A Parent’s Guide to Dental Care for Children with Autism Spectrum Disorder
Children with autism may have problems expressing themselves with words and cannot tell the dentist if a tooth is hurting. You may have learned to understand your child’s body language and expressions and may know this from your child’s behavior (such as avoiding eating on the hurting side, rubbing the face on the hurting side, disturbed sleep) if a tooth is hurting. Share these observations with the dentist so that your child’s dental problems are treated.
Every child with autism has unique abilities. Tell the dentist about your child’s strengths, so that the dentist can use these as building blocks to improve your child’s care.
Children with autism need to see a pediatric dentist regularly.
A child should have his/ her first dental visit no later than 12 months of age.
Children with autism perform better in familiar environments and when routine is maintained with repetition. The more your child sees the dentist, the more comfortable he/ she will become, even if the first few appointments are difficult. This is an important reason to establish a dental home for your child early and always keep the check-up appointments.
Children with autism (or autism spectrum disorder) may have one or more of the following reasons for oral and/or dental problems.
Oral sensory problems such as limited food choices or being a “textural” eater may cause children to avoid brushing their teeth or avoid flavored toothpaste.
Children may be hyperactive or resistant when caregiver tries to brush their teeth
Medicines used to help with behavior may make their mouth dry and not have enough spit. Having a dry mouth creates bacteria that cause cavities.
Prepare your child for a visit to the dentist:
Check with the dental office if you can come a few days before your child’s appointment and take pictures of the parking lot, front door, waiting room, dental chair, dental instruments and the dental team members. You can then print these as a picture book, or make a digital album and show your child what will happen at the dental appointment in step-by-step pictures.
Make sure your child takes his/ her medicine on schedule.
Make sure he or she has a good night’s rest before the appointment.
If your child feels more relaxed with a weighted blanket, let the dentist know before the appointment. You may be able to bring it to the appointment or the dentist may use a lead-apron to help your child feel relaxed.
Questions to ask your child’s dentist:
Can my child bring their iPad or tablet?
Yes. If your child uses an app to communicate or is more relaxed if they play their favorite game on their iPad or tablet, bring it with you to the appointment.
Can my child get the laughing gas if they are scared?
Maybe. If your child can keep the nosepiece of the system on his/ her face, then they can safely get the laughing gas (nitrous oxide). The dentist may give you a nosepiece to take home and ask you to help your child practice breathing through this nosepiece before the next appointment.
Can my child be sedated for dental care?
Maybe. Some children with autism may be able to be sedated if they can swallow medicines. Sometimes, the dentist may be able to spray the sedation medicine into your child’s nose, if swallowing medicines is difficult for your child.
Will my child need to be treated under general anesthesia in a hospital?
Maybe. The dentist my recommend this if your child has problems in muscle tone, seizures, or an extremely defiant response to dental treatment. Your child’s dentist will discuss with you the risks and benefits of doing this and why this may be the best way to treat your child.
Does my child need prescription fluoride products?
Maybe. The dentist will decide based on the dental exam and x-rays.
How often should my child see the dentist?
Most children should see the dentist every 6 months. However, if your child is at high risk for cavities he or she may need to see the dentist more often such as every 3 or 4 months.
How can I prevent cavities in my child?
Brush your child’s teeth every morning and night.
Use toothpaste with fluoride in it and has the ADA seal of approval on the tube. You may have to try different flavors to find one that your child likes.
Floss after brushing at night.
Drink fluoridated water.
Stay away from foods that have added sugar. In-between meal snacks should not be sweet treats.
Do not drink juices, sodas, or sports drinks often.
Questions your child’s dentist might ask you:
Who are the doctors your child sees and how can I get in touch with them?
What medicines does your child take? What are the dosages? How does your child take the medicine (Are they liquid or pills)?
How do these medicines effect your child’s behavior?
Does your child have any drug and food allergies?
Does your child responds negatively to any stimuli (such as light, loud sounds, touch, hand holding)?
What grade level you child is in? Does he/ she has an IEP?
Does your child receives behavioral therapy such as ABA?
How does your child behave in other situations such as doctor’s visits, shots, or haircuts?
What does your child eat for meals and snacks? What do they drink?
Do you have difficulty brushing your child’s teeth at home?
Has your child had any complications or problems when having dental work done in the past?
Is your child afraid of the dentist?
Questions to ask your child’s pediatrician:
Does my child need any extra protection while receiving dental care?
Is there anything the dentist should do differently for my child?
Children with autism or autistic spectrum disorders can get cavities, just like children who do not have autism. Dental cavities are preventable by ensuring a healthy, low-sugar diet and regular brushing and flossing.
How to find a pediatric dentist:
American Academy of Pediatric Dentistry: www.aapd.org
American Board of Pediatric Dentistry: www.abpd.org
Additional Information on Autism Spectrum Disorder:
Note: The information you see describes general oral health information for children with autism or autistic spectrum disorders, but it does not apply to everyone. This information is not medical advice. Please contact a healthcare provider if your child has a medical problem. If you think your child may have a medical emergency, please call your child’s doctor or an emergency number immediately.
Text by Priyanshi Ritwik, DDS, MS
Edited by Julie Schiavo, MLIS, AHIP