BY STEPHANIE CRIST
Local dentists offer advice and special approaches to ease special needs children through dental procedures
Alex remembers. He doesn’t want to go in. Down the hall there’s a room. In the room is a chair. On the chair is a board with a wrap called a “blanket.” But there are straps for his wrists and the blanket is wrapped very tightly. Cushions brace his head. A device is used to pry open his mouth.
It sounds like torture. But this room is part of a dental clinic designed to meet the special needs of children with disabilities. Alex, my son, is a child with autism and very strong sensory aversions. Even with all the accommodations this clinic has to offer, dental visits can be traumatic. But there are things you can do to make dental appointments successful.
“Children with special needs are often really perceptive and read their parents really well,” says Dr. Rush A. Peace, who specializes in both pediatric and special care dentistry. “They translate just what the mother is feeling; if the mother is apprehensive, the child is apprehensive, too.” While these apprehensions may be reasonable, they are not helpful.
“Parents that present dentistry to their children in a positive manner convey a good feeling toward the dentist and the dental experience. A change in your attitude can make a big difference in your child’s dental care experience,” said pediatric dentist Sherida Jacobs.
By bringing a change of clothes you can ensure your child’s comfort if he or she gets wet or vomits. Be sure to have your child’s favorite blanket or toy on hand. If your child is like Alex, then he or she might not have a comfort object. Instead, I made up a very simple song to sing whenever he’s in distress—it helps Alex feel special, loved, and safe. You may want to role play with your child to prepare for their first dental visit. Dr. Jacobs advises parents to practice laying the child back on their lap and have them open their mouths wide.
Stories can also help prepare your child. While a book with a character that your child loves is a great start, you may also want to make it more personal by writing a short story that stars your child. You can prepare a picture book that includes real pictures of the dental clinic, the staff, and the tools that will be used. Make sure the story you choose emphasizes a positive attitude. You can make reading these stories a ritual before each visit. “Prior to an appointment, parents can discuss the upcoming dental visit in a child-friendly, positive way that their child can understand,” Dr. Jacobs said.
“Do not make a big thing of it,” Dr. Peace said. “If the mother says, ‘It will not hurt,’ the child assumes just the opposite.” Instead, he advises parents to say something simple, such as, “We’re going over to the doctor to take care of your mouth.”
Dr. Marilyn Murphy, a pediatric dentist with thirty years of experience serving children with special needs states that the most important thing is to start them when they’re very young. “Brushing and flossing every day is important,” she says, “I lay them on the floor to brush (when they come in for dental work), that way they’re used to it when it’s time to get in the dental chair, because that leans back, too,” she adds.
Introduce your child to the staff before the work starts so they don’t seem like strangers. Your child might not be able to touch the dental equipment for sanitary and safety reasons, but a quick look and a simple explanation can make these tools less scary. Dr. Peace takes these recommendations one step further by scheduling a consultation visit first. You and your child can meet the staff. The dentist can see the kind of care your child needs and how cooperative your child is, and your child gets a reward just for coming in. This is also a great time to pick up literature on homecare instructions.
During the dental visit, Dr. Peace advises parents to stay in the waiting room and out of our way. “Otherwise we’re having to treat the parent,” he says. This is especially important with children, like Alex, whose behaviors need to be managed in order to provide dental care. However, some dentists prefer to have parents in the room. “There are times when we need parents to hold their child’s hands or to just sit beside them for reassurance,” Dr. Jacobs said.
“A nice, calm, relaxed mama helps a lot,” Dr. Murphy said. The kids pick up on that.” It’s also important to show your child how to cooperate by following the staff’s instructions. Sometimes this means just being quiet.
“Children are easily confused by too much talking from numerous people,” Dr. Jacobs said. “We try to keep the communication simple and between the patient and the dentist or hygienist.”
Provide your dental care providers with insight into your child’s behavior. Nobody knows your child the way you do. Your child’s dentist may not understand what your child is trying to communicate. Be attuned to sounds of distress, but don’t overreact to them. Overreacting will increase your child’s anxiety. Use a soft, calm voice.
Once the work is complete, show your appreciation for your child’s cooperation. “Talk very positively,” Dr. Murphy says. “They do listen to what mama says.” Dr. Jacobs and Dr. Peace both offer positive reinforcements in the form of a balloon or a prize. You might want to get your child something special like a small toy or a new box of crayons to thank your child for cooperating during the procedure. Don’t scold your child for lapses in cooperation.
“Parents should be realistic in their expectations of how well their child will do for a dental exam and not feel badly if the child does not fully cooperate,” Dr. Jacobs stated.
Invasive dental appointments can compromise your child’s sense of trust. Time with mom or dad can help re-build that trust before you schedule an additional appointment.
Dental visits can be trying, but these recommendations can help your child cope with this necessary experience. As anxious as Alex was going into his last dental visit, he turned it into a great success. For thirty seconds he was able to stay still while the dentist worked. During the previous appointment it took four tries to get a usable x-ray of a suspect tooth. During this last visit it took only two. During previous visits Alex became so upset he vomited. During this last visit he did not. Best of all, when the appointment was over and Alex had been calmed and comforted, he looked at the dentist and gave her a smile.
You, too, can work through this difficult experience to a precious and healthy smile from your child.