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Autism and Dentistry: Dental Challenges for Families and Treating Dentists

By HERWriter
 
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Autistic patients – and patients with similar behavioral and intellectual difficulties – present a unique challenge for dentists. Dentistry involves bright lights, loud instruments and touching a very sensitive part of the body. Many “normal” people are uneasy about dental treatment, imagine what it’s like for an autistic person.

Autistic patients are usually hypersensitive to their environment and may react out of sensory overload. They don’t take well to a change in their schedules, new noises, smells, sounds, and activities.

Fortunately, dentists are becoming more aware of the needs of special needs patients. There are still sufficient numbers of dentists who may refuse to treat such patients usually because they’re unsure how to make them comfortable.

Programs like University of South Carolina (which has had a special patients clinic for 24 years), Special Care Dentistry Association (www.scdaonline.org), the National Foundation of Dentistry for the Handicapped (www.nfdh.org), the National Institute of Dental and Craniofacial Research, and the University of Western Ontario (London, Canada) have been cropping up in the last couple of decades to address the concerns of dental practitioners and families. Some offer services where dentists and hygienists will visit care homes, hospitals, personal homes, and treatment centers to care for patients who cannot get out to a dental office. Many will offer their time and care free of charge and offer programs whereby people can donate money to help sponsor this kind of care.

Many autistic patients have the same dental issues as “normal” patients, although sometimes these are exacerbated by improper oral hygiene (either by the patient or caregiver, or where the patient simply won’t allow even a toothbrush into their mouth) and overindulgence in sweets, often used as rewards.

Unique dental issues

For those autistic patients who engage in bruxism or self-injurious behaviors (such as picking at the gums or biting their lip) a mouth guard might be recommended so long as it is tolerated by the patient.

Dentists will be able to advise whether medications are affecting saliva production or may contain sugar. Lower saliva productions levels have been shown to increase the possibility of the development of the bacteria that causes cavities and bad breath. Add that to increased sugar intake and it becomes clear that this situation has to be monitored closely. Simply rinsing with water after taking sugary medications or treats can help.

For those with seizure disorders trauma and injury can be common. Caregivers should know how to preserve the lost or broken tooth and know to seek dental treatment right away.

Dental visit tips

1) Arrange for a tour of the office. Let the patient sit in the chair with normal overhead lights. No drills running. Let them see the trays and touch and feel everything, including the X-ray machine. Let them meet all the staff.

2) Make the first official dental visit short and as uninvasive as possible.

3) Ensure that the dentist or hygienist explains (or you explain on their behalf) what is going to happen, what is going to be touched, what instrument is going to be used, what that instrument is going to feel like, how long it’s going to take.

4) Never be afraid of insisting that you be present during the dental appointment – it’s likely inevitable that your child or dependent will require you there anyway. Make sure the dental staff is comfortable with this.

5) More extensive dental treatments, extractions, fillings and even X-rays can be done under sedation or general anaesthesia if the patient’s behavior is likely to create difficulty for the dentist in providing safe care.

Sources: www.usc.edu/hsc.dental, www.nidcr.nih.gov, http://dentalresource.org, www.nfdh.org

Add a Comment25 Comments

HERWriter (reply to Anonymous)

That's why it's important to find a dental routine that works for you. An alternative might be a waterpik. With some of these there is no brush contact with the teeth or gums, but the plaque and food particles are still taken care of. Rinsing everyday with a non-alcoholic/no-sugar solution (I found one with baking soda and witch hazel) works to keep the alkalinity (prime environment for bacteria and cavities) down in your mouth.

Perhaps other products will come available in the future that will address these needs more directly.

August 30, 2009 - 3:58pm

Hi,
My son has not been diagnosed with autism yet. He is 8 and has taken several of the medications that autistic children take (depakote, Tegretol, Topomax, Lamictal). He took the meds. for a minor tic and abnormal EEG.
I would love more information on the physical damage incurred from either the cause of autism (vaccines) or the treatment there after (drugs) on teeth and gums. For example I know one of the drugs my son was taking can cause his gums to grow and you got into it a little regarding meds. and salivation. My concern is that at 8 1/2 my son has not lost any baby teeth.
He's no longer on meds. as he has recovered, although it has been a year since the meds.
Thanks

August 30, 2009 - 8:06am
HERWriter (reply to Marilyn965)

Even non-autistic children are sometimes delayed in losing their teeth. Not every child loses teeth at the same age as everyone else. I know our son didn't lose any until closer to 9 - he has Aspergers.

August 30, 2009 - 3:55pm
EmpowHER Guest
Anonymous

Ms Oakley,

thank you very much for this. I thought this information was quite valuable and wrote a post to send some people here for good information. http://leftbrainrightbrain.co.uk/?p=2939

Expect to see a number of commenters being referred by the Age of Autism blog--a blog which promotes vaccines and mercury as causes of autism.

August 30, 2009 - 7:50am
HERWriter (reply to Anonymous)

You're welcome and thank you for the referrals.

August 30, 2009 - 3:53pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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