Dental Care from a Dental Assistant

Preparing for dental appointments

The dentist’s office can be alarming to anyone, but the sensory experience in a dental office is particularly hard for kids with ASD. It’s a lot, but IT IS POSSIBLE!

•First, focus on dental care at home. People with ASD may have difficulty engaging in healthy dental hygiene habits due to sensory sensitivities. Some may have certain habits, like grinding their teeth, tapping or hitting their mouth and teeth, chewing nonfood objects, or eating sugary foods, that can also affect their dental health. Additionally, it may be difficult for some with ASD to communicate problems with their teeth, resulting in delays in care. •Book your child’s dental checkup as young as possible. It is recommended to start dental visits by the age of 1, or as early as 6 months when their first primary teeth erupt. This will set them up for positive future appointments. •Dental related videos. There are many positive videos you can find online that can help to prepare your child for their first dental appointment. This is especially great for children who love their screen time. •Games! The internet and even app stores offer a variety of dental games. There are also physical play dental kits. This can give children a better understanding of what is going on, and give them the virtual opportunity to work as a dental professional themselves. https://a.co/d/8liVBE1 https://a.co/d/henBQZC https://a.co/d/5HxBzys https://a.co/d/c6uy6Dw This is what my office uses •One of my favorite techniques to use for nervous children is allowing them to touch the instruments I’m using before I use them. For example, I let them smell the polishing paste, and squish the polishing tip before going in their mouth. If this is something you think would ease your child, ask your dental office to try it! •Don’t be discouraged if your child’s first, second, or even third visit doesn’t go as planned. There is always room for growth. •Accessorize with familiarity. Bring a blanket, maybe a stuffed animal. Bringing a child who has autism to the dentist is likely to be a challenge. It doesn’t have to be impossible. Aim for happiness and expect success.

Primary teeth It is a common misconception that primary teeth, or baby teeth, are less important than adult teeth. I am often asked ‘Well does my child need this work done? The teeth are going to fall out anyways.’ And while yes, typically primary teeth fall out, they are still going to be in your child’s mouth for up to 12 years. Great oral care at a young age will set your child up for great oral care as an adult!

Brushing Are you struggling to brush your child’s teeth? They kick, scream, cry, bite? You are not alone. This can happen with any child, this is not specific to children with ASD. In the past couple of years, U-shaped toothbrushes have become a growing trend for young children. For a parent introducing brushing and has failed with a traditional toothbrush, this might be something to start with, anything to get the child to do some sort of brushing. Something is better than nothing! If your child allows you to brush their teeth but still struggles, a traditional soft-bristled toothbrush is recommended. There are so many toothbrushes on the market these days, that you are bound to find one your child approves up. Try one with lights, or one that vibrates, or both! https://a.co/d/hR96QTL https://a.co/d/8EKHak6

Teach your child how to brush/encourage them to brush. Children often mimic their surroundings so brush your teeth in front of your children. You could even make it a habit to brush together every morning and night. If you have a dog, teach your child to brush the dog's teeth. There are many dog toothpaste as well as dog toothbrushes, both look very similar to our brands. Both links below I use for my dog and have been given our veterinarian's approval! https://a.co/d/dMPw5lC https://a.co/d/eVX2bWH

Let your child pick their favorite color of toothpaste or even their favorite flavor. Toothpaste is not a one-flavor-fits-all category, trying different flavors can be useful. Research the ingredients before purchasing if you aren’t sure about the exact product. If you find that your child, like many, refuses to open… try encouraging them to open by allowing them to brush for themselves or brushing a toy of theirs that has teeth or a mouth. If neither of these works, try a mouth prop, not all of these, or maybe even none of these will work for your child and that is OK! https://a.co/d/cG6sLsS Brushing Buddy – SnoofyBee.com

Flossing Should you floss your child’s teeth? If they are touching. If there is spacing and the teeth are not touching, flossing is not a necessity BUT if your child will allow you to floss their teeth then make it a habit!

Fluoride Some patients refuse fluoride without knowing its powerful benefits. Fluoride in the correct dosages is safe and effective and a safe way to prevent tooth decay. Fluoride toothpaste is recommended once your child can spit. Until then, the 6-month dose of fluoride varnish your dentist ‘paints’ on their teeth will do just fine and is even useful for children who have small areas of decay or children who don’t brush often.

Sedation Did you know dental sedation does not have to mean putting your child to sleep or even leaving the room? Sedation is recommended for patients with dental anxiety, special needs patients, and apprehensive patients whether they are children or adults. The most common sedation offered is nitrous oxide. It is used to calm your child and to reduce the anxiety or discomfort associated with dental procedures. With nitrous oxide, your child may be drowsy, and may even fall asleep, but they will not become unconscious. I.V. Sedation is another type of sedation offered, but you will often be referred to a specialist. The dentist performs the dental treatment with the child anesthetized under I.V. sedation.

Bottles & Pacifiers Baby Bottle Tooth Decay most often occurs in the upper front teeth, but other teeth may also be affected. Bottle decay is caused by the frequent, prolonged exposure of the baby’s teeth to drinks that contain sugar. Tooth decay can occur when the baby is put to bed with a bottle, or when a bottle is used as a pacifier for a fussy baby. The sugars in these liquids cause bacteria to build up in infants. Bottle Tooth Decay - American Dental Association The toddler stage is the prime age to stop with the pacifier. Most dentists agree that you should start reducing your child’s use of pacifiers around age 2, and aim for all pacifier use to stop by age 3. After the age of 4, more serious dental-related problems can happen due to pacifier use. The use of pacifiers and thumb sucking has been proven to negatively affect the growth of the mouth and alignment of teeth. Taking the bottle or pacifier away… •Build a bear! Have your child place their pacifier in the bear at the store, this can ease the fight. •Simply cut off the nipple. •If sucking a bottle, pacifier, or thumb is their soothing tool, instead of scolding your child, find what might be causing their anxiety or discomfort.

Food & Drinks As always, it is advised that you keep your child’s sugar intake low. Candies, ice cream, and sugary treats should be kept as a treat and not an everyday occurrence. While avoiding sugar can be hard, especially with children who find very few foods they like, all in all as long as your child is eating then you’re on the right path! Drinks… Avoid giving your child juices or anything other than water if they are drinking out of a bottle, these should certainly not be given them to during nap/bedtime, as this will lead to bottle decay. This of course does not include babies, this is in regards to toddlers ages 2+. Sugary drinks include juices, sports drinks, and sodas, these should be avoided as often as possible. Although it’s never killed anyone indulging in a different drink here and there. It is recommended for anyone to drink water after having anything other than water to rinse the sugars out of the mouth. Chewy foods are especially harmful to your children’s teeth. These foods are more likely to become lodged in between teeth or stuck in the pits and grooves. Sticky food will leave the acids to party in the mouth, thus creating decay. Snacking should be kept at a minimum to avoid the constant dose of acids in your child’s mouth. Continuous or prolonged snacking, such as eating a bag of popcorn over the course of a few hours, can also affect your child’s oral health. This allows the continuous inflow of sugars and acids into the mouth which can lead to decay (cavities).

Grinding

Does your child grind their teeth? No need to look further, I have advice for you, toddlers and children do not usually grind due to stress/anxiety like adults do. Toddlers and Children have teeth erupting and shedding for about 11-12 consecutive years. Your child’s first baby tooth comes in around 6 months of age and their last baby tooth falls out around 12 years of age. Their jaws are growing and changing so much, and their tiny but mighty minds are going so quickly, that it makes grinding typical. Now the big question is how to stop it. If you find that your child grinds their teeth in their sleep, try nudging them until they stop. If you discover that your child grinds their teeth during the day, direct them towards something else to get them to stop. Offer an oral sensory chew, or offer them an electric toothbrush. These things are said to steer them from grinding and satisfying that sensation. Offer calming tools as well, because although little ones do not usually grind due to stress, it could still be the case. Keeping up with regular dental visits will allow the doctor to monitor the health of their teeth and warn if the grinding might be harming them. Most kids outgrow grinding once they lose their baby teeth.

Related Article: Bruxism (Teeth Grinding or Clenching) (for Parents) - Nemours KidsHealth Chew necklace: https://a.co/d/4YmSJgr Chewy Tube: https://a.co/d/bqnQD7o Vibrating oral stimulation: Special Supplies Buzz Buddy Oral Stimulation kit with 6 Soft Textured Interchangeable Heads, Calm Sensory Needs, Support Speech, and Stimulate Self Feeding, Gentle Vibrations Colgate Kids electric brush: https://a.co/d/fubC6Hj

The Pacifier

While dental professionals understand that the pacifier may be a soother for many children, prolonged use can harm their oral health in the long run, so I’m here to give advice and offer alternatives. Prolonged use of a pacifier can cause issues such as open bite, overbite, buck teeth, speech impediments, and more. Non dental related issues can also be caused such as social issues or ear infections. I say these things not to scare you, but to educate you. If you stop pacifier use earlier rather than later, the teeth can correct themselves. But further down the line, there is a possibility that professional dental assistance will be needed in correcting pacifier teeth. Use other alternatives for soothing rather than a pacifier such as white noise, chewies, rocking, and loveys. Related article: Pacifier Teeth: Does Pacifiers Cause Dental Problems | Fox Kids Dentistry

Bottles

Bottles and pacifiers can bring up similar issues when it comes to prolonged use. There are many factors in tooth decay, a common one in children is frequent and prolonged bottle use. If your child uses a bottle, you can help in preventing baby bottle decay by having your child drink only water. Do not send them to bed with a bottle filled with juice or milk, this increases the chance of baby bottle decay. Another way to prevent bottle decay is brushing twice a day, which is already a great habit to start as soon as your child’s teeth erupt. As stated above, bottle and pacifier use cause similar issues, have a look at the pacifier section to see more issues that can be caused by sucking a bottle.

Frequently asked ‘Is this normal?’

How often should my child visit the dentist?

Regular 6-month dental visits are recommended for children starting at age 6 months when their first baby teeth come in.

Is it normal for my child to have spacing in their teeth?

Yes! Adult teeth are much larger than baby teeth, having spacing in baby teeth typically means there is less chance for your child to grow crowded adult teeth.

Is it normal for my child to have to be sedated for dental work?

If your child is unable to cooperate with their dental work without sedation, great! But if not, then it may be something they need. It is common for children to have some sort of sedation during their dental work. While sedation might sound scary, find an office you trust, and do your research to find what is best for your child. There are usually a few forms of sedation to choose from.

Why is it important to look after baby teeth if they fall out anyway?

Baby teeth are very important. First, they are the natural space maintainers for permanent teeth. Losing a baby tooth too early can cause the adjacent teeth to drift into the space left behind. When this happens, there will be no space for the permanent tooth to grow. Second, the root of the baby tooth is the pathway that guides the new permanent tooth to erupt. When the new tooth erupts, it gradually dissolves the roots of the baby tooth and then comes and replaces them. That’s why when a baby tooth falls, you only see a crown and you don’t see the roots. Third, from when the child is age 6 until the age of 12 they have some baby teeth and some permanent teeth. Bacteria by nature is contagious and it spreads, so all the teeth, baby and new, are pooling in the same saliva that contains bacteria which puts the permanent teeth at risk of getting cavities.

Do I need to floss my child’s teeth?

If they are touching. If the teeth are spaced out and none of them are touching, the toothbrush bristles likely clean well enough between them, but flossing would be a good thing to start so your child is used to it by the time they do need to floss.

Disclaimer: I am a dental assistant, not a Dentist, whereas I have experience in dentistry I do not have a doctorate. I have learned these tips and tricks through my own experience as well as being advised by my doctors and dental community. Just as every doctor diagnoses differently, every dental assistant works differently. This advice may not be for everyone and not all of these will work for your child, but I am here to help. Remember, if you aren’t doing these things, this post is not to shame you but to help educate you Keep smiling!