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Interviewer: It can be stressful enough going to the dentist in the best of circumstances, but for children with autism, the sights and the sounds, and the smells can be overwhelming.
Dr. James Bekker is with and he's going to give us some tips to make it an easier experience. So first of all is it pretty common for reactions to be pretty extreme or is the range pretty broad?
Pre-Visit Communication with the Dentist
Dr. Bekker: There is a broad range, but every child with autism is different. There's such a spectrum and for parents who deal with this on a regular basis, they know that their child has very specific things that they respond to and a positive way and in a negative way. So coming to the dentist can be made so much easier if the dentist beforehand can identify what makes the child happy and what scares the child.
Interviewer: So a conversation with the parents sounds like it's a good idea.
Dr. Bekker: Right.
Interviewer: Tell your dentist those things.
Dr. Bekker: Right. So we have a packet that parents can fill out ahead of time where we'll talk about their child that we talked about their likes, dislikes, triggers, what makes them anxious, what is their happy place, what makes them comply with what you need to do as a physician or a doctor. You do that ahead of time and find out a little bit more about the child so when the child comes to your office you have already set up the situation that the things that make that child respond in a positive way or there.
I've had a child who loves vacuuming, I've had a child who loves playing with water, whatever it is that they like, you key in on that and then when they come in you are right on their level, you are related to them, you know who they are, you know what they like and you take away some of that strangeness and some of that fear right off the bat. That makes the child much more comfortable but it really makes the parents more comfortable.
Interviewer: Yeah. There's probably nothing worse than bringing your child to the dentist and then having them scream or react negatively like that.
Dr. Bekker: Right, and if the parents see that you kind of know what you're doing, that you've been down this road before with other children and you're keying in on what is good for their child it really helps them relax. You also schedule in your office at a time when . . . Parents are sometimes nervous about, "If I bring my child to this office are the other children going to look, are they going to be afraid of my child? Will my child have a negative interaction in the waiting room?"
If you schedule it so that that waiting situation or that reception goes smoothly and you're prepared for the child ahead of time. Maybe you don't have other patients scheduled at that time and you can focus just on that one child. You get them in, you get treatment and analysis and diagnosis done quickly and then they can be on their way. You don't have the anxiety of sitting and waiting in an office.
Managing Parent and Child Anxiety
Interviewer: Yeah, sure. So those are a couple of really good ideas of what a parent can communicate to a dentist, let them know that they have an autistic child and could you do these things? What are some other things a parent could do before that visit to maybe. . . Is there any way you can prepare a child with autism for that by talking to them?
Dr. Bekker: Yes, and some of the things that apply to all children will apply specifically to children with autism. If a child picks up that a parent is really nervous about a situation, then the child will be more nervous. If the parent can be relaxed about the situation, the child is more relaxed. The parent can use terms that are positive terms. They can talk along the lines of this will be fun, this will be easy, this will be quick, he's really nice, or she's my friend. Those kinds of positive terms about the experience are really helpful ahead of time.
If the parent is saying things like he won't hurt you, I won't let her take you away, then the child's anxiousness is elevated. And every child is that way.
Choosing the Right Dentist for a Child with Autism
Interviewer: Yeah. Interesting. So is there something that a parent with an autistic child should look for when choosing a dentist?
Dr. Bekker: You need to have someone who has experience. You can go on their website and for the most part you may want to try and find a pediatric dentist, that's a specialty in dentistry where they go two extra years and do a residency in pediatric dentistry, and they are more attuned to the needs of special needs children. There are many general dentists in the community that have experience with special needs, but you need to do a little bit more homework to find out who those are.
Special Accommodations at the University of Utah School of Dentistry
Interviewer: Yeah. What are some of the things that you're doing here at the University of Utah School of Dentistry? I understand you have some rooms that are kind of specially built for this. Explain that a little bit.
Dr. Bekker: We do. We have some areas that are child-friendly, we have a special waiting room and I guess we don't call them waiting rooms, we call them reception rooms because we hope that nobody ever has to wait. We have this special reception area, we have a special clinic for pediatric patients and patients with special needs where we have TV monitors on the ceiling and you have all different kinds of movies or Discovery Channel, whatever the child likes to watch available. We found that the TV is one of the best anesthetics that we have.
Interviewer: Is it really. It works for most.
Dr. Bekker: It works for most and we also have treatment areas that are completely private so that the child and the parents can be somewhere away from the hustle and bustle of the other parts of the clinic.
Interviewer: That will probably help a lot to cut down on a lot of that input.
Dr. Bekker: It does, especially with children in the autism spectrum, noises are a big issue. Things that they don't understand that make scary noises can really set them off. So if you can have a quiet or calmer place it really helps.
Interviewer: So that's really got to help with all that external stimulation that can be troublesome sometimes with autistic individuals.
Dr. Bekker: It really does.
Interviewer: What about smells and lighting, do those types of things cause problems generally or not so often?
Dr. Bekker: Smells do to some degree but lighting especially does with children in the autism spectrum. We can have the room darkened. In the new technology a lot of what we do in our diagnosis treatment planning and actual treatment, is with magnifying scopes that have an LED light right on them and it just zooms in on the area of treatment and the whole rest of the room can be darkened.
Interviewer: So any final thoughts or final tips for a parent with an autistic child that would help them through this experience?
Dr. Bekker: I think the most important thing is don't be afraid. Find a good pediatric dentist, find a good situation that is ready for your child because it can be a great experience. I've been doing this for many years and I have children with autism who love to come to the dentist. I have children with autism who don't particularly like it, but they do it and that's really important. Having that good oral health piece is so much more important than staying away just because you're afraid of the situation.
updated: October 3, 2024
originally published: March 26, 2015