Going to the dentist can be a very stressful experience for those on the autism spectrum and their caregivers. Here are some strategies that can help to make the experience better.
Possible reasons for disliking the experience
Lack of understanding
Some people do not understand the purpose of going to see someone who looks into their mouth and uses strange equipment, whilst they are expected to lie on a chair with a large light shining on their face. They may not have understood the importance of having healthy teeth and gums and the consequences of not having regular appointments.
One of the main anxiety triggers relates to sensory experiences. Mouths are extremely sensitive, and for an autistic person, the sensation of a cold instrument entering their mouth could be very painful. In addition, the noise of the drills and cleaning instruments could also be a problem. Sometimes the taste of the mouth wash or the paste being used will also have an adverse impact. There may be other sensory factors that could cause distress, such as the dentist’s perfume, mustache, or the color of their clothing.
Invasion of space
Dentists are one of the few professionals who we permit to enter our personal space. Most people find this uncomfortable but understand that the dentist needs to be so close in order to examine teeth. For autistic people, this close proximity may be extremely distressing.
Strategies to help
The following strategies are dependent on the person’s level of understanding and their individual needs and should be adapted accordingly.
As a result of past negative experiences, many carers understandably avoid telling the person with autism about their dental visit until the last minute or on the day of the appointment. But even though it may initially cause a behavior pattern change, it is better in most situations to try and inform the person as early as possible. This can be difficult if their concept of time is poor. The use of visual supports (that is, a calendar) can help.
If it is the person’s first visit to the dentist, you may like to take them to visit the building, to meet the dentist and meet other staff prior to any treatment. You may also like to show them the equipment which the dentist will use and how it works.
It is also important to prepare the dentist and their team by giving them as much information as possible about the person’s needs so they can make adjustments to the procedure.
Try to ensure that the appointment is the first of the day – maybe even book a double time slot. This reduces the chance of the dentist running late and provides enough time not to feel rushed.
Social stories are an effective way of providing information about an activity and the reason for doing it, what happens at the dentist and why we need to go for a check-up.
There are lots of basic story books about visiting the dentist which may help you, that is, I know why I brush my teeth, Topsy and Tim go to the dentist, Sensitive Sam visits the dentist.
Breaking down the visit
You could use visual supports, such as a sequence of pictures or photos that show the different steps involved in the dentist visit. This could help the person to know which is coming next and when each step is finished. You could also include a reward picture at the end of the sequence so they have something to look forward to.
Use visual or auditory timers (like sand timers, buzzers, a mobile phone alarm) to help the person to understand that this experience has a time limit.
Letting the person take comforters into the dentist’s surgery could help to occupy or distract them. For some people, listening the music on headphones, or having music in the background, can act as a good blocker.
For some people, the experience of visiting the dentist is so distressing that it may be necessary to consider sedating them. If you feel this is the case, you will need to talk to your dentist and a medical professional to discuss the options.