Patients with Autism: Reducing Anxiety for Increased Cooperation

By Therese Vannier, RDA/OMSA April 3, 2018

The Centers for Disease Control and Prevention (CDC) estimates that 1 in 68 children in the United States is identified with autism spectrum disorder (ASD), a general term describing a group of complex developmental brain disorders such as Asperger syndrome, Rett syndrome, and childhood disintegrative disorder. When it comes to treating autistic dental patients, clinicians are often confronted with challenging situations. The disorder may present a constellation of conditions requiring special knowledge and management efforts from your entire team.

Reducing anxiety and increasing cooperation with an autistic dental patient

ASD patients often have sensory sensitivities, circumscribed interests, and repetitive behaviors. They process sensation atypically and may be excessively disturbed by non-threatening things found in a dental practice environment. Bright lights, foreign sounds, touch, strong odors, or foul taste can make dental visits unappealing for these patients. According to the National Institute of Neurological Disorders and Stroke, patients with ASD may get angry or have emotional outbursts, especially when placed in a new or overly stimulating environment.

As medical professionals, there are things you and your team can do to help alleviate the trauma of the dental experience for these patients. First and foremost, they respond best to calm and quiet voices. When communicating, bend down to the child’s eye level and be confident and nurturing. Tell the patient what you are going to do so they aren’t surprised by sudden actions or movements.

Another way to make your practice more conducive for patients with ASD is to swap the unpredictable motion and on/off sound of your traditional HVE for a suction device that stays put. The Isolite 3, Isodry and Isovac offer continuous suction, and the drone of the device’s HVE produces white noise that can help drown out suspicious sounds from lasers, drills, ultrasonic scalers, and prophy angles.

It’s a good idea to learn as much as you can about your patient prior to meeting them. Talk with their parent or caregiver and ask if they have any suggestions that might help you better meet the patient’s needs.

Here are a few tips for increasing patient cooperation and ensuring successful outcomes:

  • Review the patient’s medical history form thoroughly.
  • Dim the lights.
  • Lower the noise volume.
  • Remove clutter from the operatory.
  • Run power-generated instruments prior to use so the patient can acclimate to their sounds.
  • Communicate what you will be doing before you do it.
  • Provide clear information.
  • End each visit on a positive note.

The dental tool kit from Autism Speaks offers tips for dental professionals about how to make the experience more successful for patients with autism.

Good oral health is a critical component of an overall healthy life, so it’s important to find ways to relieve the anxiety for all patients – including autistic dental patients – so they continue to return for regular care. Kids with ASD can be a lot of fun to work with, and they might even develop a special friendship with their dentist, hygienist, and assistant. It just takes a little more time, patience, and understanding.