Since the 1970s April in the medical community has meant one thing: Autism awareness. Thanks to the steadfast efforts of advocacy organizations like Autism Speaks and the Autism Society, among others, much has been learned about the disorder.
Yet despite that knowledge and a wealth of new treatment methods, the incidence of autism continues to rise. A spectrum disorder impacting a person’s sensory processing capabilities, social skills and sometimes cognitive function, today 1 in 68 children born in the United States are diagnosed with some form of the disorder — nearly twice the rate of a decade ago, according to the Centers of Disease Control.
While the debate rages over what’s driving the increase — environmental toxins and/or better, more accurate diagnosis and genetic factors —at the patient care level the debate is moot. Children with autism must be treated effectively and that treatment cannot be delayed. That’s true especially when it comes to dental visits.
Surveys continue to show that autistic children are more likely to have difficulty visiting the dentist. In fact, according to one survey of 400 parents of children with autism, nearly two-thirds found oral cleaning at the dental office difficult. Some parents, overwhelmed by the task, delay making a first appointment until their child is 10 or older. A smaller percentage of parents give up entirely, avoiding the dentist until an emergency forces an appointment.
Not surprisingly, such delay tactics ultimately backfire. By not instilling good oral hygiene at home and by avoiding dental visits, parents encourage poor behaviors that could cause more problems in the future. It’s well documented that advanced gum disease and tooth decay has been linked to a variety of medical problems, including: obesity, heart disease, diabetes, cancer, and even Alzheimer’s — though this last claim requires additional research.
Building a Better Dental Experience
The key to helping autistic children have a better dental experience is “early intervention.” This is a term often used in education. Early intervention is the process by which a child is introduced to behaviors and learning strategies that improve their ability to process information and act in age-appropriate ways. In the school setting occupational therapy is particularly common as it assists with sensory integration.
In the run-up to a dental visit, parents should begin discussing the experience with their child and even have them practice lying back on a reclining chair and opening their mouth for as long as they can. They may even want to purchase a mouth mirror so parent and child can count teeth just like the real dentist. As much as possible good behavior should be praised or rewarded, while poor behavior corrected, but not admonished. Once the child is actually in the office, it’s imperative that the dentist knows what types of noises, smells and lights are likely to upset their patient. In accommodating dental practices (particularly pediatric ones) a pre-dental visit is scheduled.
Consider this appointment a “trial run” where the child has an opportunity to sit in the real dental chair and become comfortable in their new surroundings, as well as getting to know the dentist that will eventually poke and prod inside their mouth. Over follow-up visits (sometimes several) the dentist can perform more and more of a complete checkup. Some dentists have even been known to perform partial examinations in their waiting rooms, in the backseat of cars, or during house calls. One dentist put it like this: “if they’re not comfortable coming in [to the dental office] — get the exam done somehow.”
It should go without saying, but physically restraining a patient or inducing oral sedation should be options of last resort. Restraints may only further unsettle an anxious patient while drugs can sometimes have unexpected reactions in autistic and disabled children. Yet disturbingly, a 2012 study published in Pediatric Dentistry suggests that these practices are more common than they aught to be. According to the study, 18 percent of parents of autistic children reported the use of restraints “often” or “almost always” during a dental visit while 40 percent reported the use of pharmacology like anesthesia. Complicating matters further, there’s at least preliminary evidence that suggests many dentists will not provide care for autistic children in the first place.
Patience with your Youngest Patients
But with the strategies outlined above, it’s clear that with a little extra time and patience, an autistic child should be able to tolerate most dental visits, without taking more drastic measures. Although Autism Awareness Month might be ending this week, there are millions of parents in the U.S. whose children have been diagnosed with the disorder. There are 11 other months of the year where a dentist appointment can be made. Perhaps, one day soon, you’ll receive a call from an anxious parent with an autistic child. Maybe they’ve made dozens of frantic phone calls to find a dentist who will treat their child; a dentist who will be receptive to the process required.
Perhaps, after reading this article, you’ll find it in your heart to accept the case and get the exam done. This is your moment to be more than a healer. It’s your chance to be a leader. Lead by accepting an autistic child’s case and you’ll be rewarded in ways that go well beyond revenue.