If you or a family member is on the autism spectrum, you are aware that seemingly mundane, ordinary tasks can become complicated when you are also managing autism and its manifestations. A visit to the dentist, which could provoke anxious feelings in anybody, can become a near crisis for our patients with autism.
But just because something is difficult doesn’t mean it’s impossible. Every person needs regular dental care. Moreover, prevention is far more effective than crisis treatment in both primary health care and in the oral health milieu as well.
What can you do to help make visits to the dentist an easier experience when there are special circumstances? Here are some ideas:
· Communicate with your dentist and their staff prior to making any appointments.
· If you are making an appointment for a loved one with autism, be sure that the dentist and her staff understand the scope of their behaviors. Do they communicate effectively? Do they react to verbal and social cues? Do they have any repetitive behaviors? How do they perform their oral health maintenance at home? Do they have any particular sensitivities (to noise, to bright lights, to tastes or textures)? How do they respond to being touched? Are there parts of the face or body where they are more open to touch than others?
· Schedule a “pre-appointment” where the patient comes, checks in, sits in the chair, meets the dentist and her staff, gets to see the instruments (unless you think seeing the instruments would provoke anxiety) and ask any questions. During this time, the parent or caregiver should determine where he or she should position himself during the dental exam. Does the patient derive comfort from a constant touch on the part of the caregiver or is just being nearby better? Perhaps there need to be several pre-appointments before the “actual” appointment.
· Be sure that all elements of the pre-appointments and the actual appointment remain the same. Familiarity breeds contentment with this population. So, the person who welcomes the patient to the office and signs them in should be the same every time. The patient should go into the same examination room every time. The same staff should be working on the patient every time.
· Work with the dentist to deal with any sensitivities. If bright light is a problem, the patient will need to have dark sunglasses. If noise sensitivity is an issue, noise-blocking head phones will be necessary. If the patient is averse to crowds, then an appointment slightly before or after hours would be ideal.
· Consider alternatives, even if they seem silly. If the patient can’t tolerate the dentist’s chair, try the regular chair. It’s not ideal, but it could work.
· Consider breaking up cleaning and treatment appointments into smaller time blocks if necessary.
· Consider anesthetic medication if the treatment is vital and the patient cannot tolerate it.
Finally, it is imperative to work as a team with your dental health practitioners in order to improve the oral health maintenance at home. Depending on the severity of the autism, self-care like teeth brushing and flossing may be difficult and may require the assistance of a caregiver. Work with the dentist and her staff to learn tips for assisting, including the best standing and sitting positions for the parent or caregiver and even ways to increase greater self-care.