A growing percentage of our practice is comprised of patients who fall under the umbrella of “special needs children”. This may range from mild disruptive tendencies to far more severe aspects of autism, ADD, ADHD and so on.
Currently, our biggest challenge is the child diagnosed with autism. As with most disorders there is a wide spectrum of autism. Some children, while diagnosed as autistic, are minimally compromised while others are clearly and profoundly developmentally challenged. In New Jersey one out of 94 births results in a child that will be diagnosed with autism. What is most critical for the autistic child and their families is early detection. Of the hundreds of autistic children that we see in our practice, parents have indicated to us that they suspected a “problem” long before the pediatrician mentioned anything to them.
It is now clear from all research that early intervention is critical in allowing a youngster with autism to go on to lead a somewhat normal, if not fully normal, life.
So too, it is critical that an autistic child’s first visit to the dentist be no different than for any other child. We recommend age 2 ˝ or earlier if any kind of problem is suspected.
Frequently, parents ask us how we are able to even look at their child’s teeth let alone clean, treat and care for their mouths. It should be remembered that while special needs children may be challenging, they are a routine occurrence in a pediatric dental office. Frequent crying and lack of cooperation is a common occurrence just as it is in a pediatrician’s office or any other child care facility. Crying is not a bad thing. It is simply a way for a non verbal child to relate his feelings whether that child is very young or falls within the guidelines of a special needs individual. All pediatric dentists are trained to work with uncooperative children and are able to visualize and examine the oral cavity. Depending on the circumstances, the pediatric dentist will do a clinical examination for the child and then sit down with the parent and explain findings and techniques to accomplish the appropriate treatment.
Parents are also concerned that they or several people may have to physically restrain their child in order to examine or accomplish dental treatment. This is not the case. If or when physical restraint is indicated it is done in an orderly manner with adequate explanation prior to any treatment.
It is helpful that two adults come with the child. This allows the dentist to sit down with one parent and explain the findings without the distraction of their child. It allows for adequate questions and answers so that the parent understands the findings and the perspective treatment if any.
Also, we see a large range of ADD and ADHD patients. These children, for the most part are cooperative but because of their disability their attention spans may be short or they are unable to sit quietly for longer periods of time. Treatment can often be adjusted so that long appointments are avoided and treatment be done efficiently to allow for appropriate treatment in the shortest amount of time. It should be remembered that for those children currently medicated for school, for example, they should take their usual medication in the appropriate doses making no special changes for their dental visits. If they take no medication normally, no medication should be given to the child prior to a dental visit unless discussed beforehand; certainly never for a child’s first visit.
A certain number of our patients that come to our practice are severely handicapped. Again, we make every effort to accommodate these children. We are wheelchair accessible and prepared to work with the individual child evaluating their oral and dental needs as necessary.
Recently, a mother brought a 4 year old child in for a routine 6 months visit after being referred to us by a general dentist. Although the child was uncooperative we went about our treatment with no particular problem. The mother, on the other hand, was clearly uncomfortable and visibly upset with the child. After completing the child’s treatment, we asked the mother why she was upset; after all, the child did quite well for a 4 year old. She told us that when she brought her child to the last dentist, the child was uncooperative and the dentist refused to see him and she was afraid that we would do the same. Not a chance! This is what pediatric dentistry is all about.
Cooperation or not we deliver uncompromising dentistry with the hope that as these children get older they all will become great patients with health mouths. As parents and professionals we must take the first steps toward that goal.
Dentistry For Children, P.A. proudly serves Essex County, New Jersey including the Nutley, Clifton and Bloomfield, New Jersey communities.