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 kid on the autism spectrum or with another developmental disability, visiting the dentist might feel so intimidating (for the child and the parent) that sadly, many may choose not to go at all. The sensory overload and strange environment, coupled with the need to comply with unfamiliar procedures and follow hard-to-tolerate directions, can be just too much for many kids. Thankfully there are places like Montgomery Pediatric Dentistry in Princeton where the staff and dentists are dedicated to making sure all kids have a successful experience and feel welcome.
OPEN UP AND SAY AHH?
My daughter, E, is 12 and on the autism spectrum. When she was little, we tried taking her to multiple pediatric dentists and they could barely get her to open her mouth. While these places had colorful, kidfriendly lobbies and the requisite TV screen on the ceiling above the exam chair, it wasn’t enough to get her to comply with the exam and we left disheartened that she would be missing out on crucial preventative dental care.
But finally, we found Montgomery Pediatric Dentistry (MPD). Geena Russo, DMD (pictured on the opposite page), one of the board-certified pediatric dentists in the practice, tells me that she did a two-year pediatric residency and that the goal of the entire staff is to make the dentist’s office a place that’s warm and welcoming for all.
START WITH WHAT’S FAMILIAR
One important way they make the checkup experience a little easier is by starting with what a child is used to, Dr. Russo says. “We might not use a dental tool or a mirror right off the bat,” she says. Instead, she’ll start with a toothbrush and toothpaste, just like what the child uses at home. “We make it similar to what they’re familiar with,” she 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 build up to using other dental tools such as the scaler and mouth mirror. Russo also uses different flavors of toothpaste to make the cleaning a little more enticing and cool sunglasses kids can wear to cope with the bright exam light.
The first time E visited MPD, the dentist was really patient, explaining everything to her before she did it. She let E touch and hold the tools. When it quickly became apparent that E wasn’t ready for electrical tools, they used a spin brush to work up to a full cleaning down the line. At that exam, they were able to count her teeth, do some cleaning and apply a fluoride treatment.
When the dentist said to me that “today was a big win” for E, I knew I had found the right place.
HOW PARENTS CAN HELP PREPARE
When it comes to visiting the dentist, there’s a lot you can do to prepare the child for the experience. For E, reading a social story and watching a video about a dentist visit is helpful for her to understand what’s going to happen.
“Parents can show the child visuals,” Russo suggests. “You can go on the practice’s website to see pictures of the dentist and staff and the location.” Call the office in advance to find out what’s involved in a routine visit to help better prepare your child. Practicing regular flossing and brushing at home is also great preparation for visits.
WHAT ABOUT SEDATION?
Sedation dentistry, which can include the use of nitrous oxide (laughing gas), oral conscious sedation (where the patient is awake) or intravenous sedation (where the patient is asleep) can be used in special circumstances, such as when a patient cannot cooperate for a necessary procedure. There are various 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 patient’s individual needs.
“We reserve sedation for really significant situations like severe cavities, when we otherwise couldn’t get the work done,” says Russo. She says they will try to take preventative measures first by finding cavities when they are still small. If sedation is needed, an anesthesiologist will administer the medication so that they can focus on the dental care.
CONSISTENT 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 it becomes just another thing they are able to do. “We want to set up kids for a lifetime of positive dentist visits,” says Russo. “The first visit might be to do a checkup, clean the teeth and say they look great.” She says that if they can see a child regularly, they can identify problems while they are still on the smaller side and address them before they become urgent. Consistency is key so that a lot of little progress ends up making a big difference.
Russo reminds parents to check their own fears about visiting the dentist at the door and to paint the experience in a positive light. I also found that managing my own expectations for the visit was key. I went into it okay that E wouldn’t be getting a full polish job the first time. I now recognize that there’s a huge difference between not opening your mouth and getting dental care which is so important to overall health. Several years later, going to the dentist is no longer a scary proposition for E (or for me).
“Many of our patients, we’ve seen them through the years and as they get older, they don’t want to leave,” Russo says. “We wouldn’t turn away anyone we are capable of helping.”
—Ronnie Koenig is a lifestyle writer who lives in Princeton with her husband and two kids.
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