Dental Care for Individuals with Autism Beverly King, M. Ed.
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Transcript of Dental Care for Individuals with Autism Beverly King, M. Ed.
Dental Care for Individuals with Autism
Beverly King, M. Ed.
Objectives
• Learn ways to teach children proper oral
hygiene.
• Discuss a variety of ways to support and
facilitate good oral hygiene practices at home.
• Learn positive behavioral strategies to
implement for dental office visits.
First Visits
• First tooth or first birthday
• Old guidelines suggested age 3– Behavior management– Damage has already occurred
Nutrition and Dental Care
Thumb Sucking/Pacifier
• Normal and healthy for infants
• Gives children a sense of emotional security and comfort.
• After age of 5 dental problems can occur
• Can cause speech problems.
• Jaws can become misaligned
• Roof of the mouth can become malformed
Positions for Brushing
Courtesy of Dr. Simon Morris, White Oaks Pediatric Dentistry, Los Gatos, CA
• Position yourself behind your child
• Tilt child’s head up
• Cradle child’s head in your arm
• Use your free hand to pull back cheek
Knee to knee position
Courtesy of Dr. Simon Morris, White Oaks Pediatric Dentistry, Los Gatos, CA
• Used for those that are uncooperative
• Sit facing another adult, knee to knee
• Sit child on your lap facing you
• Wrap legs around your waist, hold arms down
Brushing Technique
Courtesy of Dr. Simon Morris, White Oaks Pediatric Dentistry, Los Gatos, CA
• Most important areas-Gum line
-Chewing surfaces
• Use free hand to lift lip, for upper area have child
close mouth
• Use circular stokes pointed at gum line
• Two minutes (sing ABC song, use a timer)
Teaching Child to Brush
• While you brush have child watch
• Next have child brush your teeth
• Next help child brush (hand over hand)
• Next have child brush and you watch
When should parents stop brushing their child’s teeth?
• Fine Motor skills
• Writing name
• 6-8 years old
• Flouride/Spit effectively
Visual Supports and Schedules
• Visual schedules break down large tasks into separate steps, allowing the child to perform each task before going on to the next
• Can teach specific tooth-brushing steps.
• Reinforce with verbal praise after each step or multiple steps are completed
• Use social story or visual schedule to before visit for familiarization
Practice Dental Visit at Home• Putting their hands on their stomach
• Putting their feet out straight
• Opening wide
• Holding their mouth open
• Counting their teeth
• Cleaning with a power brush
• Spitting into the sink
• Taking X-rays
Provide Visual Examples
http://www.youtube.com/ Search dentist visit
Search dental visit visualhttps://www.google.com
Social Stories
• Describes the social situation
• Provides descriptive, perspective, or directive statements
• Considers the perspective of the child
• Teaches routines for new events
The Gray Center : www.thegraycenter.org
Example
Preparing For The First Visit• Check to see if your dentist has materials
available for families to access via website or prior to visit.PaperworkTask Analysis Social ScriptsFun activities
• Schedule preferred appointment time
• Discuss insurance/payment options
First Visit
• Greeting
• Introduction to staff
• Interview
• Tour of facility
• Familiarize with equipment (model)
Dental Exam
• Use clear simple language
• Give direct request
• Explain each procedure
• Break down each task into smaller steps
• Reward individual steps
• Allow use of personal items for calming
• Use a timer or count downs
Sensory Processing
Auditory High-speed Handpiece, Ultrasonic Scaler
Gustatory Gloves, cotton rolls, gauze, alginate, metal, medicaments, fluoride, paste
Olfactory Cleaning products, medicaments, fluoride, paste, perfume
Vision Florescent, Operatory, and Curing Lights
Tactile Touch (over/under reactive), Proximity to people, water, lead apron, cotton rolls, gauze, napkin
Sensory Processing(continued)
*Vestibular Operatory chair, Panoramic X-ray
*Thermoception Water, Slow-speed Handpiece
*Proprioception Positioning mouth, tongue, or body
*Nociception Pain sensor
Video Example
• http://www.whiteoakspediatricdentistry.com/videos/cleaning-with-hygienist/
Questions
Recommended books
• “I Know Why I Brush My Teeth” By Kate Rowan
• “The Tooth Book” By Dr. Seuss
• “Little Bear Brushes His Teeth” By Jutta Langreuter/Vera Sobat
• “The Berenstain Bears Visit the Dentist” By Stan and Jan Berenstain
References• American Academy of Pediatric Dentistry Clinical Affairs
Committee-Behavior, American Academy of Pediatric Dentistry Council of Clinical Affairs. Guideline on behavior guidance for the pediatric dental patient. PediatrDent 2008-2009;30(7 Suppl):125-33. [63 references] PubMed
• Elliott-Smith S. Special Products for Patients with Special Needs. Available at: www.adha.org. Accessed February 2010.
• Folse G., Glassman P., Miller C. Serving the Patient with Special Needs. Available at: www.adha.org. Accessed February 2010.
References
• The National Autism Society, Patients with Autism Spectrum Disorders: Information for Health Professionals. Available at: www.autism.org . Accessed February 2010.
• The National Autism Society, Dentist: preparing for a Visit. Available at: www.autism.org . Accessed February 2010.
• The National Institute of Dental and Craniofacial Research, Practical Oral Care for People with Autism. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/DevelopmentalDisabilities/PracticalOralCarePeopleAutism.htm . Accessed February 2010.
• The Academy of Dental Therapeutics and Stomatology, Building Bridges: Dental Care for Patients with Autism, Available at http://www.ineedce.com . Accessed February 2010.