For a child with autism, a routine visit to the dentist can be an overwhelming experience filled with strange sounds, bright lights and unfamiliar faces. But there are many ways that parents can prepare their child with autism for that visit to the dentist, says Ahmed El-Maghraby, D.M.D., M.P.H, FAGD, Clinical Care Coordinator at the Midwestern University Dental Institute in Downers Grove. He trains future dentists to care for the unique needs of children with autism.
“Because autism involves sensory issues, a visit to the dentist can often cause sensory overload,” says Dr. El-Maghraby. “There are new people, unusual textures, someone touching their face, gloves in their mouth. All of these are a lot of new sensory experiences that can create a challenge, so it’s important for parents to prepare their child for success.”
It’s quite possible that your child had their first visit with the dentist at a very young age, but by now, it’s probably a distant memory. If this is the case, don’t assume that your child will remember sitting in the dental chair. Instead, take some time to prepare your child for the experience.
A child who is already accustomed to brushing their teeth may be more amenable to letting dental staff look inside their mouth, and that’s a big win, Dr. El-Maghraby says. But what else can parents do before the visit? Here, we share Dr. El-Maghraby’s tips for preparing their child with autism for a successful and low-stress trip to the dentist.
Start with a story
Where appropriate, parents can prepare their child for that visit to the dentist by putting the appointment on the child’s visual schedule and highlighting the visit in conversations leading up to the day of the appointment.
“You can say, ‘On Wednesday, you will go to school, on Thursday you will have speech therapy and on Friday you will visit the dentist,’” says Dr. El-Maghraby. Allow enough time for your child to recognize the event and answer any questions they have using positive language. Be sure to schedule the appointment so it doesn’t conflict with any favored activity like a special class they enjoy.
If you use social stories to acquaint your child with visits to the barber, doctor, library or other community scenarios, using a social story about visiting the dentist is a great way to share what the experience will be like while putting your child into the story. You can also read books together that describe the experience.
“A children’s book will project good imagery about what is going on. It will illustrate how you will go to the office, wait in the waiting room until your name is called, walk into the examination room and meet the dental assistant, and sit in the silly chair that goes up and down,” Dr. El-Maghraby explains. “The office may even send you a detailed history package ahead of time so they can gather information about your child, and some offices will send a book that you can read together.”
Loop in your child’s ABA therapist
Be sure to share with your child’s ABA therapist that they will have a dentist appointment soon and ask for their help in preparing your child. “The ABA therapist may have toy tools that your child can touch, a flashlight to show them what the lights might be like and even putty they can use to explain orthodontic impressions,” Dr. El-Maghraby says.
Just as your child’s ABA therapist will be working to desensitize your child, you can help by asking the dental office if you can bring your child in once or a few times prior to the visit. “This can help your child get over that fear and make the experience less overwhelming for them,” he says. “It’s helpful if they can come into the office, have a tour, sit in the chair and see if they can tolerate having the lights in their face.”
Because it’s reassuring for some kids with autism to know what — and who — to expect on the day of the visit, get a list of office staff, complete with pictures if you can. Or view this information online and talk about who your child might meet.
Share as much information as you can
Dental offices know how to accommodate the preferences of their patients, so don’t be afraid to share small details about your child to make the visit more successful. If your child prefers fruity toothpaste, or likes to wear sunglasses and headphones, this is all good information to share with the staff prior to the visit. Does your child like to have the TV on for distraction or is irritated by the noise? Let them know.
Ditto regarding any rewards they may offer kids for a job well done. If your child prefers dinosaurs to stickers, tuck a dinosaur into your pocket and give it to the dental staff to present to the child, if you think it will leave a good impression.
For some children, modeling the experience first is helpful. “Maybe the dentist can bring in mom or a sibling to have their exam and cleaning done first so the child can watch what happens,” suggests Dr. El-Maghraby. If your child likes the feeling of being under a weighted blanket, ask the dental office if they can try using the heavy lead X-ray vest during the exam and cleaning.
While it’s sometimes more helpful for a parent to be in the same room, help the dentist do their job by stepping back. “When a child is with the dentist, it’s important for there to be one authority in the room. Let that person be the dentist, and let the dentist bring you into the conversation,” he says.
Practice good oral hygiene
Help your child have a relatively easy visit by paying attention to their dental health throughout the year. “Prioritize brushing their teeth and celebrate the small victories,” says Dr. El-Maghraby. “If your child is not comfortable with having their teeth brushed, keep trying. When they can tolerate one second of brushing, work up to three seconds, then the whole lower side, and eventually introducing toothpaste. At the very least, try to wipe their mouth with gauze to clean their teeth.”
A diet with only very occasional sweet treats can help, too. “Don’t reward your child with sugar and candy or a second scoop of ice cream. A good diet can help prevent cavities from even happening,” Dr. El-Maghraby says.
Finally, always speak about dental visits using positive language. Set the expectation that your child’s appointment will be a good experience through lots of positive talk.
“We see kids who have never been to the dentist before come in already scared because of the way their parents talk about their own experiences,” Dr. El-Maghraby says. “Always remember to tell your child that they will have fun, that the dentist and staff will be nice, that they will count their teeth and then they will get a treat.”
Learn more about the Midwestern University Dental Institute at www.mwuclinics.com