Research hopes to make dental visits less stressful for children with autism

Giving children the power of choice – even in something as simple as the colour of mouthwash they use after their dental examination – could make a world of difference to a child with autism, according to Nicole Thomas, from the Plymouth University Peninsula Schools of Medicine and Dentistry.

Nicole interviewed 17 parents about their experiences of taking their children for routine dental examinations – working alongside researchers at the Peninsula Cerebra Research Unit (PenCRU) at the University of Exeter Medical School, supported by the National Institute for Health Research Collaboration for Applied Health Research and Care South West Peninsula (NIHR PenCLAHRC). She was also advised by members of the PenCRU Family Faculty – a group of parents of disabled children.

Emerging from the study were five key areas that improved the chances of a dental visit being successful, with clear communication between parents and professionals central to ensuring the children have as good experience as possible.

Nicole said: “Going to the dentist can be challenging for any child, but I know from experience that taking a child with autism for a routine check-up can be really stressful for everyone involved, from the huge amount of preparation prior to and the impact afterwards if it is unsuccessful. So I, with the outstanding support of my mentor, Sharon Blake from the University of Exeter, was surprised at the small changes required that could make a really significant difference.”

All participating parents said their children were hypersensitive to the feelings and negative body language of those around them which made dental examinations challenging. Being flexible to make minor environmental adjustments and giving children choices – such as mouthwash colour or brightness of the lights – was found to be effective in helping them feel less stressed, and she added that the behaviour of the whole dental team, from receptionists through to practitioners, was vital in terms of influence.

The research showed that parents’ confidence when visiting the dentist was also a key factor.

Nicole added: “Some parents respect the dentist’s viewpoint so much that they don’t have the confidence to ask about what to expect and request changes to surroundings, but this study shows that clear and open communication on both sides creates a collaborative partnership that works in the best interest of all.”

In addition, having clear referral pathways to specialist dental services to avoid any delay and distress for families whose children are still not able to cope with conventional dental setting was highlighted as vitally important.

Nicole concluded: “Our next step is to work with dental service providers and autism support groups and charities to raise awareness of the study’s findings. We hope that promoting small changes could have an impact on a large number of people.”

Fully entitled Autism and Primary Care Dentistry: parents’ experiences of taking children with autism or working diagnosis for dental examinations, the study has been published in the International Journal of Paediatric Dentistry and was funded through a professional training grant, the Colgate Robin Davies Dental Care Professional Award from the Oral and Dental Research Trust.

There is also a video and accessible plain language summary of the research on the PenCRU website http://www.pencru.org/projectsmeetings/researchprojects/apexd/.

Sharon Blake, Associate Research Fellow at the University of Exeter said: “It has been my privilege to support Nicole with this important research. She worked tirelessly around her day job as a dental hygienist and family commitments. I am absolutely delighted that following this research training, Nicole is now studying for a PhD and we were able to contribute to understanding the challenges and best practice in respect of accessing dental services for children with autism.”

Nicole hopes the findings will empower parents to feel confident to advocate for their child’s individual needs, as well as help dental professionals, like herself, understand the small changes they could incorporate to make a big difference.