Taking care of your child’s teeth and gums is an important part of their overall health, but visiting the dentist can be daunting for some kids – especially those who have special needs.
Children can be intimidated by the bright lights in the dental office, the unusual noises or needing to hold their mouth open for the exam. Finding the right “dental home” for your child can make the process much smoother, says Dr. Naila Farooq, a board-certified pediatric dentist at Lakes Pediatric Dentistry in Commerce Township.
“The biggest barrier I feel is that they don’t seek a dental home for their child until they’re older,” says Farooq, who has a child with autism. “A lot of them come in after [age] 5.”
That’s understandable, she says, since parents of kids with special needs are often overwhelmed with other issues such as behavior when children are very young. Dental hygiene may not be a focus, but it should be.
“They just get enough advice to just get by,” she says. “I think if they were guided in that fashion by the pediatrician or the primary care physician and the schools to go for a first visit by age 1, I think that really helps.”
Start early and often
Children who have difficulties with sensory processing may feel overwhelmed during their first dental visits.
“A lot of times they’re very sensitive to touch, taste, noise, all of those things,” Farooq explains.
Starting appointments before a child’s first birthday means they can start becoming desensitized to the environment. Look for a dentist who’s open to shortening visits or even splitting a cleaning into multiple visits until the child feels more comfortable.
“They can come in several times for a shorter visit until they get desensitized enough to handle the visit,” she says.
You can also request a “play date” at the office – a short visit with no cleanings or procedures scheduled – just to get your child acquainted with the environment and the staff, Farooq recommends.
“I think that’s fair because even with typical kids … sometimes the anxiety level is off the charts,” she says. “It’s just the way that these kids are wired.”
Ideally, your dentist will develop “a relationship with the whole family,” she says.
Find a pediatric dentist
While many general practice dentists are excellent with children, the southeast Michigan area has plenty of pediatric dentists who are specifically trained to work with children and have tactics for children who are struggling.
“As a pediatric dentist you’re like a dentist with specialized behavior modification skills, basically,” she says, noting that pediatric dentists are prepared to work with any child feeling anxiety, panic or fear. “That same thing applies to a special needs child. The anxiety level is very high in them and the parents.”
A pediatric dental practice may be a more welcoming environment for these situations, Farooq says.
“In the Oakland County area there are lots of pediatric dentists … I feel like that is a safer environment,” she says.
Dentists who are experienced with children who have special needs can utilize a variety of tools and accommodations to put kids at ease. This could include turning off the overhead light, using certain terms that are less anxiety-inducing and allowing for extra time beyond a standard appointment window.
If needed, a papoose (medical stabilization board) may also be used – and often phased out as children get older and more comfortable with the dentist, Farooq says.
“With time, you do develop a relationship of respect because you have to respect them, too,” she says.
Sedation only for “last resort”
In rare circumstances, sedation may be needed, but parents should know it’s a last resort and be leary if it’s recommended from the start.
“I think that’s the thing for last resort. If they’re used to me and we’ve had this relationship for a very long time then I feel you can avoid sedation,” Farooq says. “Sedation is only for very extreme cases. It’s very, very rare for us to refer a child for sedation because of their special needs status.”
Someone who offers advice
Look for a dentist who spends time with the parent and child discussing the importance of dental care – including regular cleanings and practicing good dental hygiene habits at home.
That includes advice for the parents on how to make those things, including tooth brushing, easier for your child with special needs.
“I think it’s always [about] providing the skill set to the parent because the kids don’t come with a handbook. Sometimes it’s going over simple things,” Farooq says. “Being consistent even if they don’t like it, being firm as a parent or as an adult around a child. Not changing the rules just because the kid is out of control.”
That’s “hard to maintain,” she admits, but parents should remind themselves of their own rules when things get tough.
“I think [parents] can get a lot more support from a dentist as well for all of those issues that they face every day at home,” Farooq says.