Compassionate Dentistry: Be Prepared
September 21, 2007 by Kristina Chew, PhD
Filed under Dentist, Health
The United Autism Foundation hopes to build the first dental hospital for autistic children, the September 19th CBS4.com news (Florida) reports. South Florida businessman Olaf Hampel, who played tackle for the Denver Broncos has
made it his mission to build the nation’s first dental facility designed for children with disabilities, especially autistic children.
Hampel explained, “For instance, we need certain equipment for children in wheelchairs.” He added, there’s also “special equipment needed to open their mouths, and to leave them open.”
……..
The foundation’s ultimate goal is to raise $10-million for a full-fledged dental and medical facility though, initial plans call for a smaller $1-million facility to meet the immediate needs of South Florida’s children with autism.
Going to the dentist is not easy for my son Charlie, as for many autistic children. He has had two successful visits in a row this past year thanks to us practicing “going to the dentist” at home (and, thanks to a big effort at school and at home last year, Charlie brushes his own teeth and well; he has never had a cavity). I am not so sure how he would feel about having “special equipment” to keep his mouth open. We have been practicing by having Charlie lie on his bed and learn to keep his hands away from his face while we brush his teeth with an electronic toothbrush, use a small mirror to look inside his mouth, and floss his teeth (Charlie especially likes this). Charlie currently goes to a pediatric dentist who specializes in special needs children; there is a dentist at the Autism Center of New Jersey Medical School so I don’t think we would have to go as far as Florida to find a dentist.
But compassionate dentistry is definitely not a bad idea—especially if it can involve teaching children how to sit in the chair and keep their mouths open and get their teeth checked, as children and throughout their entire lives.
Jeff Stimpson
Jill Cornfield
This would be sooo awesome. Mat has to be strapped down to a table. He usually winds up puking at least once. He only goes in once a year because of the trauma he endures instead of every six months. It’s so hard for all of us. I’d rather pluck my eyes out than take him to the dentist. This would be cool!!
When he says “special equipment needed to open their mouths, and to leave them open.” what does that mean, does anyone know?
Holy cow, I just take my kid to a pediatric dentist who sedates her. She sleeps through the whole thing. I can’t imagine trying to handle it any other way without terrifying her. She has a lot of sensory issues with her mouth.
That’s what scares me about the phrase “special equipment”, you know?
Hi Kristina,
Our experience with dental prep has been somewhat like yours and Charlie’s–also having done a lot of speech and oral stim work also helped since our girl was very used to having things in her mouth. So far, so good…in fact my daughter is probably more happy and willing to go to see her dentist than I am to see mine. Her first visits were more difficult and we went the sedation route, but my dentist has a shared goal with us of moving to more typical visits and the last 3 years has been in the office wide awake.
In addition to having a “special center” for special needs dentistry, wouldn’t it be a nice adjunct if dental schools had more training in or specialization in “special needs” dentistry, which includes desensitization and behavioral training? We feel very, very lucky to have a nearby DDS who is open to special needs and has a gift for it, but I know many who have to go a long way, if even that, to find a general dentist willing and able to treat these patients. Some families in our state have to travel hours to the major medical center because of lack of a willing dentist in their area. This concerns me because the situation is even worse once you get beyond the pediatric years. I did a state survey last year and was able to locate 2 dentists willing to treat adults with special needs, both in the same area, and both several hundred miles away from the majority of the populace.
(Currently our girl needs orthodontic work, but even though we have lucked out on the general dentistry, the orthodontists have so far to a man been hesitant or trying to pass the buck, even though they all agree that she needs the work done (I recently had my first soapbox speech about discrimination at one of those offices). So I guess that if it is to happen, either I shame one of these guys or we make the several hundred mile trek ourselves.)
One thing that does concern me is the highlight of “special equipment”. While that may be useful and necessary because of specific motor issues, I hope that the intent is not to use those as a fast-track around teaching and desensitization programs. Going to the dentist should be a regular lifetime proposition. Sometimes all that may be needed to make the difference between comfort and fear is a little more time and a little more patience.
This is something that is out there for dental professionals:
D-Termined Program of Repetitive Tasking and Familiarization in Dentistry
http://www.specializedcare.com/detail.cfm?id=328
A sample that is considerably abbreviated for time is on youtube (I think the full DVD is superior in giving a picture of the program):
http://www.youtube.com/watch?v=artQFqd6osQ
Sorry about the novel :-).
Same scare by me about the “special equipment”—one dentist we used to go to wanted Charlie, after the first worried peep, to go to the “quiet room” and use a papoose. I can see the reasoning, but restaining Charlie is never a good idea.
Regan, thank you—-a most helpful novel!
Just like with getting a haircut, going to the dentist can be hard. We’ve found best results by locating “autism friendly” businesses, i.e. businesses whose owners or employees have autistic children themselves. Our kids dentist and hairstylist both have autistic children of their own. I feel more comfortable with them. They’re sort of the local go-to business with kids on the spectrum. I actually like the idea a lot. If I were in a medical or service profession, I’d like to join the autism-friendly club, and provide services to autistic children and/or their parents. I think it’s a great club, and it’s a great community resource.
I hope folks will excuse a small moment of satisfaction…today Eleanor had an excellent checkup experience without any additional assist from me at all- big change from the first visit, but on reflection not that long of a time. Her dentist, on hearing the braces saga got on the phone and leaned on a couple of orthodontists on Eleanor’s behalf so that she has an appointment in town, instead of the other end of the state. (What a guy.)
FYI, I was browsing congressional bills and there is currently one in committee, I *think* sponsored by Harkin, with a provision to mandate medical and dental schools to provide training in care for special needs and differently abled clients–cognitive and physical. I don’t recall the bill number, but it may be searchable on Thomas.gov, or I’ll post it here if I locate it.
Please post it if you find it!
Kudos to Eleanor!
We’ve been preparing for “D-day” on Friday—of course the electric Sponge Bob toothbrush that Charlie has grown to like broke tonight. Off to the store I go.
Isn’t it always the FAVORITE one that breaks (or falls in the toilet)? Hope Charlie has an excellent checkup.
(This is the bill. Sorry about the length.)
Locate bill by text, sponsor or bill number
http://thomas.loc.gov/
——————————————-
S.1050″ Sen. Harking, Tom-intro 3/29/07 +2 cosponsors
3/29/2007:
Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S4183-4184)
HR.3294: Rep. Lowey, Nita-intro 8/1/07+6 cosponsors
9/19/2007:
Referred to the Subcommittee on Health, Employment, Labor, and Pensions.
To amend the Rehabilitation Act of 1973 and the Public Health Service Act to set standards for medical diagnostic equipment and to establish a program for promoting good health, disease prevention, and wellness and for the prevention of secondary conditions for individuals with disabilities, and for other purposes.
See esp.
SEC. 4. IMPROVING EDUCATION AND TRAINING TO PROVIDE MEDICAL SERVICES TO INDIVIDUALS WITH DISABILITIES.
————————————————-
“These issues, which many of us take for granted, represent
significant barriers to people with disabilities.
Further, health and wellness programs on topics such as smoking cessation, weight control, nutrition, or fitness may not focus on the unique challenges faced by individuals with disabilities. And it may be difficult for persons with particular disabilities, such as those with intellectual disabilities, to find physicians or dentists who are willing to take them on as patients.
All of these factors can also increase the incidence of secondary conditions for people with disabilities.
…The bill would…improve education and training of physicians and dentists by requiring that medical schools, dental schools, and their residency programs provide training to improve competency and clinical skills in providing care to patients with disabilities, including
those with intellectual disabilities.
I invite my fellow Members to join me in support of this legislation. Together, we can make certain that people with disabilities are not limited in their access to quality medical care, or in their opportunities for health and wellness.”
Sen. Tom Harkin, sponsor, 3/29/07 Congressional Record.
Pediatric dental training programs throughout the country train new dentists in the skills and techniques required to treat patients with special health care needs. Training in the specific techniques for dealing with the a-typical behavior patterns of the autistic child are limited.Many dentists have developed great skill in managing this special population and if you contact your state dental association, they should be able to put you in touch with a specialist. Gradual desensitzation and repetitive training techniques have been proven to be very successful in guiding the autistic child to a higher level of positive responses. With the right dentist, comprehensive care including orthodontics should be a reality. Many special techniques and items can be used to assist the parent and dentist in treating the autistic patient. For example to assist in mouth opening, I have used rubber chewey toys from the pet store, triangular solid rubber door stopppers from home depot and also a professional mouth opener called the molt mouth prop are just a few examples. Good luck to all and keep seeking out that dentist who works for your child. CB
First of all, I’m suprised that no-one has mentioned the growing Big Brother fiasco and it’s relation to this so-called “foundation” plugging the dental hospital. So what is the deal with this hospital? Is there really such a thing? Will there ever be such a thing? At this point I doubt it. And what exactly is Olaf Hampel’s connection with Adam Jasinski anyway? The web site is bogus. unitedautismfoundation.org is horribly broken and Adam Jasinski has the nerve to call ppl like me a retard. I seriously doubt any “donations” which have been made to this organization are going to the purpose being advertised. Can you say “scam” people? Someone in the government needs to be investigating the legitimacy of these guys and responding with appropriate legal action.
Both S1050 and HR 3294 are still in committee and in need of co-sponsors and letters.
Title: To amend the Rehabilitation Act of 1973 and the Public Health Service Act to set standards for medical diagnostic equipment and to establish a program for promoting good health, disease prevention, and wellness and for the prevention of secondary conditions for individuals with disabilities, and for other purposes.
http://thomas.loc.gov/cgi-bin/bdquery/z?d110:HR03294:
http://thomas.loc.gov/cgi-bin/bdquery/z?d110:s.01050:
I am a pediatric dentist in Los Angeles area. Special equipment, does not always mean something scary and only for special needs. In my opinion all kids are special and need to be taken care off with care and talking to, showing everything to not scare them. an equipment that keeps their mouth open, is just a piece of rubber block about teo fingers put together width that is placed in the mouth to keep the mouth open. You can do different options of sedating with oral sedation ,or intravenous sedation with an anesthisiologist(twilight), or nitrous oxide, or even sitting knee to knee with the doctor , the child on your lap if small child. There are different options. My practice is 30-40% autistic kids and we have never had major issues of not being able to do the treatment with the parents and/caretaker’s help. Ask me questions if you want. i am trying to open a dental center specially for autistic kids.