Going to the dentist can be a traumatic and emotional experience for a child. Add the challenges of a sensory processing disorder and the issues are multiplied. Here are some pointers to help plan and implement a successful first visit with the dentist.
Inform the Dentist
Since it is almost impossible to find a pediatric dentist who has been trained in treating children on the Autism Spectrum or children who have sensory processing disorders, it is important for the parent or Occupational Therapist to communicate with the Dentist about that child’s special requirements.
- Your Child’s Particular Sensory Sensitivity to touch, oral stimuli, taste, smell, sound, vibration, movement, and light must be addressed.
- Sensory-adapted Dental Environment If your child is sensitive in any of these areas, your dentist must be prepared to make adaptations to the environment in the dental clinic (such as dimming the lights in the waiting room to make a more calming atmosphere.) This will decrease aversive sensory stimuli, and reduce anxious and uncooperative behaviors during oral care.
Adjust Schedule Routine by making the appointment time at a normally inactive period and allowing extra time for preparation and implementation of the sensory strategies.
- Options for treatment include use of a mild anti-anxiety medication or (in severe cases) treatment in hospital under general anesthetic.
Occupational Therapist participation
An OT could accompany the child and parent to the dental clinic to facilitate sensory strategies, calm the child during the dental cleaning, and educate the dental practitioners.
Prepare before the actual procedure
- A Social Story used in advance of an appointment with the dentist can prepare the child for the sequence of events that she can expect to occur during dental treatments. When accompanied by pictures (to facilitate the child’s understanding) social stories guide and teach appropriate behavior and reduce anxiety by explaining the routine and increasing the predictability of the experience with the dentist.
Acclimatization visit entails several trips to the dental clinic prior to the actual cleaning to establish a routine of going to the dentist and reduce the child’s anxiety associated with the dental clinic.
- Sensory Diet,Heavy Work Have your child do some physical activity just prior to the visit, such as pulling a loaded wagon, jumping on a trampoline or skipping.
Calming techniques during the procedure
- Apply pressure to the child’s joints and large muscles; these “proprioceptive” activities can help decrease a child’s tendency towards overreaction to touch. Provide deep pressure through bear hugs, back rubs, or body massages.
- Place a weighted vest to the legs or torso to supply extra calming sensory input. You can fill the pockets of a vest or jacket with beanbags, or you can use a leaded X-ray apron if available in your dental office.
- Use a handheld massager or a vibrating pillow to deliver relaxing vibrations. As a safety precaution, be sure that the child doesn’t put the massager on his or her neck.
Wrap the child’s arms, legs, or trunk with elastic bandage wraps. Be careful not to get the bandage too tight. Start with the wrist or ankle and wrap your way up the arm or leg. This can be turned into a fun game of “mummy” or “doctor.”
- Familiar toy or fidget object for self-calming during the dental cleaning (think Linus Blanket).
- Dentistry and Autism Specturm, by Dr. Greg Evans DDS
- Going to the Dentist – Interactive Storybook for Children – Help your child prepare for the first dentist appointment 1.0
- Sensory Struggles at the Dentist New sights, sounds and sensations can pose challenges to children with developmental disabilities
- Helping Our Sensory Child Through the First Dentist Visit
- Oral Defensiveness: Making Dentist Visits More Tolerable sensory-processing-disorder.com
- Special Interest Section Quarterly Sponsored in Part by WPS Vol 36, No 3 – September 2013 Published by the American Occupational Therapy Association “Helping Children with Autism Spectrum Disorders Participate in Oral Care” by: Elyse Peterson OTD, OTR/L, Leah Stein MA, OTR/L, Sharon Cermak OTR/L FAOTA