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Treating Patients with Autism in a Dental Setting

Course Number: 402

Preparing for the Dental Appointment

It is strongly recommended the families and dental team members take some extra time to prepare for the first appointment. The worksheet in Appendix A includes information that will help the staff understand the needs and abilities of the patient.

Here are some general recommendations on scheduling the appointment:

  • Mornings are generally better than afternoons. Getting though a typical day of school and therapy can be very taxing on an individual with autism. A dental appointment at the end of the day may be the tipping point for a patient to have a meltdown, especially if it has been a bad day. Each individual is different, trust the parent/caregiver if they feel afternoons are better.

  • The first appointment of the day is ideal for many reasons.

    • Minimal time in the waiting room and waiting for the doctor. Waiting is especially difficult for patients with ASD and the parents/caregivers accompanying them.

    • The office is quiet and calm first thing in the morning. Staff is fresh and happy and usually more patient. The sterilizers are not yet humming, the drills are not drilling and the staff is not frantically rushing to the next appointment.

    • The waiting room is not bustling with people coming and going.

    • If possible create an appointment ten minutes earlier than regular scheduling. This allows the patient to come in, go directly to the treatment room and get started before the hustle and bustle of the day begins. This also allows for a longer appointment.

    • The operatory was cleaned the night before and the smells of cleaning solutions have settled and are not as obvious.

  • Have everything that could possibly be needed in that appointment ready and within arm's reach, preferably out on the counter. Walking away from the operatory is distracting and confusing, opening and closing drawers is noisy and can contribute to sensory overload.

  • Do not wear perfume (not recommended anyway) or scented lotion that may be offensive to a sensitive nose.

  • If possible, have the patient practice at home. Have the parent/caregiver come in a few weeks before the appointment to pick up a “practice kit” and take a few minutes to demonstrate how to use the items at home. Included in the kit will be disposables that help familiarize the patient with items used during the appointment. Practice should begin a few weeks before the first appointment and be completed several times a week. It is imperative the practice sessions are enjoyable and not forced on the patient. Instruct the parent/caregiver to remain neutral and positive and not scare or upset the patient. The practice sessions at home are helpful in introducing the child to having different items in the mouth. Items in the kit may include:

    • Prophy angle

    • Saliva ejector

    • Fluoride varnish brush

    • Patient bib with disposable holder

    • Gloves, mask for parent/caregiver to wear

    • Disposable XCP holder for bitewings without the metal bar

    • Cotton tip applicator used to place topical anesthetic

    • Disposable mirror

    • Dry angles

    • Consider including pictures of these items placed in the mouth correctly so the parent/caregiver knows how to correctly use it but also for the patient to look at.

  • Ask the parent/caregiver to practice having the patient lie down to have their teeth brushed several times a week before the dental appointment. Use a dry toothbrush so the patient will not choke while lying down.