Many of us do not enjoy visiting the dentist, though we know how important it is for our health to do so regularly. It may be an association with pain and discomfort, a bad childhood memory or a dislike of having someone remarkably close to you and poking around in your mouth! A trip to the dentist for any young child can be difficult, and for an autistic child there may be even more issues. However, as is often the case with autism, a few relatively minor adjustments may make a huge difference. The good news is that some planning and preparation can help to make the trip go much better than it otherwise may have done. Research has shown that clear and open communication between parents and dental practices creates a collaborative partnership that works in the best interest of all. This resource aims to cover what you can do before and during the visit to make it as stress free for your autistic child as possible. Of course, there are no guarantees, but as the parent of an autistic child we know that it is important to you to do everything you can to make the experience go as well as possible for your child. How a trip to the dentist could be problematic for your autistic child There are several areas you need to consider that may cause issues for an autistic child visiting a dentist. Firstly, many autistic people are hypersensitive in one or more of their senses, so they may be particularly wary of loud or strange noises, or strong smells or tastes. Bright lights may be a problem, and certain textures could be unpleasant, especially in a sensitive area like the inside of the mouth. All of these may well arise on a typical visit to the dentist. Secondly, autistic people often love their routines and can find changes and new places and experiences difficult. A visit to the dentist will usually be an occasional event rather than a regular part of a routine, which may be unsettling. If this is combined with a memory of a bad experience on a previous visit, anxiety and stress levels will rise. Thirdly, an autistic child may find it hard to describe how they are feeling and answer questions about what is causing pain and where the pain is. This may make the dentist’s job harder and cause further stress for your child if not managed. How to find a dentist to accommodate your child’s needs Dentists are people just like all the rest of us, so have different approaches, personalities, strengths and weaknesses. It is well worth doing some research and talking to dental practices you are considering rather than just choosing the one closest to where you live. Some practices may prefer not to treat your child because they are unsure if they can properly accommodate them. If a surgery takes this view, try to be grateful for their honesty and openness rather than upset that they do not want to see your child. If you know of any local autism support groups, they may be able to tell you about dentists in your area that have been sympathetic and helpful in treating autistic children. Other parents of autistic children, if you know any, may be able to help too. A key question to ask a dental practice is whether they have experience of treating autistic children and what, if any, adjustments they can put in place to make the visit go more smoothly. Talk to them about your child’s particular sensitivities and how they might be catered for, and check if you will be able to accompany your child into the room for the examination. Can they accommodate you at the time of day that is best for your child, and are they able to ensure that waiting times will be kept to a minimum? If you are going to need several visits for a course of treatment, will the same staff be present for each appointment? How does the dentist manage children whose behaviour or anxiety during the visit makes things difficult? How to prepare your child for a trip to the dentist Proper preparation for your trip may pay huge dividends later. For all of us, many of our anxieties arise from fear of the unknown. The more you can prepare your child for what is going to happen, the less anxious they are likely to be. One really good way to do this is to read a story about a child visiting the dentist. There are many such books available to buy, or you could even put together your own story. If there are pictures in the book, you will be able to talk through the different things that your child will see at the dental surgery and talk through any concerns they may have. Reading the story several times over in the days before the visit will give your child the chance to think through what is going to happen for themselves. You may also want to show the book or story to your dentist so that they can refer to it when speaking to your child. It may be possible for you to take your child to visit the surgery to look around before they go to be examined or treated. Again, this will help to remove some of the uncertainty, reduce anxiety and give your child further opportunity to think through what is going to happen and to ask questions in their own time. Even if you are unable to visit in advance, try and find out exactly what the procedure will be when you visit – who will you see, in what rooms and in what order? It can also help to tell your child’s teacher and anyone else they see regularly, such as other family members or therapists, about the trip to the dentist in advance. They can then support you and reinforce the reassuring messages you are giving to your child. When it comes to the day of the visit for treatment, try to make wider plans by including doing something fun before going and perhaps a treat afterwards. If you think your child will be less stressed if they are tired when they arrive, take them for a good, active play session first. If being tired will make them more irritable or sensitive, schedule the visit for just after a time when they will have recently rested. If your child is not used to having their teeth cleaned and therefore having anything other than food in their mouth, it will be helpful if you can work on this before visiting the dentist. Oral hygiene is an extremely important habit to encourage, and there are many ways to make this fun and appealing to children, such as novelty toothbrushes, tasty flavours of toothpaste and stories to read that include teeth cleaning. As with all the suggestions here, you know your child best and what they like and dislike, so focus on approaches that you think are most likely to be effective, while always remembering that occasionally a completely different approach is what gets the best results! What adjustments can be made during your visit There are many different things that can be done during the visit itself to make it go as smoothly as possible for your child. You will ideally have discussed these in advance with the practice and talked to your child about what will happen. Some ideas are: Adjusting the dentist’s chair to the correct position before the child gets in if the movement may distress them (or on the other hand, making a big thing of the fun chair that moves while they are sitting on it!) Covering the chair with fabrics that have a texture your child likes or even bringing a favourite blanket or other towel from home for them to sit on for comfort. If your child likes a weighted blanket, perhaps they could have this over them during the examination. If your child is sensitive to light, talk to the dentists about whether the light can be kept out of their eyes, or bring sunglasses for them to wear (this could even be made a fun part of the adventure!) If sounds are an issue, consider using ear protectors or headphones that your child is used to wearing. Allow your child to hold and play with a favourite fidget toy while being treated. Talk to the dentist about whether it would be helpful to bring your child’s own toothbrush and toothpaste with you for familiarity, and make sure they know about any flavours or textures that your child finds particularly unpleasant. It may help your child if the dentist tells them what they are about to do and shows them the tools they are going to use – very few of us would respond well to having something put into our mouth without having any idea what it is! Telling your child how long each stage will take in a way that they will understand and praising them for getting through each part may also be helpful. If your child struggles to communicate how they are feeling, talk to them in advance about what they will do if they are in pain or uncomfortable, such as squeezing your hand or tapping their foot, and make sure that the dentist knows this sign. Consider and discuss with the dentist the option of using a tablet for the child to watch a favourite programme during the treatment to distract them. If your child has a brother or sister, they may be comforted by watching their sibling be treated first. Be positive and supportive of the dental team while you care for your child during the appointment. Your child will very quickly pick up on any anxiety on your part and it will undermine any confidence they are feeling. Asking the dentist questions about treatment options and what they are doing is, of course, welcome and important, but showing stress or flinching yourself during a procedure will not help your child. If you are concerned about something the dentist does, it is probably best to discuss it with them later rather than to have a dispute in front of your child unless you have very serious concerns about what is taking place. Inevitably a resource of this type can only give an overview of the issues. Every child is different and will have different needs and preferences. Download the PDF resource Other Resources How to support your autistic child during Covid-19 This resource is a guide to help your autistic child through this challenging time, how you can help them to get an understanding of what is going on, and how to prepare them for what they can expect on a day-to-day basis. How to communicate with a non-verbal autistic child This resource provides information around what non-verbal autism is, as well as actionable advice on how to communicate with a non-verbal autistic child. What is Non-Verbal Autism? This resource aims to provide a range of information, support and ideas about how to help a child with autism.