Wednesday, September 21, 2011

How To Make a Visit to the Dentist Less Scary for Autistics, Aspergians, Sensitives and Any Anxious Person

Advice for sensitive patients, dentists, and medical office designers.

Sensory issues are part and parcel of the autistic and aspergian experience, but we're not the only sensitives in the world ("The Princess and the Pea" was written in 1835, folks!) Today I had to go to the dentist for an exam and cleaning and was inspired to write this blog. I've been meaning to do it for ages; since a visit to a dentist in upstate NY three years ago. I asked him to hand me a toy that he had for kids so I could squeeze it to help me deal with my anxiety. I thanked him and explained, kind of apologetically, that I had Aspergers and he replied, "Don't worry, I'm used to dealing with all sorts of crazy folks." Lesson Number One, my fellow Aspergians: Never apologize for having AS. Be polite, yes, but apologetic, Never!
This article is aimed at the patients-but it is also aimed at the professionals who run/own these practices.
To the auties, aspies, sensitives and anxious folks: you will be poked, prodded, blinded by the light, scraped, suctioned and maybe even subjected to some of the worst music ever heard by human ears. Take heart, there are things you can do to ease the pain to the point of being almost painless

  1. Don't forget your squidgy toys...if you don't bring them, the dentist might not have them, and if you are over the age of twelve you might be embarrassed to ask if they have any of these things in their cupboard.
  2. The lead bib that that they throw over you during x-ray time is similar to the weighted vests and shoulder bibs they make specifically for autistics. Ask to keep yours on after the x-ray is over and before the worst part begins--the cleaning. The heavy bib very comforting, like Temple Grandin's squeeze machine. You could even ask for it at the beginning, during the examination itself, when the dentist uses that little tiny metal claw that looks like it belongs on the arm of a Tinkerbell-sized Captain Hook.
  3. Ask if you can wear sunglasses. It'll keep you from having to completely close your eyes which might cause you to fall asleep and make dentist angry (we wouldn't want that). They'll also keep you from having to look dentist in the eye. For the first several dental visits of my life, I made eye contact with my dentist the whole time, causing him I'm sure, to think that I was either a nutter or a giant flirt. The office might have blinds or busy wallpaper patterns or bothersome lights, so the sunglasses will help you with that as well.
  4. You probably cannot wear an Ipod since you need to hear the dentist's directions (turn your head, open wide, etc.) but perhaps, you could ask if they mind if you wear either noise canceling headphones or perhaps just keep one earbud in your ear so you can have control of the tunes.
  5. Lastly, do not be afraid to ask for numbing cream for the cleaning, even for the exam. The basic stuff won't cost extra and really does help if you have a low pain threshold or are afraid of possible pain and are on hyper-alert. The cream will wear off by the time the exam is over.

Okay, the rest is for you dentists. You think you have created the coolest, most state-of-the-art office for your patients, but you are probably not thoroughly understanding the needs of your autistic, sensitive, or high anxiety patients.
Visually: high contrast wallpaper, e.g. black and white, might contain some groovy pattern to you, but might be so disorienting to an aspie that they get dizzy and even throw up, especially if they've had any sort of laughing gas or muscle relaxer. Even slatted blinds can drive us nuts. I got up out of my chair today at the dentist, ostensibly to look at the view (which was gorgeous) but also to raise the blinds--the lowered, slatted position created a dark and light, almost flickering pattern which can be painful to the autistic brain. And God forbid, Dr. Dentist, if you must use fluorescents, make sure they are the full-spectrum kind which contain the same colors as natural light and NOT flickering.
Doctor, do let the patient keep the bib and offer it at the beginning. It's a virtual hug that makes us feel more secure.
Tactile things, such as a squidgy toy, furry pillow (since grown ups won't want to be seen cuddling Tigger) are also good stress relievers.
Ask the patient if they would prefer to wear goggles in the beginning, not just when the polishing starts and the pink stuff starts to fly. I have been hit in the eye by my own tartar during the manual cleaning and believe me, I found it pretty gross. Get and offer tinted goggles. We don't like extended eye contact (if any) so if we keep our eyes closed, don't be offended.
And please, don't ask us questions while we are sitting there like horses at auction having our teeth and jaws examined. We respect and need what you do, but there's nothing more embarrassing than trying to answer questions while drooling and slurring.
Think about having a choice of music. While you have to be happy too, asking us if we prefer jazz, pop or classical give us some control even though you've chosen the Cds or stations.
Aspies talk to each other, in their communities and online and if you are known for having a sensory-friendly environment, you will have an edge over your competitors. And perhaps there will be more Aspies with shiny white teeth walking around, smiling a little more.

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