Sensory Integration and Special Needs in the Dental Office
Most people have some degree of aversion to the sensory-rich dental experience. The sights, sounds, smells, tastes, and metallic instruments are literally in our faces. We can’t move or escape, while the dentist contorts our lips, sprays water while our mouths are open, and we try to breathe and communicate. It’s a challenge whether special needs are present or not.
What can be done to make the experience easier, and less traumatic? Always, we need to look at each dental experience as a learning moment for future medical and dental encounters. In my 35 years of clinical experience with people on the autistic spectrum, physical restraint of young patients can create intractable memories of fear that may never be overcome. Even overly authoritarian demeanor on the part of healthcare personnel can create long-term fear and avoidance, which will complicate future treatment.
Our approach must be client-centered, and individualized to educate, gain trust, and be patient. Prevention is essential. At home, we need to help people learn to be as self-sufficient as possible for cleaning their teeth. We also need to address nutritional issues that promote tooth damage such as sparkling, fruity, or otherwise acidic beverages. Refined foods that aren’t satiating, are sticky, or promote constant nibbling can create unnecessary dental care. There is a trend toward consumer products; toothpaste, rinses, or pastes that remineralize damaged enamel. Look for those, and ask your dentist, and hygienist for recommendations.
Technology in the form of less invasive imaging can help patients who have difficulty with conventional X-rays. CBCT is a form of three-dimensional imaging that can give information on cavities, extra teeth, or wisdom teeth if the patient can be still for about twenty seconds. The CariVu is a special camera that can rapidly scan a patient’s mouth for cavities without an X-ray. Silver diamine fluoride is a topical liquid that can stop cavities without the need for numbing a patient, or more involved restorations.
Patients can be given medication appropriate for their needs to help relax and relieve pain. While we want to minimize reliance on drugs and sedation, they can provide comfortable experiences that allow for better, proper dental care.
As always, it’s about treating the individual, to have an understanding of their needs, consulting with family and caregivers, and providing a comprehensive and humanistic environment.
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Here are a few helpful tips to improve the dental office visit and patient experience by creating a nurturing environment.
- Bring a soft, cozy blanket. Blankets provide warmth and security in the dental chair.
- Wear sunglasses during a dental appointment. Sunglasses will not only protect the eyes from any bright light; they can also provide a comforting barrier for the patient by bringing a sense of protection and emotional security. Sunglasses and subdued lighting can down-regulate our anxiety.
- Play some soothing music. Bring headphones or make music arrangements with your dental care provider. Music therapy in healthcare can lower stress level and enhance relaxation.
- Attentive post-treatment care. Go above and beyond in providing comfort after any dental treatment. Every patient should have consideration for controlling pain post-operatively. Patients can be given Tylenol or ibuprofen before leaving the office so that they’re comfortable when the numbness wears off. Sensory patients can be particularly discomforted by the numb feeling. Dentists can now make the numbness wear off much more quickly with Oraverse. Ice cream, ice pops or soup; comfort foods can help patients feel well cared for, nourished and cozy after a dental appointment.
We have come a long way in understanding the aspects of autism and special needs. We can achieve improved dental care and patient experience by incorporating this knowledge with modern dental technology. Positive dental experiences can have a lifelong, lasting effect on good oral health, and lots of smiles.
Louis Siegelman DDS, is a dentist anesthesiologist with a dental practice in NYC focused on the treatment of dental anxiety. In addition to maintaining a private practice, Dr. Siegelman is involved in teaching, resident training and education. His career is devoted to helping people with dental phobia and special needs.
This article was featured in Issue 76 – Raising A Child with Autism