Autism and Dental Care

Patients with autism often have difficulty staying still and allowing the dentist to do what’s needed, which is why a loved one should always be present. Everyone needs a “figurative” hand to hold sometimes, especially those who fear the dentist, and it’s no different for patients with autism.

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The Most Common Dental Problems Seen in Patients With Autism

Poor oral health is not always brought on or indicated through autistic patients, but proper oral health can be a problem in some cases. Some dental problems that are seen in autistic patients can be purely genetic, but often times it’s not chalked up all that easily.

Autistic patients sometimes struggle with oral hygiene, both the dentist and at home, so the proper amount of care can be difficult. For example, periodontal disease and cavities are the two most common dental problems that are often seen in autistic patients.

Listed below are other examples of common dental problems that patients with autism are more prone to:

  • Gingival overgrowth

  • Early and late tooth decay

  • Severe, early periodontal gum disease

  • The habit of constantly grinding their teeth, which is also known as “bruxism”

  • Tooth anomalies that are related to the size, shape, and the number of teeth present in the mouth

  • Accelerated, inconsistent, and/or delayed eruption of one or more teeth

  • Pits, discoloration, lines, and other developmental defects that are seen in teeth

Depending on how severe the autism is, a lot of patients will have difficulty communicating their pain. This results in dental health issues becoming so advanced that general anesthesia is not just required to help them relax, but is necessary due to the pain and procedure they will need.

The Problem With the Dentist

Patients with autism, especially children, have extreme sensory and oral motor integration issues. For individuals affected significantly with autism, the dentist can be a very frightful experience. All of the tools, noise, and people can easily stress a patient out and make them impossible to work on, and a lot of dentists will suggest a sedative right away.

A lot of patients with autism have a general fear of the dentist because it overrides their senses and is a lot for them to process in such a short time. Finding a dentist who knows and understands their fears by working with multiple special needs patients previously, is the best way to help them slowly overcome their fear.

Talk to Prospective Dentists About Your Concerns

Talking to prospective dentists is the best thing you can do to make the visit easier for an autistic patient. A well trained and comfortable dentist makes the process easier for everyone, and is better able to anticipate and understand the needs of patients with autism.

This is not always easy though, as studies show upwards of 60% of dentists do not feel prepared to treat patients with additional needs. This is a staggering amount, and shows that not all dentists will be a good fit for an autistic patient. The same study showed that the quality of education was a large factor in preparedness during the dentist’s career.

Thankfully, many dental programs have begun providing additional training materials about dealing with special needs patients. This includes the rise of internet programs, which are helping to change the perception on a wide range of needs including those of autistic patients. This should hopefully make a wider range of dentists more comfortable practicing on those who have them.

How to Help at the Dentist

There are ways you can help your loved one feel safe and secure while at the dentist. For example, if you are a parent of a young child who has autism, do not bring them to multiple offices. Instead, find one dentist that is understanding and will work with you and your child to keep their oral health in top shape. This eliminates the anxiety that they would have by going to different places each time.

Making the Necessary Preparations Before the Visit

For children and adults alike, you can also take the necessary steps to prepare them for their visit. Take them for a tour by showing them the website, telling them about the dentist they will be seeing. You can also tell them about your experiences at the dentist, even if it’s not the same one, and say that you feel much better after you went.

Sedation Can Be Beneficial

However, sometimes sedation is necessary to ensure they are getting the proper care that they need for their oral health. This is typical because patients with autism can be extremely difficult and uncooperative, and sedation is the only way to get whatever problem may be fixed.

A lot of people have concerns about this because they do not feel that sedation is safe, but it’s often the only way for patients to receive the care they need. This is typical because a lot of patients with autism do not like anyone touching their teeth or putting things in their mouth.

Sedation dentistry is actually very popular, even if the patient does not have any form of a special need. Sedation dentistry, also known as “sleepy dentistry”, is used to give patients peace of mind and help them to relax while they are in the chair. Keep in mind that this is not the same thing as having a patient under anesthesia. Sedation dentistry keeps the patient somewhat awake and does not cause them to go to sleep completely.

In this type of situation, you can ask your dentist about seeing a specialist who can give you all of the information you’ll need. Oral sedation dentistry may be the best option you’ve got if you know for a fact that your loved one may refuse the treatment that they need.

Finding the Proper Dentist

Letting the dentist know that your loved one is an autistic individual is the first step. If they know and are not able to take them on themselves, they will be able to find someone who can for you long before the appointment, so ensure that you make the office aware well before.

Additional Needs Dentists

Dentists who only care for patients with special needs are typically hard to find, but they are out there. These dentists require an additional three years of dental postgraduate training. If you find one, you should definitely stick with this dentist, because they are the best option. Special needs dentistry is real, so ask your local dentistry office if they have any information that could help you in finding one.

Asking Your Friends and Family for Suggestions

Speaking with a friend or family member who also has a loved one with special needs in their direct care is a great way to see about the perfect dentist. Do not just book an appointment based on what they have told you, but instead do some additional research yourself to see whether or not they are what you are looking for in a dentist.

Asking Your Doctor

Even though your doctor is nowhere near being a dentist, asking him or her is one of the best ways to find the best dentist. They may know someone who is best for the job because a lot of dentists work closely with doctors that have patients who have neurological conditions, such as epilepsy and cerebral palsy.

Equipment Requirements That Are Needed

If the patient uses a wheelchair, ensure that you are choosing a dentistry that can accommodate this and any other requirement that they may have. Even though this is a regular standard to you, it may not be such a regular requirement for a dental office, so make sure to ask these questions before you book your appointment. The last thing you want is to bring them to their appointment and then find out they will not be able to treat him or her because of the lack of needed equipment.

Advocacy Organizations Are a Huge Help

If there are special needs advocacy organizations within your area that you can speak to about this, definitely do so. They will be able to point you in the right direction for dentists that have experience and can properly care for special needs patients. Some dentists may refuse to take on patients with special needs because of the difficulty, so asking an advocacy organization is a great way to get a straight answer and be pointed in the right direction.

Dental Insurance and Your Options

If you have your loved one on your dental insurance, call the company you are with and inquire about any special needs dentists they may be able to recommend based on your dental insurance policy. You may be lucky and find out that a special needs dentist is covered under your policy, but don’t have your hopes set too high.

Bring Something Familiar

If the patient is a child, consider bringing their favorite toy. If they are older, think of something else to bring, such as their favorite book. Either way, bringing something they love and are familiar with is a great way to ease the tension and anxiety.

Possible Split Treatments

If they simply cannot relax during a cleaning or any other procedure, but there is more to come, consider splitting the treatments. If you’re at a special needs dentist specifically, they will more than likely offer this solution.

Instead of doing a number of treatments in one go, a lot of dentists will accommodate special needs patients and split them up over a short or long period of time. However, it all depends on the severity of the case and what needs to be done.

Online by Dr. Greg Grillo and Dr. David Hudnall