At the Dentist

 

Going to the dentist can be challanging at times. 

 

Some parents and carers are worried about how children with special needs will cope at the dentist and avoid going in the first place. This is not ideal as if the teeth are not checked routinely, early problems can be missed and once the problem becomes symptomatic, extensive treatment, sometimes a general anaesthetic procedure may be required. It is always best to see the dentist routinely starting at an early age to get your child familiarised with the dental clinic, dental staff, simple procedures, and to prevent problems to happen in the first place. Visiting the dentist should not be a stressful experience.

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​There are some strategies one can consider before, during, and after the dental appointments to make it easier for you and your child to visit the dentist. Of course every child is different and you would know your child best and can use some of the ideas from this website to come up with your own set of strategies tailored to your child's need.

 

Before the appointment

 

For some children, the use of visual aids could be useful for some children. This could involve a calander, images, social stories. Ask whether the dental clinic have photos you can look at, or pictures on a website, so you can review with your child before the appointment. Further ideas and examples on an example visual aids we developed regarding visiting the dentist could be find HERE.

 

If it is the child's first time to the dentist, it may be a good idea to contact the dental staff by giving them as much information about your child and your child's (and yours) specific conditions and preferences as possible (e.g. time of the day, to be allowed to wear headphones to listen to music in the clinic, quiet waiting area, allow a longer time slot, avoid waiting too long in the waiting room) so they can be aware and make adaptations or arrangements to suite your child's need where possible. You may be visiting a dental team who have a reputation of looking after children with special needs. If you are unsure about their experience, it is perfectly fine to ask them their past experience with treating with children or individuals with similar background. It may be a good opportunity to raise awareness and educate with regards to looking after children with special needs to an eager and passionate dental team, even if they have limited experiences with treating children with special needs. However, if you are uncomfortable with their answers or communications before the appointment, it may be worthwhile to ask for recommendations of which dentist to go to from your local organisations or support groups.

 

 

You may want to practice lying your child back and have they open their mouth wide at home. Practice brushing with an electric toothbrush may help with desensitising your child to the use of some dental instruments. There are disposable dental mirror available you may want to get for practising at home. 

 

Most dental clinics require a new patient and medical form to be completed prior to the first appointment. It may be worthwhile to ask the clinic to email you a copy (or collect from the clinic prior to the appointment) and fill in the form at home before the appointment, and return to the clinic earlier if possible. This will provide the dental team more information about your child in advance, and more importantly, avoid prolonging the length of waiting period in the waiting room. 

 

While you are waiting

 

It is a good idea to take your child's comfort item, fiddle toy, or distractor (e.g. electronic device, headphones) to help occupy or distract them. These items can also be used during the dental visit if possible. If you think your child copes better waiting in the car and prefers to do so, you can let the dental staff know in advance or call ahead to see if they are running on time. You may also want to bring a family member, a friend, or another carer to help provide support and make the visit easier.

 

During the appointment

 

The movement of the dental chair alone may be upsetting for some children. You can ask the dentist to lay the chair back first before sitting your child onto the chair, or ask the dentist to demonstrate how the chair moves first. 

 

If your child normally uses a wheelchair, the dental team can help you with transferring your child onto the dental chair. However, simple dental examinations can be done while your child remains in the wheelchair, ideally slightly reclined. You may want to offer gentle holding onto your child's hands and the dental operator would usually stand behind your child and offer gentle stabilisation of their head if required when carrying out the dental check.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Some children are very sensitive to bright light. Some dentists provide sunglasses to wear for the visit, you can bring along your child's own sunglasses to use. 

 

If your child is particularly sensitive to noise. Wearing headphones and listening to music or audio can be a good distract during the visit. Earplugs is another option if your child is happy to wear them.

 

Don't hesitate to suggest ways the dental team can do to make the dental visit easier for your child. You know your child best and should feel comfortable and in control. It's also fine to ask questions and more information about the treatment options until you understand and are comfortable with the discussions. 

 

After the appointment

 

It is a good idea to follow up on your dentist's suggestions or recommendations. For example, using an electric toothbrush, home care, and other preventive care. Feel free to talk to the dental team about what can be improved to make it better for your child's next dental visit. 

 

 

 

Common Dental Procedures

 

• Check-up

  • ​Dental examination - checking the health of all oral structures, identify any problems, discuss ways to improve oral health. Pictures of some of the instruments used by the dentist can be found under visual aids

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

• X-rays

  • ​X-rays are usually needed to check between the teeth for dental caries (that cannot be visualised by looking in the mouth as the teeth can be very tight together at the back), or for checking the presence and location of adult teeth in children, or to assess presence of any infection or pathology

 

 

 

 

 

 

 

 

 

 

 

 

• Clean

  • ​Professional clean usually involves using special instruments to remove calculus (tartar) build-up as the build-up (which is usually yellow and hard that stuck to the teeth) cannot be removed by normal brushing alone. It also involves thorough removal of plaque (sticky white/yellow film on the teeth near the gum) build-up with an electric-powered instrument 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

• Fluoride application

  • ​Fluoride of higher concentration (compared with toothpaste) in form of gel, foam, or vanish is usually used in the dental clinic. Studies shown that professional application of fluoride at least twice a year can reduce dental caries significantly

 

• Dental restorations (fillings)

  • ​Involves removal of the weakened tooth structure including the bacteria (removing all the 'brown' decay) and restoring that missing portion of the tooth (usually with a white filling if the hole is small, or a stainless steel crown if the hole is larger for the back baby molar teeth where a white filling may not be strong enough) 

 

 

 

 

 

 

 

 

 

 

 

 

 

• Dental extractions

  • ​Involve numbing up the tooth and removing the tooth

 

• Fissure sealants

  • ​These are coatings that can be placed to seal up the pits and grooves on the eating surfaces of the molar (back) teeth, where bacteria can hide and cause problems. Studies shown that fissure sealants are very effective in preventing dental caries from forming in adult molar teeth

 

 

 

 

 

 

 

 

 

 

 

 

​General anaesthesia

 

For some dental treatment, it may be easier and safer to be performed under a general anaesthetic procedure. This is usually carried out in a public or private hospital as a day-procedure (can go home on the same day). All Paediatric Dentists (Children's Dentists), Special Needs Dentists and some general dentists offer dental treatment under general anaesthesia. A premediation may be given to help settle the child prior to the general anaesthetic procedure, depending on the anaesthetist recommendation. 

 

Relative Anaesthesia

 

Relative anaesthesia (Nitrous oxide sedation/inhalation sedation/Happy Gas) could be a suitable option for dental procedures. It involves the child wearing a mask (can place fruity flavourings) on the nose. It is a very safe option and helps keep the child relax. However, not all children are suitable to have dental procedures done under relative anaesthesia. If the child is not able to keep the mask on, or is extremely nervous or distressed, relative anaesthesia would not be effective.