Oral Health Care Strategies for Autism

istock_000015231692smallInformation in this article was made available from a guide for parents and dental providers of children with special needs developed by the Oklahoma Dental Foundation in partnership with several funders.  The entire guide is available for download at: Oral Health Care For Children With Special Health Care Needs

The following is an excerpt from page 11 of the guide.

Children with autism spectrum disorders can display a variety of behaviors and reactions that can complicate oral care. Coexisting conditions will be covered elsewhere in this guide. Use the following strategies to deal with behavioral issues and unusual responses to stimuli.

Desensitization
• Family member/caregiver pre-appointment interviews are critical
• Consider what time of day the child is the most calm and cooperative
• Some children display quick frustration and violent tempers. Keep a clear path around the
dental area to avoid injury and keep instruments out of reach
• Plan a desensitization appointment
• Let the child sit alone in the chair, floor or wherever they are comfortable until they adjust to the environment. Be creative, an exam can be given standing up for example
• Begin the exam with fingers only
• Use a toothbrush before instruments if the child is old enough to recognize the familiar object
• Ask permission with words or body language before starting dental treatment
• Do not expect the child to give a verbal ok before proceeding. If they don’t try to stop you,
then you have permission
• Make appointments short and positive

Avoiding Overstimulation
• Keep light out of the child’s eyes
• Turn down or off any music or intercom/PA systems
• Praise good behavior and ignore inappropriate behavior as much as possible
• Try to gain cooperation in the least restrictive manner before considering stabilization
• Refer to tips in the Behavioral Management for Oral Health section
• Use the same staff, dental office/chair and appointment time
• Ask staff to minimize distractions. Reduce sounds, odors (including perfumes or cologne) or anything else that might be disruptive to the child
• Allow time for the child to adjust to the noise level and get fully comfortable before starting dental treatment

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