Dental Tribune America

Children with autism often overlooked for dental care

CHARLESTON, S.C., U.S.: Autism affects a child’s social skills. Even simple tasks, such as scheduling an appointment at a dentist’s office, may often be a challenge for children with autism spectrum disorder (ASD) and their parents. As a result, by delaying or missing early dental appointments, children with ASD develop an increased risk of dental caries and oral infections that could impact their entire body. They also miss out on the opportunity to develop a comfortable routine with a dentist.

Dentably magazine recently ranked South Carolina as one of the top states where children with ASD have a high risk of oral health problems. The ranking was based on data obtained from the National Survey of Children’s Health. The survey reported that more than 90 percent of children in South Carolina with behavioral and developmental disorders are not receiving services like behavioral, occupational and speech therapy. Autism Speaks, an advocacy organization, lists behavior as one of the most crucial things parents of autistic children consider when thinking about receiving dental care.

“Everybody deserves a dental home,” said Dr. Cynthia L. Hipp, associate professor at the Medical University of South Carolina (MUSC). Hipp also works in MUSC’s Pamela Kaminsky Clinic for Adolescents and Adults with Special Health Care Needs and recalls going to great lengths to help patients feel more comfortable during their visit, even doing dental examinations on the floor or in cars. “You have to think outside of the box,” she said, while noting that it may often require great patience to ease a child’s fear of the dentist.

To facilitate the process, Hipp advises parents to contact a dentist before scheduling an appointment and to communicate what makes their children feel comfortable. It may also help to familiarize children with the office prior to the dental appointment, since it is important for them to establish routines. Finally, there are children’s books available for parents to help them educate their children about the visit.

Resistant or combative patients may require a higher level of emergency care. Some dentists who are not familiar with patients with autism may refuse to treat them, Hipp explained. The Centers for Disease Control and Prevention has reported that each year an increasing number of children have been diagnosed with autism. “As our population is growing ... we really have to train our future dentists,” said Dr. Michelle Ziegler, Program Director of Advanced Education in General Dentistry and Division Director for Special Care Dentistry at MUSC.

In a 2005 study of over 200 randomly selected dentists in Michigan, more than 60 percent agreed that dental school did not prepare them for working with patients with special needs. “I think it’s certainly not been a priority for dental schools to teach this,” Ziegler commented. Another web-based survey published in 2010 found that the 22 U.S. and Canadian dental schools chosen for the study used a vast number of approaches to educating predoctoral students about the issue, but reported curriculum overload as the main challenge for implementing changes in curriculum.

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