set of expectations.
You’ll also want to practice having your child sit still and maintain an open mouth, just as they will during the exam. If that’s not a possibility, ask the doctor about sedation. It’s become a bit stigmatized in recent years, but those fears are mostly rooted in general anesthesia. There are different degrees of sedation, and the most common for oral surgery allow the patient to remain somewhat awake. That said, the first visit is likely to be purely a visual exam.
Regardless of the strategy, remember that the goal is to establish a positive outcome.
If you’ve been referred by your child’s dentist to a periodontist or you’re concerned about any of the dental issues mentioned above, schedule a meeting with me here.