Autistic Children at the Dentist

[MEM]

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.

Thanks for posting this response!

I am fortunate to work for the Dean of a dental school in New England. My DS11 is on the highly functioning end of the autism spectrum and a few years ago developed a fear of the dentist. Routine visits were okay because they were not painful, but then he had to see an oral surgeon to have some baby teeth extracted that were preventing the permanent teeth from erupting. He got quite ill from the ketamine and he remembered that the next visit and went wild. Because I am in the field of dental education, I consulted with as many experts as I could about him. Sure, sedation and general anesthesia work, but our Director of Anesthesia said that each time the child is put under general, the risks INCREASE. He advised us to work with our son to "engage" him in his treatment. After the extractions he needed orthodontia in order to bring down the partially erupted teeth. It took about six months of visits to the orthodontic resident who was assigned to him but now he looks forward to it. Each visit was alittle longer and a little more "invasive". One of our D.M.D. students complimented my son on his "tooth jewelry" (his braces) and now he wears them proudly.

With regard to the idea that baby teeth do not need to be restored since they will fall out, the fact is that unrestored baby teeth can affect the development and health of the permanent teeth.