Today was the first time I had taken my 5-year-old son with Autism Spectrum Disorder to the dentist without either my husband or his ABA therapist. In the past dental visits have been very challenging. However, I am thrilled to report this was the best visit ever! If your child on the autism spectrum struggles at dental appointments the following tips may help.
Why Children on the Autism Spectrum May Struggle with Dental Visits
Dental visits can be overwhelming for many children, but for children on the autism spectrum, these appointments present a whole new set of challenges.
Children with autism often have sensory sensitivities. The bright lights that shine in their faces, the sensation of the instruments such as the tooth polisher, air/water syringe, and suction device, as well as the tastes of the paste and other treatments can cause sensory overload. These children often lack the ability to be still for long periods of time, especially when they are uncomfortable. In addition, many of them lack the communication skills necessary to understand what is happening or to share how they are feeling. The whole process can be scary which may lead to them not complying with the dental staff making their job nearly impossible.
These are just some of the reasons why many parents of children with autism may avoid taking their child to the dentist. This is especially concerning because children with autism often also struggle with proper daily dental hygiene. So not having regular dental visits to have their teeth monitored can cause children with autism to have poorer dental health than their neurotypical peers.
What Can you Do to Help
It has taken a couple of years for us to get to today. The first time I brought my son to the dentist he was so confused about what was happening. He fought the hygienist and nearly bit the dentist when he tried to count his teeth. But that was then, today we finally crossed the threshold! Here are some things that have helped my son get to this point, maybe some of these suggestions will help you help your child.
Prepare in Advance
- Watch Social Stories on YouTube about dental appointments.
- Do your research. Ask other parents of autistic children for recommendations. Search online for pediatric dentists that offer services for special needs children. Some offer early appointment sensory-friendly environments with low lights and fewer distractions.
- Call ahead and ask the dentist office if you can bring your child in advance of the appointment for a tour and for the hygienist to show them the instruments and demonstrate what they will be doing.
- Roleplay going to the dentist at home. Purchase an inexpensive dental mirror and have your child lay down and practice keeping their legs and arms still and mouth open while you look at their teeth. It may help to use a timer and gradually increase the time you role play dentist.
- If your child attends ABA therapy, ask the therapists for their help in preparing them.
Booking the Appointment
- Tell the dentist office your child is on the autism spectrum and ask if they have a hygienist that works well with these children.
- Be sure to book a day and time where your child is the calmest and avoid times when they may be tired or irritable.
- Request a private treatment room. Some dentist offices have pediatric treatment chairs in clusters and some in private rooms. The fewer distractions possible will help the visit go more smoothly.
The Day of the Appointment
- Have a reinforcer for your child for after the appointment. Maybe a wrapped new toy or the promise of a trip to the park. Pick something highly motivating for them to get them excited about the appointment. Remember, reinforcers are meant to be faded out over time, so using these, in the beginning, is a great way to build motivation.
- If your child has a behavior therapist, ask if they can attend with you.
- Ask the hygienist’s name and dentist’s name and introduce your child to them, so they feel comfortable. Encourage them to spend a few minutes speaking to your child before they begin working on them.
- Ask the hygienist and dentist to tell your child at each step what they are going to be doing and to show them the instruments. These children often don’t respond well to surprises. Knowing what is coming often helps decrease their anxiety.
- Take pictures of each step of the process so you can use your photos and create your own social story to prepare your child for the next visit.
- If it isn’t going well, it is okay to ask the hygienist or dentist to stop. You are the expert on your child. If you believe it is going downhill, you want to end as positively as possible, even if that means skipping a few teeth from getting cleaned. Hopefully, it goes better the next time!
After the Appointment
Regardless of how well the appointment goes find something to praise your child about the visit and offer the reinforcer for that. The more positive your praise, the more chance of improvement over time.
After today’s appointment, my son was so excited to show his dad his new PJ Masks toothbrush he got at the dentist as well as the PJ Masks character he got from mom (his current highly preferred show!). He also was so proud when we showed dad the pictures of each step of his dental cleaning.
They sure come in handy when you smile, so keep your teeth around for a while. – Dr. Suess
Special Thanks to Ashley, CDA and Dr. David Donald, D.D.S, P.A. of Children’s Dentistry of Longwood, Florida.