Your Child's Oral Health  

Dentistry and autism

Autism spectrum is a relatively common disorder of neurological development that is characterized by several criteria: impaired communication, impaired social interaction, and restrictive, repetitive behaviour.  The manifestations of autism spectrum range from severe impairment to high functioning individuals who are able to communicate quite well, but may have a distinctly odd social approach, and narrowly focused interests.   
A dental appointment for an individual with autism can be a challenging event, for the patient, family, and the dental team.  Pediatric dental offices see patients with all kinds of special needs, developmental conditions, and disabilities.
Children with Autism often have sensitivity to sensory stimulation, and can find loud sounds, lights, smells, and touching overwhelming.  Dental visits generally involve all of these things, and as such, can elicit patient responses that make care all but impossible.  Besides the behavioural challenges that individuals with autism can present with, the dental problems they experience are just like everyone else.  Often the challenge with dental visits is an extension of the challenge with daily home care, so patients have the potential to have severe dental problems.
One of the many wonderful things about the autism spectrum disorders is that affected individuals often have a terrific affinity for routines, and an excellent memory.  Many parents of children with autism will say that their children recall even seemingly minor events with incredible clarity.  These features can be harnessed during an office orientation program to provide predictable, repetitive experiences that can be altered in small increments over time to allow individuals to adapt to new situations smoothly.  Patients are brought to the office for several orientation visits to familiarize them with the office, people and processes.  This process teaches children, and parents, new behaviour which they will use at future dental visits. This can be a very effective desensitising process in the dental environment.  This process is identical to that used in applied behavioural analysis (ABA) and relationship development intervention (RDI) therapies.  Not all patients will benefit from this process, but it is helpful in a great many circumstances.  
When dental treatment is required, often patients who have completed this process will be successful receiving care in the office with or without a relaxing agent such as nitrous oxide, or laughing gas.  For others, however, another treatment method such as sedation or general anaesthetic is required.
Pediatric dentists have advanced training to treat children with special needs, including autism, and do so on a daily basis.  Individualized care is provided based on individual needs.  Many patients do very well for most things, however, sometimes just doing an examination can create a lot of commotion.  That said, the kids are great and no worse for wear at the end of the day.  Many times the parents and caregivers are more stressed by the appointment than the child!  
The bottom line is that individuals with autism need dental care just like everyone else.  Much of the time all it takes is practice and understanding on the part of the caregivers and the dental team, and what results is a healthy, friendly relationship that makes the dental visit something to look forward to.

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About the Author

Dr. Alan Milnes is a pediatric dentist with 35 years of practice experience and 20 years of experience as a full time University Professor at the Universities of Manitoba and Toronto. He has operated a full time pediatric dental practice in Kelowna since 1997, the only pediatric dental office in either the Interior or Northern Health Authorities.

Dr. Terry Farquhar  completed his pediatric dental residency training in Halifax, Nova Scotia and Rochester, New York. Prior to entering Dentistry, Dr. Farquhar  worked as a pediatric nurse at Alberta Children's Hospital in Calgary.

Their pediatric dental specialty practice provides a complete range of dental services for ALL children and teens including treatment in-office using various forms of behaviour guidance, oral, inhalational and intravenous sedation and treatment in hospital under general anesthesia.

"We are dealing with an epidemic of tooth decay in children, a condition called early childhood tooth decay. Many children with dental disease have a poor quality of life because of chronic pain and infection which makes sleeping and eating difficult. Providing information through our column to parents of children in the Interior of BC will be helpful in giving them important tools to prevent dental disease in their children."

Please visit our website for a look at what we do each and every day and our qualifications - www.okanagandentalcareforkids.com; email: [email protected]

The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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