Dental Dilemmas

My son’s first visit to a pediatric dentist remains one of the worst things I’ve had to endure with him yet. My son fainted at one point after half an hour of screaming. The dentist had me pin his head in between my knees. There was something inhumane about the whole appointment. Vowing never to have a repeat experience like that one, I set out to make a trip to the dentist less of a dilemma.

The first step and most important is to take away the unpredictability of the dental visit. (I’ve talked about the need for predictability in another blog post). There are two ways to achieve this – by creating a social story and letting your child see the dentist’s office before you go to the actual appointment. The social story walks the child through the dental visit step by step. Start with a photo of the outside of the building. This can be the title page –“ (Name) Visits the Dentist”. Photograph the elevator or stairs and then the door to the office. Get pictures of the staff in the order the child will meet them: receptionist, dental hygienist, and dentist. Snap pictures of the waiting area and perhaps some toys that might amuse your child. There are a few fun moments at the dentist and you need to play those up. Show what the dentist’s chair looks like and the light above it. Do children get a toy at the end of the appointment? If so, get a picture of some of the choices. At the end of the social story, have a picture of some type of reward for the dental visit. My son would do anything for McDonald’s fries so the final page of his story was an empty McDonald’s fries bag.

Make sure your first time to the office is simply an exploratory one. Let your child play in the waiting room and get used to the area. Pre-arrange your visit so a receptionist can take you on a mini tour. Let your child sit in the dentist’s chair and tell him/her the dentist will simply count his/her teeth at their first appointment. Practice what that will feel like. Walk through the basic steps of a visit – checking in with the receptionist, waiting, then being called to sit in the chair. Our dentist has been marvelous, allowing us to come for appointments just to have teeth counted.

There are ways to prepare at home for a dental visit – try tooth brushing. We started with a washcloth on our finger and ran it around the surface of our son’s teeth. We later moved to a toddler toothbrush with no toothpaste on it. Since our son loves numbers, we would count to ten while moving the brush around. Next we added child’s toothpaste, not the mint kind which often has too strong a flavour. Marc moved the brush around his mouth by himself while we counted to ten. When our son was resistant to brushing his teeth (this went in phases) we used the pic symbol for tooth brushing. A pic symbol is a drawing of the activity that you want your child to do. Because children with autism are visual, showing what you want them to do rather than telling them is often more effective in getting the response you want.

When choosing a dentist, shop around. Try to find a pediatric dentist or one that has experience working with children. Phone the office first and explain the situation to see if they can accommodate your wishes for a pre-visit and perhaps several visits to see the dentist before an actual exam takes place. Ask other moms who have an autistic child what dentist they see. We found our dentist through another mom. He has been supportive in accommodating our needs in order for both our son and daughter to have a successful visit. We had to do five visits with Marc sitting in the dentist’s chair and the dentist counting his teeth before Marc would submit to a full exam.

In the end, patience paid off. There are no more tears and meltdowns at the dentist’s office. I certainly have not had to endure a repeat performance of the first dental visit. Dental hygiene still remains a challenge for both of my children so we have to see the dentist every 3 months. In some ways that is a good thing because it keeps the office visits fresh in their minds.

When should you take your child for the first dental visit? Around three years of age, after the baby teeth are in. The social story and pre-visits may sound like an extra hassle, but you will be glad you did them when you have a worry-free successful trip to the dentist. A positive first experience will lessen the chances of a stressful visit in the future. Remember, with autistic children preparation and predictability are the keys to success. Happy brushing!