Dentist Visits for Kids with Sensory Defensiveness

Dear Melissa,

I am worried about my son’s first dentist appointment. It is scheduled next month! My son is 5 years old and has a diagnosis of Autism. He barely lets me brush his teeth due to his sensory defensiveness.

In my work as a pediatric occupational therapist, I help prepare my kiddos for the dentist by practicing ahead of time. I have them lie down on their backs while I gently “tap” their teeth. We gradually work towards me brushing their teeth with a regular then electric toothbrush. We also read and write stories about going to the dentist. However, as a mom and sensory-based occupational therapist, I know that the particular dentist and hygienist you choose really matters.

It is very common for children on the Autism Spectrum and children with Sensory Processing Disorder (SPD) to have various forms of oral defensiveness. Therefore, it should not surprise us that these children are often terrified of the dentist. When it comes to finding the right dentist, I use Dr. Karen Green for my own kids, and I also recommend her to the families I work with. She is a Board Certified Pediatric Dentist at Pediatric Dental Associates and Orthodontics. I have found the staff to be very calm and patient. I recently reached out to Dr. Green to gain her perspective on this subject.

Melissa: What do you wish a parent would tell you (the dentist) before their child’s first dental visit if the parent thinks that the child will have a stressful time?
Dr. Green: If you are concerned that your child may have a stressful first visit, let us know. It is nice when the parent informs us as to how oral hygiene procedures usually go at home. Is the child is resistant to brushing? Do they scream at the sight of floss?

Melissa: What do you wish a parent would tell/do with their child before their first dental visit to make it less scary?
Dr. Green: It may be helpful to bring your child to the office for a “comfort visit” where you show the child the office and let them become comfortable in the environment. Books,pictures and/or videos about going to the dentist are often helpful. It also may be beneficial to practice brushing your child’s teeth while they are laying down. Know that if you as the parent are overly anxious about the dental visit, the child will usually pick up on this anxiety and become more nervous.
Melissa: What can the dentist/dental office do to help alleviate fears of the child/parent?
Dr. Green: The dental home you choose for your child should be willing to help lessen the fears by providing an inviting atmosphere and using kid-friendly phrases for dental tools and procedures. We use phrases such as “train whistle” instead of drill,”silly nose” instead of gas mask, and “brave air” instead of nitrous oxide. We avoid the use of the word “shot”, we often describe it as “giving your tooth a little sleepy juice”.

Melissa: At what age should a child first see the dentist?
Dr. Green:The first dental visit should be scheduled after the eruption of the first tooth and no later than 12 months of age (as recommended by the American Academy of Pediatric Dentistry). Prevention is key. Dental problems often start early, and the sooner we catch a problem or potential problem the better! We address diet, hygiene, age-appropriate injury prevention, and counseling for nonnutritive oral habits (e.g., finger sucking, pacifier, blankets). We also provide anticipatory guidance (what to expect for your child’s developing mouth).

Melissa: How often should most children see the dentist?

Dr. Green: For most children, we recommend seeing the dentist every 6 months. This is adjusted based on the needs of the child.