Making Going to the Dentist Easier for Kids with Autism | Autism and Dental Care

Dr. Mary Barbera

Many kids with autism have a hard time going to the dentist, and since dental visits only happen one to two times a year it’s hard to work on this skill. So today I’m going to show you a video on autism dental care and talk about strategies you can work on to make going to the dentist easier.

Each week I provide you with some of my ideas about turning autism around. So, if you haven’t subscribed to my YouTube channel, you can do that now. Many children with autism, whether they’re 2 or 20 years old, if they have limited to no spoken language, they may exhibit problem behaviors related to going to the dentist or the doctor. Some will have trouble with nail clipping or any medical procedures, like blood draws, or tolerating you putting eye drops in their eyes or shots of any kind. These kinds of community outings, if you want to call them community outings, may have serious problems. A child may even have difficulty with tolerating haircuts, which shouldn’t involve any pain. I did a video blog on getting haircuts and making those go smoother a while ago, so you may want to check that out as well.

Parents may be okay with managing problem behaviors in the home, or even at a favorite store, but taking kids to visit the dentist or doctor’s office or for a blood draw may be extremely difficult. I do want to say that no matter what the age or the size of your child or client, you do not want to be holding kids down for these types of procedures. You don’t want kids crying during haircuts or dental visits or during blood draws, and holding kids down is not the answer. It’s not humane, it’s not appropriate, and as the child grows and becomes stronger someone will get hurt and it just usually backfires. While we’re going to be focusing on dental visits in today’s video blog, you will learn strategies that really do cross over all of these settings as well.

Autism Dental Care

The first step to improving your dental visits is always assessment. Has it been a while since you’ve taken your child to the dentist? Was the whole trip a disaster or were there parts that were okay? If you’re a professional, you may have a client, a parent, asking you how to improve or how to go to their first dentist appointment.

Whether you’re a parent or a professional, you need to recall, or have the parent recall, the steps of the last dental visit and write those steps down. If you can, after you write the steps down then you may want to write down which of those steps caused the problem behavior. For instance, did your child get upset on the ride there? Did he get upset when he saw the dental office or when you walked in? What happened when they reclined the chair, or the dentist came in, or when the dentist put the little mirror in his mouth to examine his teeth?

During the assessment also think about tooth care at home, because if the child has a difficult time tolerating tooth brushing they’re obviously going to have more issues probably at the dentist. Can they tolerate you brushing their teeth if they’re younger? If they’re a little bit older, can they brush their own teeth? Can they floss their teeth and do they do a really good job with tooth brushing? It’s important to assess if they have good oral hygiene as well. We may need to think about desensitization of tooth brushing before we worry too much about dental visits since tooth brushing occurs a couple of times a day versus a couple of times a year for the visits.

Dental Care Goals

After you get baseline data, you should make a goal for the child. Maybe the goal is to go to the dentist and be able to tolerate sitting in the chair, reclining it, having their teeth examined just very superficially. And maybe the goal isn’t anything elaborate like the child will tolerate getting a cavity filled. Because for some kids it may only be realistic that dental visits, at least for now, include an observation and not include scraping of the teeth for the plaque. Or cavities being filled. Because there’s a lot of variables, including pain and toleration of pain. These kinds of kids that can’t do all that may need to be put under anesthesia every few years for more invasive dental work. For some of my clients, this is true, especially for children who are not consistent in tolerating and reporting pain.

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Side Note on Fillings:

I learned over the years that the silver fillings actually have mercury in them. We should be getting white composite fillings in our children’s teeth. And in our own teeth as well. A lot of dental offices have phased out, or are phasing out silver fillings, but you may want to double-check.

Desensitizing Autism Dental Care

Okay, with that aside, we want to do the assessment and we want to make a realistic plan. And that plan, or that goal, could change. Maybe for now, the goal is