Preparing An Autistic Child for the Dentist

A trip to the dentist can be traumatic for an autistic child. Not only are there the usual fears associated with strangers who put their hands in your mouth, but there are also strange sounds, tastes and sensations, bright lights, and occasional pain. While trips to the dentist will never be a treat, though, there are steps guardians and dentists can take to prepare a child — and a dental practice — for a positive experience.

Tips to Make the Experience as Painless as Possible

• Guardians need to be aware that not all dentists are trained to work with kids on the autism spectrum. Pediatric dentists are more likely to be a good choice, but even then it's well worth your time to ask around for recommendations, interview the dentist, and visit the practice. Questions to ask include Do you work with kids with disabilities? How do you handle children's anxiety? Are guardians allowed to stay with their children? What do you do if a child's behavior makes dental work difficult?
• Evaluate the dentist's responses carefully. Ideally, the dentist should have experience working with children with disabilities, have specific responses to your questions about anxiety, allow guardians to remain with their children, and have appropriate responses to anxiety management. Note that strapping a child to a "papoose board" to keep them immobile — unless there is a major emergency — is not a reasonable approach to managing a child's anxiety! Though it may work for the moment, it is likely to increase anxiety for future visits.
• Print out or prepare your own picture book or Social Story, showing and telling what will happen in the dentist's office. Find pictures online, or take pictures in your own pediatric dentist's office. Read through the story often with a child before you take them to the dentist, and bring it along when you go (you can laminate it if it's likely to become damaged). Giving a copy of the story to the dentist and/or hygienist is also worthwhile, so they can use it with the child you bring in.
• Consider buying or borrowing some basic dental instruments so that the child in your care can see, touch and interact with them before going to the dentist.
• Think about a child's comfort or discomfort with various flavors. Our little one, for example, hates mint — but loves Tom's of Maine strawberry toothpaste. For several years, we brought our own toothpaste for the hygienist to use. It wasn't ideal for dental hygiene, but of course, it was far better than a sensory meltdown.
• If a pediatric dentist doesn't have a video screen available for patients, consider bringing along a portable DVD player and a child's favorite video. Distracting a child from their mouth can be a very potent tool for maintaining calm.
• If a child has a problem with bright lights or loud noise, bring along sunglasses and earplugs.
• Talk with a pediatric dentist and hygienist ahead of time, to get a clear sense of their office procedure. Will you need to wait in a room with a lot of kids and noise? Will the dentist or the hygienist see the child first? Be sure there are no surprises, and come prepared with the toys, foods, videos or other comfort objects the child will need.
• Support the dentist. While it's great to have a guardian in the room with a child during dental work, it's not especially helpful to have them flinching, second-guessing the dentist, or leaping up every two seconds. Unless something truly unacceptable is going on (like a child being injured, for example), it's best to be reassuring but passive. If, after the visit, you decide you don't like the dentist — simply don't return.
• Ask questions. While you're at the dentist with a child, it's fine to ask questions — and in fact, you should. If a cavity or other issue is found, get detailed information about how the dentist will treat it. If you're not sure about the appropriateness of a treatment for the child, ask for alternatives. It's important that you, as a guardian, feel in control and understand the options.
• Follow up with the dentist's suggestions, with the child's disability in mind. For example, if your dentist recommends an electric toothbrush, choose one that features a character the child loves. If the dentist recommends a fluoride rinse, choose one with a flavor the child enjoys (you can find plenty of flavors online if you search!). If the dentist recommends X-rays or sealants, learn about the procedures and prepare the child for pictures and practice ahead of time.

Tips

• Tom's of Maine produces natural fluoride toothpaste and rinses in a wide variety of flavors. It's worth checking their products for a flavor a child can tolerate.
• Earplugs made for airplane rides and headphones made to block sound can help a child cope with the noises of a dentist's office.
• Don't forget to bring along comfort objects that can help a child remain calm.