Dental Dilemma

By Maureen Bennie

Is there anyone out there who can honestly say they like going to the dentist? I recently went to mine for a cleaning that was six months overdue. Most of us dread the dentist. For the child with autism, it is a frightening experience because of sensory overload. My son’s first visit to a pediatric dentist remains one of the worst things I’ve had to endure with him yet. My son fainted at one point after half an hour of screaming. The dentist had me pin his head in between my knees. There was something inhumane about the whole appointment. Vowing never to have a repeat experience like that one, I set out to make a trip to the dentist less of a dilemma.

The first step and most important is to take away the unpredictability of the dental visit. There are two ways to achieve this – by creating a social story and letting your child see the dentist’s office before you go to the actual appointment. The social story walks the child through the dental visit step by step. Start with a photo of the outside of the building. This can be the title page -” (Name) Visits the Dentist”. Photograph the elevator or stairs and then the door to the office. Get pictures of the staff in the order the child will meet them: receptionist, dental hygienist, and dentist. Snap pictures of the waiting area and perhaps some toys that might amuse your child. There are a few fun moments at the dentist and you need to play those up.

Show what the dentist’s chair looks like and the light above it. Do children get a toy at the end of the appointment? If so, get a picture of some of the choices. At the end of the social story, have a picture of some type of reward for the dental visit. My son will do anything for McDonald’s fries so the final page of his story is an empty McDonald’s fries bag.
Make sure your first time to the office is simply an exploratory one. Let your child play in the waiting room and get used to the area. Pre-arrange your visit so a receptionist can take you on a mini tour. Let your child sit in the dentist’s chair and tell him/her the dentist will simply count his/her teeth at their first appointment. Practice what that will feel like. Walk through the basic steps of a visit – checking in with the receptionist, waiting, then being called to sit in the chair.

Ways to prepare at home for a dental visit are try tooth brushing. We started with a washcloth on our finger and ran it around the surface of our son’s teeth. We later moved to a toddler toothbrush with no toothpaste on it. Since our son loves numbers, we would count to ten while moving the brush around. Next we added paste. Now he moves the brush around his mouth by himself while we count to ten. If our son is resistant to brushing his teeth (this goes in phases) we use the PEC symbol for tooth brushing. A PEC symbol is a drawing of the activity that you want your child to do. Because children with autism are visual, showing what you want them to do rather then telling them is often more effective in getting the response you want.

As for choosing a dentist, shop around. Try to find a pediatric dentist or one that has experience working with children. Phone the office first and explain the situation to see if they can accommodate your wishes for a pre-visit and perhaps several visits to see the dentist before an actual exam takes place. Ask other moms who have an autistic child what dentist they see. We found our Calgary, Alberta pediatric dentist, Dr. Brad Krusky, through another mom. He has been supportive in accommodating our needs in order for our son to have a successful visit. We had to do five visits with Marc sitting in the dentist’s chair and Dr. Krusky counting his teeth before Marc would submit to a full exam.

In the end, patience paid off. There are no more tears and meltdowns at the dentist’s office. I certainly have not had to endure a repeat performance of the first dental visit. When should you take your child for the first dental visit? Around three years of age, after the baby teeth are in. The social story and pre-visits may sound like an extra hassle, but you will be glad you did them when you have a worry-free successful trip to the dentist. A positive first experience will lessen the chances of a stressful visit in the future. Remember, with autistic children preparation and predictability are the keys to success. Happy brushing!

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