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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.
This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.
