Many children struggle with the idea of going to the dentist, but for children with autism, a trip to the dentist’s office can create severe anxiety and even panic.
Here are some simple suggestions that may ease stress levels and make your dental visit a success.
1. Visual Schedules
A visual schedule is a great way to keep your child with autism organized and focused. It can show your child how many more days he/ she has before a dental appointment.
A visual schedule can also assist children in becoming independent with remembering to brush their own teeth, for example.
A posted visual schedule on the refrigerator in the kitchen, bathroom, or in your child’s bedroom can be a great way for your child to be reminded to brush and floss his/her teeth.
Older children can also have daily reminders programmed into their cell phones to keep them organized.
2. Task Analysis
Many children with autism struggle with multi-step instructions. Even the simple act of brushing or flssing his/her teeth can appear complex to a child with autism.
Breaking the process down into smaller steps will allow your child to experience success chaining together these steps. The steps can be laminated and posted in the child’s bedroom or bathroom at home.
They can also be downloaded to his/her cell phone or iPad for use at school. This allows for generalization of these new skills between the home and the school with minimal prompting.
Many parents of children with autism are well aware of the use of edibles to reinforce their children’s behavior. However, edibles do not always have to be presented in the form of candy, cookies, or pop.
Healthier substitutes such as popcorn, sliced fruit or vegetables, or crackers can be offered. This will assist with reducing sugary snacks. Healthier snack foods can also assist with reducing the need to see a dentist.
4. Expert Dentist
Parents of children with autism can be excellent sources of information when it comes to locating a dentist with experience working with children who have special needs.
Some dentists have specialized training or experience dealing with children with various challenges. Parents can share with you the experiences they have had with certain local dentists.
Before scheduling the dental appointment, inform the dentist that your child is on the spectrum. Talk about specialized needs and how they can be addressed during the child’s dental appointment.
Various options and treatments can be discussed and explained. This may also include the use of sedation anesthesia to keep the child calm during a dental procedure.
Finally, let the dentist know what medications your child with autism is currently taking or any allergies. This will all be important information for your dentist to have.
Some children with autism do not transition well to new environments and may have trouble interacting with new people. Advocate for your child by explaining this to your dentist.
Inquire if your child with autism can visit the office prior to the actual dental appointment. This way your child can meet the dentist, sit in the dental chair, see some of the equipment that will be used, ask some questions, etc.
This might assist with reducing some of the anxiety the child with autism is encountering.
6. Social Stories
Parents and teachers can work together to create a social story about a dental appointment or procedure. Stories can be read or reviewed both in the classroom and at home.
A well-written social story can assist the student with what to expect during the dental process. He/She can learn that the dentist is a trusted professional who will attempt to cause them no pain.
7. Sensory Needs
Every child with autism is different and will demonstrate different sensory needs. Some children may become frightened by the sound of the drill during a dental visit.
They may need to wear headphones to block out the sound of the drill or to listen to their favorite music to relax. Others will be bothered by the lights during the visit and need to wear sunglasses.
Preferred items are important to children with autism. They may want these items with them during their dental appointment. These items could include a stuffed animal, fidget, iPad, baseball card, cell phone, or even a photo of a family member.
Some children with autism may also request a weighted blanket be placed across their laps or to wear a weighted vest. All of these sensory items may bring them comfort.
8. Communication Needs
Just as every child with autism may demonstrate different sensory needs, so too will every child display different communication modalities.
When stressed, some children may become extremely quiet, have selective mutism, hum, or attempt to rock back and forth. Others will become “hyperlexic” and begin talking a mile a minute.
There are even children with autism who are considered nonverbal and not able to voice their levels of discomfort or pain. Parents may need to advocate for their children by examining and interpreting their facial cues and body language.
Some children use American Sign Language (ASL) to communicate. The dentist may mistakenly identify your child as deaf, and this will need to be explained to him/her.
Finally, there are also students with autism that use a communication board such as the Picture Exchange Communication System (PEC), or an iPad with Pro-lo-quo to voice their needs.
Your child’s form of communication may require you to advocate to be in the same room with him/ her during the dental process to interpret for his/her communication needs.
9. Preparing for After Care
Work with family members and school personnel on the possible restrictions after various dental procedures.
If a student with autism gets braces and likes to chew gum, then he/she may need to be prompted to chew sugar-free gum as a substitute. He/She may also have to transition to a different edible.
One of our older students with autism had all four of his wisdom teeth extracted during a single dental procedure. His preferred food item was popcorn.
When he returned to the classroom after his dental surgery, his mouth still had stitches in it. One of his Independent Learning Tasks at the time was to follow a task analysis to learn to make his own microwave popcorn.
Once he returned to school, we immediately realized that eating the popcorn could be dangerous to him and tear his stitches.
However, not following the daily task analysis for making his own popcorn could throw his schedule for the day “off and cause the student to act out.
We tried many substitute food choices such as ice cream, pudding, soup, and Popsicles. However, the student did not like any of these new choices.
Prior planning and working together with parents, school personnel, and the dentist can assist with keeping such situations from occurring.
Making the visit to the dental office positive for your child with autism is a definite possibility that everyone should aim for.
10. Prevention and Modeling
The best suggestion for dealing with the dentist is not to have a reason to visit one. Parents can assist with non-dental visits by modeling a healthy diet and good oral hygiene for all members of the family.
Avoiding cavities, filings, or root canals, etc. will reduce both your stress and the stress of your child. However, even with the best possible diet and oral hygiene routine, your child with autism may still need to have his/her teeth cleaned, have wisdom teeth removed, or even get braces.
Ron Malcolm, EdD, is an assistant director of special education for a public school district. He is also an associate faculty member at the University of Phoenix and a special graduate faculty member at the University of Kansas.