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

What is your New Year’s resolution? How about make it a priority for you and your child to go to see the dentist?

Have been dragging your feet in booking an appointment for you and your child’s dental appointment? Many people are like you who may not be very fond of the dentist.  Dental phobia is a prevalent problem and the cause of this fear is thought to be multifactorial, like people’s emotions and their past experiences.  Research has found that dental anxiety in a family member can play a role in a child’s dental experience.  Children who have childhood onset dental anxiety often have  had a mother, father or sibling may also be anxious about dental treatment.  Mild fear and anxiety are expected and consistent with normal development of a young child.  However, this anxiety can interfere with a child’s willingness to pursue necessary treatment or even just visiting the dentist all together.  It can become an overwhelming  concern that the child’s daily functions, like eating and sleeping are impaired.  Research has also found that the more anxious the patient is the more pain he can experience during treatment and his oral health satisfaction is lower.  Those with dental fear usually require more time and more medicine to accomplish dental procedures than those who are relaxed.  This is why we, as a dental team, spend a lot of emphasis on taming your child’s worry dragon.

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In order to ease a child’s dental fear, communication skills are imperative.  It is important to assist a child to understand his phobia and help reduce the anxiety he experiences.  Providing dental information or details in a way that are understandable but not intimidating to a child is important so that we can ease any unnecessary negative anticipation.  Positive reinforcement is also very effective whether it be congratulating them for completing a treatment or holding their hand through a procedure they are scared of having done. There are many other behavioral techniques we can also use.   Perceived control, which gives the child some control over the situation (eg. would you like to have the top teeth cleaned first or the bottom cleaned first?) or  Tell-show-do:  when the child can hear and see what will be done before it is actually done on them are just a few examples.  These various techniques will help children overcome their fears and ultimately lead to more efficient and successful treatment and a better overall dental health.

If you have the will, we always have a way for you.  It’s a new beginning of the year – let’s make it a New Year’s Resolution to stop procrastinating and go to the dentist.  Conquering your own reluctance to the dentist not only improves your own oral health but also enables your child to have positive attitudes for their oral  health as they grow up!

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Copyright 2013 The Children’s Oral Care Centre