Avoiding Meltdowns at the Dentist: Tips for Parents of Kids on the Spectrum

"My  son would rather have a mouth full of cavities - and the pain that goes with it - than go to the dentist. Are there ways to help a child with high functioning autism to become less fearful of dental work?"

Young people with ASD level 1, or High-Functioning Autism, have the same rate of dental problems as the general population. As hard as it is for most kids to go to the dentist, it’s even harder to have a positive dental experience for kids on the autism spectrum. Even so, there are some things you can do to improve the dental experience for your child.

Below are some tips. Some will work - some won't. But everything here is worth a try:
  1. Visit the dentist’s office before an actual visit.
  2. Have the child touch the equipment.
  3. Explain to the child what will happen.
  4. Have the child bring a comfort item like a favorite toy or blanket.
  5. It is a good idea to have a gradual and slow exposure  to the environment of the dental office so your child doesn’t get frightened by the experience.
  6. Make sure you tell the dentist how best to handle your child.
  7. Tell the dentist what works and what doesn’t work when working with your child.
  8. Remind the dentist that children with ASD are more easily overwhelmed by an overload of the senses, which can over-stimulate the child.
  9. Ask that the dentist keep the chaos in the office to a minimum.
  10. Make the child’s first visit to the dentist positive and short; have the dentist count the teeth or something else innocuous.
  11. Ask that the dentist approach the child as quietly and as non-threatening as possible.
  12. Have the dentist explain everything to the child and show the child what’s going to happen before actually doing it.
  13. Praise the child for acceptable behavior and have the child sit in the dental chair for awhile so he/she can become accustomed to it.
  14. Kids with ASD want to know what’s coming next without having to be surprised, so have the dentist tell the child where and why he needs to touch the child, especially if you’re dealing with dental equipment.
  15. Ask that the dentist talk calmly and avoids words that have double meanings; these children take everything literally, so it’s important to say exactly what you mean.
  16. Ask the dentist to start the exam using only his/her fingers.
  17. Ask the dentist to avoid shining the light in the child's eyes.
  18. Using a toothbrush to examine the teeth is a good idea because it’s a safe, familiar item. The dentist can use a dental mirror after that.
  19. Ask if you can hold your child’s hand during the dental examination.
  20. Anything that is familiar will make for a good experience.
  21. Some autistic children respond well to being lightly wrapped in a small blanket during the examination. In other cases, the child will need sedation or will need to undergo general anaesthesia in order to accomplish any significant dental work. General anaesthesia is especially important in older children that don’t respond well, even to light sedation.
  22. Lastly, you may want to have your child view the social story in video format below and see if it might help alleviate some anxiety as it relates to dentist visits. This is a true story told by an autistic child himself.
Good luck!


•    Anonymous said... A pediatric dentist. An ultrasonic toothbrush to minimize need for dental work. Alpha-Stim for anxiety.
•    Anonymous said... find a hygenist and dentist that will take the time to work with your child not against them
•    Anonymous said... I agree find a dentist & hygenist that are willing to take the time that's needed with your son. We were referred to a pediatric dentist who specialized in special needs children...let's just say that this man shouldn't be allowed to work on ANY child. We had far better luck with a local dentist who was up for the challenge
•    Anonymous said... I found a dentist that specializes in special needs patients, and that was very helpful for my son. Hopefully you can find one in your area. good luck.
•    Anonymous said... I was terrified of the dentist when I was younger so was determined my son wouldn't be like me ( obviously didn't know until later he was an aspie ) I took him with me each time I went to the dentist from a baby and the dentist always looked at him at the same time so he doesn't have the fear. I do actually pay now though as he is no longer nhs but my son doesn't want another dentist xxx
•    Anonymous said... It will depend a lot on having a good dentist that will set him at ease. My daughter's dentist can do whatever he needs to do because he built up the trust with her first.
•    Anonymous said... My 6 year old son just had fillings done yesterday! I was really surprised how well he did!! He had the "conscious/twilight sedation" but he was pretty much awake the whole time. He drifted in & out, but did AWESOME!! See if you can find a dentist that does that type of sedation. Just be careful that he doesn't bite/chew on his lip when he is numb afterwards. My son has a very sore fat lip now.....but other than that he did great!! Best of luck!!
•    Anonymous said... My 6 yr old ASD son is so disturbed by having his face and mouth touched that every time we brush teeth it is a big struggle. He developed 3 cavities from it and when we tried to have his regular dentist feel them he had the biggest meltdown of his life. Eventually the dentist had to make a referral to the local children's hospital to have him put under, so that the cavities could be fixed. What an ordeal. Yet, he still fights me on brushing his teeth.
•    Anonymous said... My son does well with the laughing gas but we've found his issue is the noise of the tools. We also now let him listen to his MP3 or IPod while he's getting work done and life seems to be much easier.
•    Anonymous said... My son hates being touched by doctors and the dentist. Positive reinforcement, reassurance helps. My 9 year old goes to a pediatric dentist that is very good with him.
•    Anonymous said... When my Aspie son was 10 we finally got referred to the children's hospital dental clinic. We had a lot of major work done with the amazing skills of the staff there. My son found the "laughing gas" helped him relax. After many appointments the dentist kindly told my son that he now needed to learn to go back to a regular dentist, as many children were waiting to get into the children's hospital for dental work. We have been able to go to our family dentist for regular check-ups and cleanings for the last few years. It seems his positive experiences helped him change his outlook. Good luck finding the right dentist to help your son.

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