By Maureen
Bennie
Is there anyone out there who can honestly say they
like going to the dentist? I recently went to mine
for a cleaning that was six months overdue. Most
of us dread the dentist. For the child with autism,
it is a frightening experience because of sensory
overload. 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. 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 will do anything for McDonald's fries
so the final page of his story is 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.
Ways to prepare at home for a dental visit are
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 paste. Now he moves
the brush around his mouth by himself while we
count to ten. If our son is resistant to brushing
his teeth (this goes in phases) we use the PEC
symbol for tooth brushing. A PEC 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 then telling them
is often more effective in getting the response
you want.
As for 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 Calgary,
Alberta pediatric dentist, Dr. Brad Krusky, through
another mom. He has been supportive in accommodating
our needs in order for our son to have a successful
visit. We had to do five visits with Marc sitting
in the dentist's chair and Dr. Krusky 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. 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!
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