Dental anxiety and the lack of understanding dental care can cause children with disabilities to exhibit resistant behaviors that can interfere with the safe delivery of dental treatment.
Published: February 28, 2019
By: Emily Reed
Visiting the dentist can often come with various challenges, but routine dental care for children with special needs is essential.
“There are lots of ways to help children have successful visits, but we always try to be positive when talking about the dentist,” says Beth Cross, with Thomas Pediatric Dentistry in Birmingham. “Each child is different, so it never hurts to let us know what works best for your child. For example, storyboards are great for children with autism.”
The American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) both recommend all children establish a “dental home” by age 1.
Additionally, the AAPD defines pediatric special needs dentistry as “the practices that treat children with physical, emotional, developmental, cognitive, sensory or mental impairment, as well as those affected by an orofacial disorder or condition.”
Olga M. Sanchez-Hernandez, a dentist with McCalla Orthodontics and Pediatric Dentistry, says that as pediatric dentists, it is a unique position to provide services to special needs patients.
“Our office treats special needs patients on a daily basis,” Sanchez-Hernandez says. “We treat them up to age 21. After that age, their dental needs might be such that they exceed the scope of what pediatric dentists do so, depending on their dental needs we refer them to an adult dentist.”
Sanchez-Hernandez says that dental care for those with special needs often requires specialized knowledge since the array of disabilities is so vast. “During our initial interview with parents or caregivers we inquire about their medical history, and presence of any special needs that the patient might have,” Sanchez-Hernandez explains. “Once documented, the doctor is alerted so that we can be prepared for them in terms of allocating more time on the schedule and having adequate auxiliary personnel available.”
Sanchez-Hernandez says it is crucial for parents to be as honest and thorough as possible to adequately prepare the dentist for what kind of care they will need to offer.
“We have encountered that some parents are afraid to share the extent of their child’s disability because they are concerned that they will not be treated,” Sanchez-Hernandez says. “It is important to make patients feel from that initial contact that they are welcomed in our office and that we will be able to work with them to address their needs.”
Dr. Stephen Mitchell, with Sparks Dental Clinic at UAB, says his office is dedicated to patients with developmental and cognitive disabilities. “We talk in our office to help alleviate fears in the office,” Mitchell adds. “Whether our patients understand our words or just understand the compassion in our voice, we believe communication is essential to alleviating fear.
“Whether our patients understand our words or just understand the compassion in our voice, we believe communication is essential to alleviating fear.” – Dr. Stephen Mitchell
“We also will sing, listen to music, watch videos or any number of other crazy things to help our patients cope. We can schedule desensitization visits and create social stories that families can rehearse at home prior to their visits.”
Mitchell admits that parents of children with special needs or challenging behaviors can often feel overwhelmed with dental visits, but he tries to let parents know everything will be OK.
“We are here because of the challenging cases,” Mitchell says. “Communication is key to calming fears. Parents are welcome in our operatory and are free to ask questions and offer suggestions on how best to manage their child. Our attending dentists have close to 100 years of combined experience treating special needs patients, and we hope that experience is reassuring to parents.”
Cross adds it is important for children with special needs to have a good experience at the dentist, so they encourage both children and parents to not get overwhelmed prior to the dental visit.
“We see children 18 and under with special needs, but if you have been a patient for years with Dr. Clark Thomas, then he will continue to see them as long as he can,” Cross adds.
Dr. Angelica Rohner with Angelica Rohner Pediatric Dentistry says if a child has specific sensory needs, there are options that can be offered such as a private room, referred to as the “sandcastle” room, which is calm and relaxing for them.
“Our office also has sensory bags filled with different items such as sound-bending headphones, fidget toys, sunglasses and weighted blankets to help children feel more comfortable,” Rohner says. “Our entire staff is trained on the latest ways to be able to provide that extra level of care to make our patients comfortable. We partnered with Kulture City to get our Sensory Inclusive Certification, which ensures daily accessibility not limited by time and location thus creating an accepting and inclusive community for all of our patients and their families.”
While dental visits can cause anxiety for some patients, Sanchez-Hernandez says help from the parents or caregiver is key.
“Dental anxiety and the lack of understanding dental care can cause children with disabilities to exhibit resistant behaviors that can interfere with the safe delivery of dental treatment,” she says. “With parental help, most patients with physical and mental disabilities can be managed in the dental office.”
Mitchell adds his practice is unique in Alabama because they exclusively see a developmentally and/or cognitively challenged population. “Our clinic is often filled with laughter and cries, joyous cheers and anxious shouts, and everything in between,” he says.
Whatever the child’s needs, it is important for parents to establish a routine, positive and consistent pattern at home.
“Toothbrushing can be challenging for some of our sensory sensitive patients,” Mitchell says. “But consistency and praise can go a long way. Also, set realistic goals. While many typically developed children have all of their teeth brushed every time, some of our patients may only be able to tolerate one side of the mouth being brushed at one time, and the other side the next time. Give time for the child to develop more comfort having things done in their mouth.”
Additional tips for a positive dental experience for those with special needs can include “playing dentist” at home, reading books about dentists to your child, or discussing what will happen at the appointment prior to the child’s visit.
Emily Reed is a freelance journalist. She lives in Alabaster and is a stay-at-home mom to her two children, Tobias and Lucy.