Going for a dental checkup is a rite of passage for kids that can be exciting for some and challenging for others. When you have a child on the autism spectrum or with another developmental disability, going to the dentist can be so intimidating (for the child and the parent) that unfortunately, many may choose not to go at all. The sensory overload and strange environment, combined with the need to comply with unfamiliar procedures and follow unbearable instructions, can be too much for many children. Luckily there are places like Montgomery Pediatric Dentistry in Princeton, where the staff and dentists are dedicated to ensuring that all children have a successful experience and feel welcome.
OPEN AND SAY AHH?
My daughter, E, is 12 years old and is on the autism spectrum. When she was little we tried to take her to many pediatric dentists and they could barely get her to open her mouth. While these places had colorful, kid-friendly lobbies and the necessary TV screen on the ceiling above the exam chair, it wasn’t enough to comply with the exam, and we left disappointed that we would be missing out on critical preventive dental care.
But eventually, we found Montgomery Pediatric Dentistry (MPD). Geena Russo, DMD (photo opposite page), one of the board-certified pediatric dentists at the practice, tells me that she did a two-year pediatric residency and that the goal of the entire staff is to make the dental office a place that is warm and welcoming to everyone.
START WITH WHAT IS KNOWN
An important way to make the checkup experience a little easier is to start with what a child is used to, says Dr. Russo. “We might not use a dental tool or a mirror right off the bat,” he says. Instead, it will start with a toothbrush and toothpaste, just like what the child uses at home. “We make it similar to what they’re used to,” he explains, and that might mean using a manual toothbrush on the patient to start. The idea is to use what the child already tolerates and develop it using other dental tools such as the scaler and mouth mirror. Russo also uses different flavors of toothpaste to make cleaning a little more tempting, and cool sunglasses that kids can wear to deal with the bright light of exams.
The first time E visited MPD, the dentist was really patient, explaining everything to her before doing it. Let E touch and hold the tools. When it quickly became apparent that E was not ready for power tools, they used a rotary brush to complete the full clean. At that exam, they were able to measure her teeth, clean and apply fluoride treatment.
When the dentist told me that “today was a big win” for E, I knew I had found the right place.
HOW CAN PARENTS HELP THE PREPARATION
When it comes to visiting the dentist, there is a lot you can do to prepare your child for the experience. For E, reading a social story and watching a video about a visit to the dentist is helpful in understanding what is going to happen.
“Parents can show the child graphics,” suggests Russo. “You can go to the practice’s website to see pictures of the dentist and staff and the location.” Call the office ahead of time to find out what is included in a routine visit to help better prepare your child. Regular flossing and brushing at home is also great preparation for visits.
WHAT ABOUT THE SHIPPING?
Dental sedation, which may include the use of nitrous oxide (laughing gas), oral conscious sedation (where the patient is awake), or intravenous sedation (where the patient is asleep) may be used in special cases, such as when a patient cannot cooperate for a necessary procedure. There are different levels of sedation, from light sedation, which simply makes the patient drowsy, to general anesthesia, which renders the patient unconscious. The type of sedation used will depend on the procedure being performed and the individual needs of the patient.
“We reserve sedation for really important situations like serious cavities, when we wouldn’t be able to get the job done otherwise,” says Russo. He says they will try to take preventative measures first by finding cavities while they are still small. If sedation is required, an anesthesiologist will administer the medication so you can focus on dental care.
CONTINUOUS VISITS
By bringing your neurodiverse child to the dentist and continuing to go for regular checkups—which are usually every six months, but can be as frequent as every three months if necessary—the goal is to acclimate them to the experience so that something else they are able to do. “We want to set kids up for a lifetime of positive dental visits,” says Russo. “The first visit might be to do a checkup, clean the teeth and say they look great.” She says if they can see a child regularly, they can spot problems while they’re still in the smallest place and treat them before they become an emergency. Consistency is key, so that very small progress ends up making a big difference.
Russo reminds parents to check their fears about visiting the dentist at the door and paint the experience in a positive light. I also found that managing my own expectations for the visit was key. I took it ok that E wouldn’t get a full polishing job the first time. I now recognize that there is a huge difference between not opening your mouth and getting dental care, which is so important for overall health. Several years later, going to the dentist is no longer a scary proposition for E (or me).
“Many of our patients, we’ve seen them over the years and as they get older, they don’t want to leave,” says Russo. “We wouldn’t turn away anyone we’re in a position to help.”
—Ronnie Koenig is a lifestyle writer living in Princeton with her husband and two children.
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