Most children have at least a little anxiety about the dentist. The bright, fluorescent lights, sharp tools, the smell/taste of oral products, touch on the face and mouth and masked strangers – the combination would have anyone on edge. For those with special needs – especially those with sensory disorders – going to the dentist can seem an overwhelming impossibility. The good news is a combination of occupational therapy to prepare a child AND the increasing availability of pediatric dentists giving special consideration to patients with disabilities makes these necessary visits not only possible, but successful.

How Dentists Are Trying to Improve Services for Patients With Special Needs

The American Dental Association reports there are a significant number of people with developmental and cognitive conditions that can make dental procedures or even routine visits very difficult. Among young children, these primarily include those with autism spectrum disorder (95 percent of whom have a sensory processing disorder), Down syndrome and spinal cord injuries. Complexity in treating this population has led to an evolution of a whole new specialty in dental care.

Health care experts have conducted a number of studies recently, including one last year, finding that a sensory-adapted dental environment can help tremendously in reducing anxiety, pain, sensory discomfort and uncooperative behaviors. Some of the methods incorporated can include:

• Lowering the lights and darkening the curtains;
• Playing soft, rhythmic music on overhead speakers;
• Allowing patients to wear an x-ray vest throughout the visit for added pressure/comfort.

Even so, the experience can be overwhelming. Occupational therapy can be key in helping prepare a child for a successful dental visit.

Our Fort Myers occupational therapy team at FOCUS recognizes that oral hygiene is an essential self-care function, and neglect can lead to serious health problems – both immediate and long-term. As such, we’re committed to helping children and their families prepare for an upcoming dental visit with oral desensitization techniques, social stories and more.

Most Parents of Children with Special Needs Report Dentist Difficulties 

Difficulty with the dentist is a major headache for many parents of children with special needs.

A 2012 survey of hundreds of parents of children with special needs (higher-than-average number of those with ASD), 60 percent said they’d had moderate to extreme difficulty in having a dentist complete a routine care cleaning. That’s compared to 13 percent of parents of typically-developing children. Children who had ASD who were “overresponders” to sensory stimuli reported far greater difficulty.

Many have a hard time just coping with brushing their teeth, let alone having a stranger’s hands and strange tools in their mouth.

Sensory defensiveness is often at the root of these difficulties. Sensory defensiveness is a type of sensory processing disorder, occurring in children with a wide range of disabilities and conditions. Sensory defensiveness is when a person has an overactive response to sensory experiences, which include not just touch, sight, taste, sound and smell, but the vestibular system (balance, sense of movement in relation to gravity), prioprioceptive (position of body parts, joints, muscles) and inner systems (hunger and elimination).

Although some dentists offer procedures that involve the use of “laughing gas” or general anesthesia to allow for a safe, successful visit, the reality is many insurers won’t cover those additional costs, which can stretch into the thousands of dollars. Plus, if it’s possible for them to adapt and ultimately develop a positive relationship with the dentist, it will mean better oral care in the long-term.

Tips to Help Make Your Dentist Visit a Successful One

Developing a plan in occupational therapy well in advance of the visit tends to yield the most positive outcomes. If you wait until the last minute, it’s likely to lead to extreme anxiety.

1. Create a visual calendar so child can count down the days and knows what is coming.
2. Craft a social story (you can get help with this in occupational therapy) to break down each step so nothing is a surprise.
3. Discuss your child’s special needs with the dentists, including behavior strategies that have worked.  Feel free to tell them specifically – in advance and in writing – if there are certain special considerations or boundaries. Thinks like: Do not touch or approach without telling them what you are doing/asking for permission; Be aware of child’s personal space; Speak slowly and in short, simple sentences; Show equipment being used before using it, etc.
4. Develop some sensory strategies that might help before, during and after a visit. These can include headphones – silent, white noise or with calming music, bring a weighted vest and maybe a stress ball to squeeze or fidgets, which can help lower anxiety.
5. Bring visual reminders/schedules.
6. Maintain good oral hygiene. Most young kids won’t do a great job brushing their teeth unless supervised. You’ll be saving your child the pain and anxiety of an even more intensive visit if you can keep up on their oral health.

If you have additional questions/need more ideas on strategy, consult with your child’s occupational therapist.

More Blog Entries:

Fort Myers OT Tips: When Your Child Might Need Feeding Therapy, June 9, 2019, Fort Myers Occupational Therapy Blog