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March 4, 2020
A Trip to the Dentist Doesn’t Have to be Scary for Children with Special Needs

Based on the 2015-16 Smile Survey, conducted by Washington State Department of Health and Delta Dental of Washington’s Arcora Foundation, 12 percent of our state’s third graders have untreated tooth decay.

This number increases dramatically for children with special needs such as autism. In fact, studies indicate 15 percent of children with autism don’t visit the dentist. Deep cavities and toothaches can be a cause for behavioral outbursts. When a child’s teeth hurt it’s tough to sleep, concentrate, eat, play or learn. 

As parents of children with special needs know, the stress of introducing their kids to bright office lights, new faces, unfamiliar smells and a moving dental chair can be especially challenging. Children with special needs often have difficulty communicating, and may struggle with the unfamiliarity, unpredictability, and physical invasiveness associated with a dental exam. This may result in avoiding dental visits, leaving pediatric oral health issues untreated. It doesn’t have to be that way.

I recommend that parents collaborate with their pediatric dentist to gradually introduce children to the dental environment and their acceptance of dental care. Here are some strategies we use to make visits a success:

  • Focus on information gathering at the first visit. It provides an opportunity for you to share medical and behavioral insights about your child, which allows the dental team to tailor the dental experience to your child’s strengths.
  • Begin the first appointment with an office tour and introduction to the dental team. Discuss strategies to help your child tolerate the exam. These might include turning out lights, selecting a private room, performing the examination in a non-dental chair, or bringing a cherished toy from home. Rewards such as going out to a favorite meal, a special prize, and iPad time can also motivate the child.
  • Prepare your child for their dental exam at home. Our office website has photographs of our providers, social stories, and a video to show your child what a typical dental visit is like. More tips can be found here.
  • When meeting with the dental team, discuss whether your child would benefit from practicing exam procedures like using a dental mirror at home. Brushing teeth as a family is another great way to teach children about healthy dental habits.
  • Plan for regular return visits. This helps children become comfortable with the dental office. Some children will learn to accept dental procedures quickly. Others may need gradual exposure to procedures. For example, having your child sit in a dental chair to ride up and down, allowing the dentist to brush your child’s teeth, and a full dental exam might each take place at a separate visit.

The key is allowing children to progress at their own pace and developing a dental visit routine. For parents who aren’t able to come in for multiple visits and children for whom this approach isn’t likely to work, we also offer a more traditional care approach. This generally allows for a full exam on the first visit. Sedation and general anesthesia services are also offered for children who would benefit from this method of care.

Clinics specializing in caring for children with special needs work hard to make accessing dental care easy.  At our office you can use your insurance, including Apple Health, and clinic staff are available to help with transportation, language translation, as well as your insurance questions. Siblings are also welcome, allowing children with special needs to join their brothers and sisters in a regular family activity.

For tips on selecting a pediatric dentist and preparing your child for a dental exam, as well as information on Washington dentists who specialize in treating children with special needs, Delta Dental has compiled a list of providers and resources. Visit www.deltadentalwa.com/blog.  

Travis Nelson, DDS, MSD, MPH is a clinical associate professor and acting chair at the University of Washington’s Department of Pediatric Dentistry. The Center for Pediatric Dentistry, located in the Arcora Foundation Building for Early Childhood Health at Seattle’s Magnuson Park is operated by the University of Washington. It’s mission is to combat the growing crisis of childhood dental disease by combining health services, education, research and public policy.



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