Raquel Yzaguirre, a Natick mom of a son with autism, knows all too well the stress of taking a child with ASD to the dentist. Her son, Malcolm, has never liked having his teeth checked, but as he grew older, it became increasingly more difficult at visits.
“He wouldn't relax into the chair,” said Yzaguirre. “He screamed, his body would get stiff and tears ran down his face. The dentist instructed me to sit in the chair first and then I had to wrap my arms and legs around him to control his body. It was a sweaty, stressful mess. Something about the lights, the sounds and maybe even the smell got to him.”
Malcolm’s experience is not unusual for kids with ASD.
Today, approximately one in 59 children in the U.S. is diagnosed with ASD, according to 2018 data from the Centers for Disease Control. And many children with ASD, like Malcolm, experience some level of anxiety about going to the dentist.
That’s where the Autism Smiles program at Tufts School of Dental Medicine comes in. Autism Smiles offers kids with ASD an opportunity to visit the dentist office and get familiar with the tools and the environment before going in for an actual treatment.
“The aim is to improve the dental experience for those with Autism Spectrum Disorder and the parents and caregivers,” said Martha Forero, assistant professor of pediatric dentistry. “They come to the appointment and we introduce different components of the dental office so they can prepare themselves for future appointments at their dental home.”
Some of those preparations include showing kids the equipment pieces that are used in a typical visit, like syringe and water suction tips, for example.
“We use a technique called tell, show and do,” said Kathryn Dolan, assistant professor of public health and community service at the dental school.
Autism Smiles was launched after a group of first-year dental students conceived the idea and presented it as a final project. Inspired by the concept, faculty and staff from Tufts Department of Public Health and Community Service and the Department of Pediatric Dentistry first organized a pilot program last year that was successful. The school held another clinic this past February and more are planned for the future.
Autism Smiles is modeled on Logan Airport’s Wings for Autism program, where children can visit an airplane before taking a flight.
“We want them to feel like there is no time pressure,” said Dolan. “We become familiar with the parents and develop the relationship before they even come in for an actual appointment.”
Participants leave with a dental toolkit to bring home to continue the work of gaining comfort and familiarity. The toolkit has story book caregivers can read to kids, and sensory items they can bring to an appointment. It also includes a stuffed toy bear and children can “practice” brushing the bear’s teeth.
For Lorraine Scanlon, a Walpole mom of 6-year-old Jacob, it has been a very positive experience. Jacob has an eating disorder and ASD and does not like anything in his mouth, said Scanlon.
“Going to the dentist was always off the table before,” she said.
Scanlon and Jacob attended the Autism Smiles clinic in February and have made remarkable progress with Jacob’s comfort level with caring for his mouth.
“Since then I have had more success brushing teeth than I have before,” said Scanlon. “All the tools they give you in the bag help. He still talks about the visit and he brushes his bear’s teeth and now we can brush his teeth.”
Jacob has his first real dental appointment next month, and Scanlon hopes it will be the beginning of many more in the future.
“That’s our ultimate goal; to get him in there and have a long term plan so he can have healthy teeth.”