Developmental Disorders

Caring for the Patient that has Autism

Reviewed By: Rebecca Comstedt, RDH, BS

Date: June 23, 2019

Caring for the Patient that has Autism

Communication is a challenge. Be patient, gentle, use pictures, talk to caregiver prior to first appointment.  Interviewing the caregiver is an important first step towards a trusting relationship between the dental health professional and the patient. Download the free “Dental Tool Kit,” on AutismSpeaks.org.

Imagine having heightened awareness of your senses, and an inability to communicate. You see the bright lights more vividly. You hear the dental drill, suction, ultrasonic cleaner, and scalers more loudly. You smell the cleaners and products more strongly. You are being reclined into a vulnerable position. You feel the cold mirror, gloved hands and gauze more profoundly. But you cannot communicate your thoughts or feelings. You may be uncooperative, angry, physical violent.

Think about each of the senses and how you might lessen the stimulation.

SIGHT

Provide sunglasses, or have them bring their own. If you have a headlamp, consider not using the overhead light.

TOUCH

Consider using the lead apron on the patient throughout the appointment (the weight can have a calming effect). Have them bring a special stuffed animal or blanket that provides security. If you can send gauze or glove home so they can play with them and get used to them.

SMELL

Consider aromatherapy (lavender and orange tend to be calming)

SOUND

Headphones! Have caregiver bring some, or provide some at the office. Music is often calming to the patient, but make sure it is music they prefer.

TASTE

Use their favorite toothpaste as a polish. Have the caregiver bring it, or purchase it in advance.

Be warm with the patient. Give High Fives. Communicate with them at eye level, avoid talking over them. Ask the patient, “what does Happy sound like?” Provide pictures for “STOP” “Break, Please”. Use a visual schedule. Keep appointments brief.

Home Care: Contact the child’s school or send a written request to put together a picture story for the child. This will help the child learn the steps in oral hygiene. Or have tooth brushing included on IEP (Individualized Educational Plan).

Behavioral modification strategies for those with Autism vary in success with each individual. Many families have had some success with Applied Behavioral Analysis (ABA). This involves rewarding the child when he/she does the desired behavior. Often candy is used, which can quickly lead to decay. Xylitol treats can be a nice alternative, but they need to be dosed appropriately (put the daily dose in a bag. Cut or break the gum/candy into smaller portions to be used as rewards throughout the day).

Medications // Frequently medications that are used for mood/behavior will cause xerostomia. Talk to the caregiver about caries prevention strategies.

Check out Autismspeaks.org and search for Dental Tool kit, for more information.