Special Needs Dentistry

The dentist’s chair isn’t a favorite destination for anyone, but add in sensory sensitivities, oral aversions or communication issues, and a simple cleaning becomes a daunting task for parents of children with special needs.

Sara Ferris was shocked when her daughter Susannah, age three and newly diagnosed as mildly on the autism spectrum, was turned away by two dentists who were uneasy about treating a mostly nonverbal child with sensory issues. “At the second dentist, we got all the way in the office and almost in the chair when they came in to tell us they couldn’t treat her,” she recalls.

Ferris eventually found a dentist who had experience working with kids with special needs, Dr. Mark Kahn on Indianapolis’ southwest side, and the difference was immediate. “When Susannah sometimes won’t sit back in the chair, she sits on my lap, and the hygienist cleans her teeth that way,” she says. “We’ve been there four years, and it’s wonderful that they think outside the box.”

Getting creative is the key to helping children with special needs feel comfortable at the dentist, local experts say. Here are their best tips:

Be picky about practitioners

Spend the time to find a dentist who understands the unique challenges of children with special needs and whose staff will work with families to create a positive experience for the child, says Dr. Jennifer Satterfield-Siegel of Special Smiles Dentistry in Carmel. She recommends parents visit prospective dental offices alone ahead of time to see how the practitioner interacts with parents and children.

“If you’re with someone who looks at the condition before the child, you’re in a lose-lose situation. You want someone who treats each child as an individual,” Satterfield-Siegel says.

Prepare your child for the experience

Once an appointment has been made, Dr. Jamie Steele of Steele Pediatric Dentistry on Indianapolis’ east side suggests parents set up a time beforehand for their child to take a tour.

“This gives them a chance to familiarize themselves with the office in a non-threatening way,” she says. “Take a few pictures of the office to use when talking to your child about their upcoming appointment.”

Use positive language

Parents should especially watch how they talk about the dentist, says Mary Anne Litwicki, a hygienist for nearly 40 years, including the last 16 at Riley Hospital for Children Pediatric Dentistry at Indiana University Health. Avoid words like shot, poke, scrape, yank and drill.

“If you tell them how much you hate going to the dentist, they will pick up on that,” Litwicki stresses. “Instead, talk about how the dentist is going to tickle their teeth, and how they might get to see some pictures of their mouth.”

Practice at home

Children with special needs can be unsettled by the bright lights, unfamiliar instruments and reclined position at the dentist. Simulating the environment at home can help, Steele says.

“Have your child lie down on the couch or bed and do a practice dental visit. Use a flashlight and a mirror to look at the teeth. You can even use a powered toothbrush to simulate the vibration and sound associated with the polishing hand piece.”

Regular tooth brushing can be a challenge for children with special needs, but consistent home care will make their time in the dental chair easier. Create a brushing routine and set clear time expectations. “There’s no rule that says it has to be done in the bathroom. Try the kitchen or while they’re taking a bath,” Satterfield-Siegel says. “Stick with it, and repeat to yourself, ‘I am doing the right thing!’”

Go slow and be patient

It’s not uncommon for children with special needs to require multiple dental visits to accomplish everything that needs to be done. Progress may be slow, but Steele encourages parents to celebrate the small milestones. “Typically, each dental visit gets a little easier,” she says. “If I have a very fearful dental patient who will stand next to mom or dad and let me do an exam, I consider that a victory if they leave happy and have built some confidence.”

Looking for a dentist? Ask other care providers and parents of children with special needs for recommendations.


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Dental Hygiene Tips for Kids With Special Needs

* If your child dislikes toothpaste, brush with a dry brush first, then add a small smear of paste for one last go over, just to get some fluoride on their teeth.

* Use the handle of a bigger toothbrush to prop your child’s mouth open on one side while you brush the opposite side. It’s tricky, but that way you can avoid getting bit.

* Limit sugars. Kids don’t need soda, sweet tea or juice. If they’re allowed to sip all day, the decay rate goes up.

* Be mindful that Pediasure is high in needed calories, but also in sugar. Brush after it is consumed or at least follow with water.

*Children who are fed via gastrostomy tube still need their teeth brushed regularly.

* Tips provided by Mary Anne Litwicki, hygienist at Riley Hospital for Children Pediatric Dentistry at Indiana University Health


Indy's Child
Indy's Child
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