Autistic Children at the Dentist

[DAG]

Hi Everyone,
We took our son to the dentist today. David Jr is almost 5 years old and autistic. It really was a struggle to get Jr to sit still while the dentist looked in his mouth. He kicked, screamed, and cried the whole time...it was quite an event. Jr can't talk yet or understand everything we tell him, so that made the visit a bit more traumatic for him.

Anyway, the dentist says that JR has 4 cavities that need to be filled in the near future. He talked to us about using restraints and sedatives to try to calm Jr down while he filled the cavities. However, there is no guarantee that the sedatives will work.

We were curious if anybody has any advice or experience in this type of matter. We thought about not getting the cavities filled since eventually those teeth will be replaced by his adult teeth, but the dentist said that was not a safe idea.

thanks....appreciate any comments.

 

[mamaminnie]

Wow, that does not sound like fun for you, jr, or the dentist. Are you using a pediatric dentist? They are sometimes better at handling dcs in general. When my AS son needed a cavity filled they gave him nitrous oxide which really calmed him down and they were able to get all the work done and x-rays too.

I'd call around and find a peds dentist w/experience in SN kids--if there's a university near you with a dental school try thrm, usually those clinics are on top of the latest methods.

HTH,

 

[SueM in MN]

Instead of sedatives and restraints, a lot of dentists use a general anesthetic to actually put the patient out or gas (as was mentioned by the other poster) when dealing with people with special needs. It sounds a little drastic, but is much less traumatic to the patient since he is totally out or almost out, not just groggy.
If you like the dentist, I'd suggest talking with the dentist about your concerns and find out just what is meant by sedation and restraints. If your child is aware of what is going on, he will be scared and very reluctant to even go into the dentist office again.

 

[Tissa]

Oh boy do I know what you are going through. My son starts freaking out even if we are just in the area of the dr's offices. We found a dental clinic that deals with special needs kids in a local childrens hospital. Thank goodness he hasn't needed any major dental work done yet so we haven't had to use sedation. I agree with not using restraints, just way too traumatic for them and you. Good luck to you and your son

 

[cymomtx]

We found a pediatric dentist that I drive 45 minutes across town to visit. He initially prescribed a demerol cocktail for my son for the first two or three procedures. As he has gotten older and more comfortable with the dentist we no longer require the prescription.

 

[minkydog]

Instead of sedatives and restraints, a lot of dentists use a general anesthetic to actually put the patient out or gas (as was mentioned by the other poster) when dealing with people with special needs. It sounds a little drastic, but is much less traumatic to the patient since he is totally out or almost out, not just groggy.
If you like the dentist, I'd suggest talking with the dentist about your concerns and find out just what is meant by sedation and restraints. If your child is aware of what is going on, he will be scared and very reluctant to even go into the dentist office again.

I second this idea. My 7yo (normal)niece just had two fillings and a root canal done under general. She had no trouble and was back to normal by nightfall.

My 10yo severely autisitic son is a real trip at the dentist.We had a dentist who spotted a crumbling molar and insisted on taking care of it at once. She basically had him held down and went to work on him. Never again. We now have a different dentist. Fortunately, everyone there knows him & loves him, so we can do it without sedation(now). With Christian we schedule cleanings every three months, so it's not so much a surprise to him. We "practice" counting his teeth(not an easy thing.) But the day will come that he will likely need serious dental work and when he does we'll be going to the Children's Hospital for it.

 

[DAG]

Thanks for all of your comments. We realize now that we have some more homework to do before Jr gets the cavities filled.

 

[MadisonMom]

For regular dental visits, we started using a social story to help prepare our ASD son. Before the social story, it would take 3 adults to restrain him while the hygenist or dentist would do the cleaning and checkup. Once we started using the social story, he needed no restraint and cooperated wonderfully at the dentist's office. We would read it each day starting about 3 days before the scheduled visit, then once or twice on the morning of visit, then at the visit, we would cross off each item as it was done. Here is the story:

____'s Trip to the Dentist

1) Everyone goes to the dentist.

2) The dentist helps me keep my teeth clean and my gums healthy.

3) I will sit in the dentist's chair.

4) They hygienist will clean my teeth with a vibrating toothbrush.

5) The vibrating toothbrush makes a buzzing noise and it may tickle my
mouth.

6) The dentist will come in and count my teeth and see if they are healthy.

7) After the dentist leaves my chair, I can pick out a toy, a sticker and a
new toothbrush.

8) After the dentist, I will go to school.

-Molly

 

[Figment1964]

For regular dental visits, we started using a social story to help prepare our ASD son. Before the social story, it would take 3 adults to restrain him while the hygenist or dentist would do the cleaning and checkup. Once we started using the social story, he needed no restraint and cooperated wonderfully at the dentist's office. We would read it each day starting about 3 days before the scheduled visit, then once or twice on the morning of visit, then at the visit, we would cross off each item as it was done. Here is the story:

____'s Trip to the Dentist

1) Everyone goes to the dentist.

2) The dentist helps me keep my teeth clean and my gums healthy.

3) I will sit in the dentist's chair.

4) They hygienist will clean my teeth with a vibrating toothbrush.

5) The vibrating toothbrush makes a buzzing noise and it may tickle my
mouth.

6) The dentist will come in and count my teeth and see if they are healthy.

7) After the dentist leaves my chair, I can pick out a toy, a sticker and a
new toothbrush.

8) After the dentist, I will go to school.

-Molly

Social stories work great for my ds, too. He sees a highly recommended pediatric dentist who is great with autistic kids but it wasn't always so. So great that my ds (12) now goes to him as his orthodontist and has a full set of braces! He used to be petrified of going to the dentist! My dentist (in a family practice) tried to work with him and seeing his discomfort suggested we go see the ped dentist. It made me respect my regular dentist all the more, too.

 

[SueM in MN]

My dentist (in a family practice) tried to work with him and seeing his discomfort suggested we go see the ped dentist. It made me respect my regular dentist all the more, too.

Sounds like you have a great regular dentist.

 

[mrsmom]

One of my kids are seen by the pediatric dentist and orthodontics at our childrens hospital She has beathing problems due to a birth defect so they work with kids with all kinds of problems and they can treat anything that arises.
Check your local childrens hospital. Good luck!
Kim

 

[itsagloomyday]

My 10 year old AS son has seen a pediatric dentist that specializes in children with special needs. All of his dental work was done under general anesthesia. While asleep, they were not only able to fill the cavities, but get a good set of x rays, do a cleaning and sealing the teeth they could. Because he was not traumatized and not forced to comply (by holding him down) he now cooperates with every 6 month cleanings and examining his teeth. We haven't attempted x rays but know he will eventually need a few molars pulled under anesthesia again, so the x rays can wait. Find a good pediatric dentist (you might try at a children's hospital if one is nearby).

 

[MariDisney]

I haven't read the responses, so forgive me if this has already been said. I am a behavior analyst and I work solely with kids with autism. What I do is have the parent is find a dentist who will allow the child to stop in almost every day just to say hi and pick a prize from their bucket. We then start to work on having the child sit in the chair, then lay down, then open mouth, etc. to earn the prize. Each time we add just a little bit of demands, always ending on a positive note and with a reinforecer/prize. Meanwhile, at home we practice all the things the dentist will do like scraping teeth, etc. We simulate the procedures as closely as possible. Depending on the child's understanding we also write social stories explaining the process and why it's necessary and read the story every day. It can take a long time to work up to getting a tooth filled (weeks or months), but in my experience there is always a more positive outcome than using drugs and restraints. Please PM me if I can be of any further help.

 

[MareQ]

My son is not Autistic but he is a Special Needs child with a terrible fear of the dentist. He has HORRIBLE teeth - at 7.5 he's had 11 extractions, caps, multiple root canals - you name it - we've done it.

For regular checkups I used to have to get in the chair with him and pretty much put him into a headlock (while plugging his ears - no clue why but he likes my fingers in his ear when he's scared - lol) For fillings and other "big" jobs we go to the hospital for general anesthesia(sp?) for extractions which are quick - we go with a papoose and a sedative.

I drive 90 minutes one way for his dentist because he's fantastic with special needs children. When he needs an extraction I travel 45 minutes one way to a guy that will do it in the same visit(Most Dr's make you come in for a consult then make you come back for the extraction - that's too frightening for my son - we need in and out appts)

Personally - I think you need to do what needs to be done for his teeth without thinking about how long they will be in there - kwim? Last thing you want is for this to progress and have him be in pain or have to have the tooth pulled.

 

[DAG]

Hi everyone,
Thanks again for all of these ideas. We just found out that there is a school of dentistry about 45 minutes away, so they may be able to help, too.

Have a great New Year,

 

[JenJen]

MariDisney Awesome suggestions!

 

[splashmt]

I would like to add a comment and also add to MadisonMom's social story....
My son ( who has Asperger's) is also not happy about dentist visits. We live outside Buffalo NY, and have found a Dentist that has a hygenist who specializes a few days a month with Children with Special Needs. She sings to my son while she is cleaning and he loves her. Loves her. She helps set the tone for the dentist to come in who Knows that its "special" day and is so awesome, low key etc. with my son. If you could find ANYONE who could help you in this way, it makes such a difference. To add to MadisonMom's social story. Make sure that you talk alot about how your child will "feel" during the appointment, and how its ok to feel that way and that you will be there for him/her. That helps so much too. I feel for you and wish you the best.

 

[Earstou]

We gave our ds one of those battery operated toothbrushes and I think it has helped him be more comfortable with the dentist's equipment (or as someone else called it-the vibrating toothbrush!).
We also had to have him put out for an extraction. He's had the laughing gas, too. The best help for us was to always have the same dental assistant, who was very caring and patient and explained everything. When she left, we had to find a new dentist, because the old dentist wasn't patient enough when my ds had problems with the change!

 

[DAG]

Hi again everyone...Jr. had all of his cavities filled today. The dentist used a combination of sedatives to keep him calm. Jr was actually calm about 70% of the time. Everything took about 4 hours to complete, which was a lot longer than I had expected.

Hopefully these will be the last of the cavities. So from now on, no more sugar filled juice or other cavity causing drinks and snacks.

thanks for all of your comments.

 

[mamaminnie]

Glad things are OK.