Month: June 2017

Blog #175~Dentist Visits for Special Needs

Taking a child with special needs to the dentist can be challenging.  It ranks right up there with hair cuts and blood draws at the medical lab.  My son Nick is 23 years old, and has Down syndrome and autism.  His speech deficits and sensory issues makes it difficult to get a proper dental examination and cleaning.  Now that Nick is an adult, we changed from a pediatric dentist to one that specializes in working with adults with special needs.  The experience for my son went very well, and here’s why it was successful.

Here are 5 tips to help with dentist visits for special needs:

*1- Find a dentist who specializes in working with persons having special needs.  Get referrals from other families and therapists.

*2- Request to schedule the appointment during the quiet time at the office.

*3- Create a social story either with a written checklist or pictures for your child to follow.  For a child with autism, if they can see it, then they can understand it.  This guide will be like a map to follow, and can help to lessen anxiety.

I printed a social story from Google Images and added a highly preferred reward of Taco Bell at the end of the visit:

At home we have a tooth brushing sequence laminated for Nick to follow.  You can print this PDF out for your child to use:  teeth

*4- The dentist should take the time to go at your child’s pace, based on their sensitivity and level of anxiousness.  His new dentist allotted plenty of time to ease into the exam, and for Nick to get comfortable with him.  Nick didn’t want to sit in the chair right away, even with my point prompts to the social story.  First, they put one of his favorite cartoons on the flat screen TV.  Then, the dentist put his gloved hands out for Nick to touch and get use to the feel and texture.  After a few minutes along with a several high-five and elbow bumps, Nick sat down in the chair.  He continued to narrow the gap of proximity, so that Nick was could get use to him being close.

On the first visit, the dentist was able to do brief examination and brush Nick’s teeth counting to 23 (his age) twice.  He took several breaks, giving lots of praise and elbow bumps.  We scheduled another visit three weeks later to try to build Nick’s tolerance level and continue to develop their relationship.  On the second visit, he was more at ease, sitting down in the chair right away.  The dentist completed a deeper examination, as Nick was able to tolerate even more this time.  He was able to clean, floss and even brush fluoride on Nick’s teeth!

*5- The key to having success on these visits was allowing time for Nick to feel more relaxed and establishing trust.  The dentist worked slowly to desensitize, picking up on any verbal or non-verbal cues.  He adjusted his pace accordingly, to match what my son could handle.  His dentist understood the importance of building this trust and relationship, thus earning the right to provide more clinical care.

The tips of *1-finding the right dentist, *2-scheduling appointments during off times, *3-providing a social story, *4-breaking down the examination slowly and *5-establishing a trusting relationship, all helped greatly to lead to successful dentist visits.

If your child has sensitivities, you may also want to see if they can tour the office before the appointment.  If need be, ask if the lighting can be adjusted and whether they offer the use of a weighted vest (which provides deep pressure which can be calming).  In some cases, it may be necessary to sedate a child that is uncooperative or needs more advanced care.

At this time with my son, we will continue to build on the solid foundation we’ve begun with his new dentist without the use of sedation for as long as possible.  These baby steps helped to lessen Nick’s anxiety for dental visits in the future.  I appreciate the time, care and concern for my son’s best interests in providing such a positive experience.  That’s what is in my noggin this week. 🙂

~Teresa

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