Dr.
Amy Luedemann-Lazar feeds David Villarreal, 2, a popsicle from a small
dental mirror at Kidstown Dental in Katy, Texas recently.
| credits: New York Times Service
| credits: New York Times Service
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.
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 this suburb of Houston.
Unlike previous dentists, Luedemann-Lazar didn’t suggest that Camryn would need to be sedated or immobilised. 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.
At the end, Luedemann-Lazar examined Camryn’s teeth and declared her cavity-free and ready to see an orthodontist.
“It was like a breakthrough,” Brown said, adding, “Dr. Amy didn’t just turn her away.”
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 recognising that with accommodations, many of them can become cooperative patients.
Researchers are studying how to overcome dental fears and sensory challenges in children with autism. And continuing-education programs are helping dentists and their staffs supplement what they learned in dental school — or, more likely, didn’t learn — about treating children with special needs.
Dr. John S. Rutkauskas, the chief executive of the American Academy of Pediatric Dentistry, said its members were growing more interested in learning such skills, but he added, “It’s still a relatively small pool of practitioners.”
Dr. Elizabeth Shick, a pediatric dentist who helped write a dental professionals’ tool kit for Autism Speaks, an advocacy organization, agreed.
“With the increase of autism spectrum disorder patients out there, there are not enough pediatric dentists to see everyone,” she said.
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 familiarise an uncooperative child with a dental cleaning.
The first DVD has long been used in some pediatric dental practices — including Luedemann-Lazar’s. 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 able to manage.”
“It’s wrong,” he continued.
“That’s the message we have to get out.”
More than 14,000 dental professionals have completed a free online Procter & Gamble course in treating patients with autism. Of more than 150 offerings on the site — from primers on oral cancer to piercings — the three-hour lesson has been the No. 1 monthly course nine times since 2013.
The instructor is Josalyn Sewell, a dental hygienist whose 11-year-old son has autism and was once sedated to fill a cavity. She calls herself a “mom on a mission.”
“There are children who are completely nonverbal,” she said, “and if they have a toothache, it completely shuts them down.”
For some children with autism, a first visit to the dentist may not occur until age 9 or 10; mouth care goes on the back burner until there’s a potential emergency.
“It’s overwhelming to have so many needs, finding a special school and special services,” said one mother, Shoshana Handel, who works at the University of New Mexico.
“If the kid’s mouth isn’t bleeding, I’m not worried about a dentist.”
When her nonverbal son, Aodhan, was 10, she finally took him to the dentist because she worried he had a painful cavity.
But experts say children should start dental care as toddlers — long before there are cavities to be drilled and filled — for the same reasons early intervention is important in areas like walking, talking and interacting with others.
“It allows us to train a child to their highest potential,” said Dr. Cavan Brunsden, a pediatric dentist in Old Bridge, New Jersey.
If the first visit does not take place until there’s an emergency, he continued, “we need to fix their decayed teeth, and then also train them to become a compliant patient for life.”
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 this suburb of Houston.
Unlike previous dentists, Luedemann-Lazar didn’t suggest that Camryn would need to be sedated or immobilised. 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.
At the end, Luedemann-Lazar examined Camryn’s teeth and declared her cavity-free and ready to see an orthodontist.
“It was like a breakthrough,” Brown said, adding, “Dr. Amy didn’t just turn her away.”
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 recognising that with accommodations, many of them can become cooperative patients.
Researchers are studying how to overcome dental fears and sensory challenges in children with autism. And continuing-education programs are helping dentists and their staffs supplement what they learned in dental school — or, more likely, didn’t learn — about treating children with special needs.
Dr. John S. Rutkauskas, the chief executive of the American Academy of Pediatric Dentistry, said its members were growing more interested in learning such skills, but he added, “It’s still a relatively small pool of practitioners.”
Dr. Elizabeth Shick, a pediatric dentist who helped write a dental professionals’ tool kit for Autism Speaks, an advocacy organization, agreed.
“With the increase of autism spectrum disorder patients out there, there are not enough pediatric dentists to see everyone,” she said.
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 familiarise an uncooperative child with a dental cleaning.
The first DVD has long been used in some pediatric dental practices — including Luedemann-Lazar’s. 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 able to manage.”
“It’s wrong,” he continued.
“That’s the message we have to get out.”
More than 14,000 dental professionals have completed a free online Procter & Gamble course in treating patients with autism. Of more than 150 offerings on the site — from primers on oral cancer to piercings — the three-hour lesson has been the No. 1 monthly course nine times since 2013.
The instructor is Josalyn Sewell, a dental hygienist whose 11-year-old son has autism and was once sedated to fill a cavity. She calls herself a “mom on a mission.”
“There are children who are completely nonverbal,” she said, “and if they have a toothache, it completely shuts them down.”
For some children with autism, a first visit to the dentist may not occur until age 9 or 10; mouth care goes on the back burner until there’s a potential emergency.
“It’s overwhelming to have so many needs, finding a special school and special services,” said one mother, Shoshana Handel, who works at the University of New Mexico.
“If the kid’s mouth isn’t bleeding, I’m not worried about a dentist.”
When her nonverbal son, Aodhan, was 10, she finally took him to the dentist because she worried he had a painful cavity.
But experts say children should start dental care as toddlers — long before there are cavities to be drilled and filled — for the same reasons early intervention is important in areas like walking, talking and interacting with others.
“It allows us to train a child to their highest potential,” said Dr. Cavan Brunsden, a pediatric dentist in Old Bridge, New Jersey.
If the first visit does not take place until there’s an emergency, he continued, “we need to fix their decayed teeth, and then also train them to become a compliant patient for life.”
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