For autistic children, a way to dental care

Like many parents of children with autism, Nicole Brown feared she might never find a dentist willing and able to care for her daughter, Camryn Cunningham, now a lanky 13-year-old who uses words sparingly.

Dr. Amy Luedemann-Lazar feeds David Villarreal, 2, a popsicle from a small dental mirror at Kidstown Dental in Katy, Texas. Parents of children with special needs have long struggled to find dentists who will treat them, but as more children receive diagnoses of autism spectrum disorder, dental practices are learning to meet the delicate challenge. (Katie Hayes Luke/The New York Times)


Finishing a basic cleaning was a colossal challenge, because Camryn was bewildered by the lights in her face and the odd noises from instruments like the saliva suctioner — not to mention how utterly unfamiliar everything was to a girl accustomed to routine. Sometimes she’d panic and bolt from the office.

Then in May, Brown, 45, a juvenile supervision officer, found Dr. Amy Luedemann-Lazar, a pediatric dentist in Katy, Texas, a suburb of Houston.

Unlike previous dentists, Luedemann-Lazar didn’t suggest that Camryn would need to be sedated or immobilized. Instead, she suggested weekly visits to help her learn to be cooperative, step by step, with lots of breaks so she wouldn’t be overwhelmed.

Bribery helped. If she sat calmly for 10 seconds, her reward was listening to a snippet of a Beyoncé song on her sister’s iPod.

This month, Camryn sat still in the chair, hands crossed on her lap, for no less than 25 minutes through an entire cleaning — her second ever — even as purple-gloved hands hovered near her face, holding a noisy tooth polisher.

Parents of children with special needs have long struggled to find dentists who will treat them. In a 2005 study, nearly three-fifths of 208 randomly chosen general dentists in Michigan said they would not provide care for children on the autism spectrum; two-thirds said the same for adults.

But as more and more children receive diagnoses of autism spectrum disorder, more dentists and dental hygienists are recognizing that with accommodations, many of them can become cooperative patients.

Dr. Elizabeth Shick, a pediatric dentist, helped write a dental professionals’ tool kit for Autism Speaks, an advocacy organization. The 146-page kit has been downloaded more than 4,000 times since its release in 2012. Autism Speaks also has a state-by-state directory with 500 dentists referred by parents, up from 40 in 2007, its first year.

Other kinds of help are available, too. Dr. David Tesini, a dentist in Sudbury, Massachusetts, recently released a new DVD of his D-Termined program that teaches professionals how to familiarize an uncooperative child with a dental cleaning. The first DVD has long been used in some pediatric dental practices.

Tesini said he developed the program, in part, because “very often, parents believe that their child is not ready to go to the dentist and has behavioral problems that the dental team won’t be e to manage.”

“It’s wrong,” he continued. “That’s the message we have to get out.”

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