Dental Care to Patients with Autism by by Dental Oral Health Therapist & Hygienist Glenys Shelton
Autism is seen across all racial, ethnic and social groups often more common in males. Approximately 1 in 150 individuals are diagnosed with autism and more than 24,000 children diagnosed each year. Symptoms range from very mild to very severe.
These disorders are associated with rigid routines and repetitive behaviours, they often react strongly to different sensations. Other characteristics involve difficulties with social interation and communication, limited interest, with other varied behavior.
Treating patients with autism is very challenging but can also be very rewarding. It is important to introduce the patient to the dental environment early before any treatment is required, to build up a trust in a slow and gentle manner.
Good oral hygiene is important to introduce to the parent/carer and patient treatment tailored to suit the child. Providing good dental treatment for patients with autism can make a lasting difference in their oral health and all dental treatment required.
Dental professionals need to understand patient fears and ways to overcome them. Information provided by parents and carers before the first visit can help, such as the best time of the day for your appointment or how the patient reacts to having more than one person in the room. It may also help if they bring a comforting object or a second adult or friend. A full medical history including tolerance levels, homecare, likes, dislikes, any previous bad dental experiences, habits, dietary aversions (e.g. gluten intolerance), sensory or chewing habits (e.g. clenching, bruxism) that the parent/carer knows of can be very helpful prior to appointment so as not discussed in front of the patient.
The following hypersensitivities should be mentioned before the visit:
- visual (extremes of light);
- auditory (noise from high speed dental machinery);
- taste;
- tactile aversions vestibular (react to chair movements);
- Proprioceptive (gagging, dislike being touched, reaction to temperature changes, gloves, cotton rolls, air/water, and metal instruments) that may be used in the mouth.
Sometimes the patient will respond well to certain verbal or physical cues, this can also be useful information before the appointment. Understanding and using calming techniques and positive reinforcements can enhance co-operation.
Dental stories or photos of the surgery can be shown to the patient prior to the appointment to familiarise them for their first dental visit to that surgery. The parent/carer can inform the dental professional before the appointment of any appropriate information regarding the patients’ fears, likes, dislikes and what the patient is capable of doing or not doing and how to best handle difficult situations i.e. head banging, biting, loud noises.
Being fully aware of patient fears and being able to communicate in a way they are used to can make their dental visits much more enjoyable.
The 1st visit is to establish trust and so the patient can understand we are caring dental professionals, and interested in their well-being. This visit should consist of an examination using a “tell-show-do” approach. Sometimes an examination without instruments may be required for more low tolerant patients. A reward for good behavior can develop a more trusting and comfortable experience.
The 2nd visit and following visits can be regular and more frequent; a little more treatment completed each visit. This helps desensitize any dental phobias.
Patients respond better to the same dental team. This avoids unnecessary anxiety and frustrations for them. Seeing the same faces provides consistency, helps build trust and confidence which will improve the outcome of the visit.
About the Author
Dental Oral Health Therapist and Hygienist Glenys Shelton is one of the longest serving members of staff works across both practices for Robertson Dental Innovations. She is available for appointments weekdays except for Thursdays. Due to the amount of children seen by Glenys it is suggest to book early for school holiday or after school appointments as these are her most popular appointment times.
