Dental visits made easy for children with autism

Dr. Phoebe Tsang and her research team would like to extend a big thank you to all participants in her study, focused on helping children with autism cope with their dental visit, at BC Children’s Hospital (BCCH).  She was also very grateful for the opportunity to collaborate with BCCH psychologist, Dr. Janet Mah in the last few years.  Their hard work has been recently published in the Journal of Clinical Pediatric Dentistry.

Here is the abstract of the study for those who are interested.  You can find the full article in with the following citation:   Journal of Clinical Pediatric Dentistry Volume 40, Number 5/2016.

autism awareness

Visual Schedule System in Dental Care for Patients with Autism: A Pilot Study

Objectives:  A pilot study to test whether a visual schedule system using picture communication symbols can help children with autism have successful routine dental cleaning visits.

Study Design: 14 boys with autism between three- to eight-years-old presented to the dental clinic for four weekly consecutive dental appointments. Patients were randomly assigned to either the control group who received the tell-show-do method (i.e., standard of care), or the test group who received the tell-show-do method plus the visual schedule system.

Results: Patients in the test group completed an average of 1.38 more steps, at 35.52 seconds per step faster, and with 18.7% lower levels of behavioral distress than those in the control group.

Conclusion: The use of a visual schedule system, along with repeated weekly visits, showed some promise in helping children with autism successfully complete more steps, progress at a quicker rate, and exhibit lower levels of behavioral distress within a dental appointment, compared to a traditional tell-show-do approach.

Visual Schedule for dental visit

Do you know what is in your toothpaste?


The options of toothpaste currently available on the market today are endless: ranging from whitening, desensitizing, antiplaque, and multi beneficial. There is even toothpaste focusing on individuals who have dry mouth. White, healthy teeth have been desired in society since the archaic age, and continue to be a trend in today’s general population. The first toothbrush was invented in China in the early 1700’s, but the toothpaste tube was not invented until the late 1800’s. Until then, most used dentifrices supplied in jars that the entire family shared. Some saw this as a health hazard, and didn’t use toothpaste until the tube was actually invented.

The most common ingredients in toothpaste are abrasives (a substance used for cleaning), detergents, and fluorides. Other, less significant, components include humectants (helps reduce the loss of moisture), water, binders to avert separation, and flavours or sweeteners to give the dentifrices a likeable taste. Arguably, the most important reason why we use tooth paste is because of its fluoride.  Fluoride strengthens tooth enamel and makes teeth less susceptible to decay. Different types of fluoride include stannous fluoride, sodium monofluorophosphate, sodium fluoride, and amine fluoride, each has a different intention, or purpose. The amount of fluoride needed to protect the teeth is very minimal so most of the toothpaste’s fluoride concentration is kept low in order it to be sold over the counter in the supermarket.

Expectations have climbed over the years for how many benefits can be squeezed in one small tube of dentifrice. It is not only expected to provide general mouth health and the prevention of tooth decay, but now it must fight gum disease, rid plaque, clear tartar, and have a whitening component. Producers also need to provide to certain groups of individuals, as in customers with tooth sensitivity, dry mouths, smokers, and those who want more natural products in their toothpaste. Anti-tartar products have high levels of pyrophosphates that are combined with sodium fluorides to reduce the buildup of tartar, but cannot take away the already hardened deposits on the tooth. Whitening toothpastes is very appealing with its claims of stain removal and teeth brightening, while being used frequently. However, ingredients in the whitening toothpastes have very short life span so it is questionable how much it will give the teeth a glistening and bright look. Actual whitening of the tooth requires bleach, which is more safely done in an office procedure or dental recommended gel. Anti-sensitivity toothpaste ingredients have remained the same since it was first created, containing strontium chloride, potassium nitrate, and sodium citrate. Anti sensitivity toothpaste seem to work well and it can be combined with other toothpaste ingredients, such as anti-tartar.
It is recommended that all children should use fluoridated toothpaste. Children 3 years or older should use no larger than a pea sized amount. Children 3 or younger can use the toothpaste as well, but no larger than the size of a grain of rice. Using fluoride toothpaste can prevent tooth decay and the side effect is minimal if its use is supervised to ensure correct amount and proper brushing techniques.

There is a wide assortment of toothpastes available on the market, and with each one comes a different proposition or promise. It is up to each individual and their needs to determine which toothpaste is most suitable for them. Talk to your dentist about what is best for one’s oral care needs.


Why going to the dentist brings you good luck

Happy Chinese New Year!

Gung Hey Fatt Choy (in Cantonese)! or

Gong Xi Fa Cai (in Mandarin )!

There are many Chinese superstitions to start your Year of Monkey on the right foot. For examples, you should not cut your hair around Chinese New Year because the good luck will be severed off. The next one may be hard to follow if you are an active person: It is considered bad luck to wash your hair and have a shower during the first week of Chinese New Year (Well, you may have good luck but you may not be very popular amongst your friends, stinking skunk!)

Based on similar logic as above, I could not wrap my head around it when I found out that it is actually good luck to see a dentist during Chinese New Year! This rule may not apply to everybody. Nonetheless – if you were born in an animal year that is in conflict with the year of monkey, and your fortune predicts that you may have a medical operation (you may shed blood), you may be able to “trade in” your bigger operation with a smaller one at the dentist. Since you may bleed a little, because of gingivitis, when have your teeth cleaned, your predicted bad fortune is considered already “fulfilled” when you shed the little blood at the dentist and your destined, more involved medical operation or bleeding event can be avoided.

You may be rushing to the phone now to make your dental appointment or you may be rolling on the floor laughing about these superstitions….. one way or the other, we would like to wish good health and prosperity of the year of Monkey!

Dentist brings good luck Chinese New Year