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| Oral Care and Autism |
Children with developmental disabilities are at a high risk for enamel irregularities, gum infections, delays in tooth
eruption, moderate to severe misalignment between the upper and lower teeth when the jaw is closed, resulting in a
faulty bite poor bite, and oral infection. To achieve and maintain good oral health, people with developmental disabilities
often require a special approach to dental care. Proper diagnosis and treatment of the dental patient presenting with
autism may be challenging to the knowledgeable dental practitioner. The initial examination may be very difficult to
perform, and the medical history may present a variety of issues that can impact on the materials that can be used. It is
important to find a dentist who has experience in treating children with special needs. With some adaptation of the skills
dental professionals use every day, most people with special needs can be treated successfully in the general practice
setting.
Obsessive routines, repetitive behaviors, unpredictable body movements, and self-injurious behavior may all be
symptoms that complicate dental care. Communication and behavioral problems pose the most significant challenges in
providing oral care. The assessment of the patient’s diet may also present a complex resolution between adequate
nutrition, medical complications, and prevention of tooth decay. Above all people with autism experience few unusual
oral health conditions.
Sensory Triggers
The dental office probably is one of the main areas that may trigger a large amount of anxiety for a child with an autism
spectrum disorder. One of the areas being tactile (sensitivity to touch) and auditory (heighten sense to noise). Mouths
are extremely sensitive places and for a person with an ASD someone putting cold instruments into their mouth could
be very painful. In addition the noise of the drills and the cleaning of the instruments could also be a problem.
Sometimes the taste of the mouthwash or the paste used may be an issue.
Dentists are one of the few professionals who invade everyone's personal space. Most people find this uncomfortable
but are aware of why the dentist has to be so close, to examine your teeth. For individuals with an ASD they may find
this close proximity extremely distressing. A common issue for many children with autism is oral sensitivity around the
face and the mouth. This sensitivity can affect eating, nutrition, speech, tooth brushing, dental check-ups and oral
health. Some children with special needs, especially those with autism, have an oral sensitivity that makes tooth
brushing difficult. They may resist having their teeth brushed by a parent or caregiver and refuse to brush their own
teeth.
Children with autism have greater difficulty accessing dental care. Some of the risk factor for children with
autism includes:
• Sensitivity around the face and mouth which can make tooth brushing and dental check-ups more challenging.
• Use of candy as reinforces or feeding issues which may lead to more frequent consumption of sticky and sweet
foods.
• Sensitivity to light and sound common in the dental office and sensitivity to touch that may make obtaining
regular dental care more difficult.
Autistic children requiring anesthesia for dental procedures
There is no evidence that anesthetic drugs have cause or worsen autism, nor is there any published data on preferred
drugs for anesthetizing autistic children. Dental anesthesia is usually performed in the dentist’s office. The mandatory
requirement is that an anesthesiologist experienced in dental and in pediatric anesthesia does the anesthesia care, and
that standard hospital operating room monitoring instruments (e.g., pulse ,ECG, and blood pressure), and resuscitation
equipment (including a defibrillator) are present in the dental suite.
If the child has serious medical problems (e.g., heart problems, breathing problems, seizures, or airway problems) it is
sometimes unsafe to give anesthesia care in the dental office, and the dentist will need to do the procedure in a hospital
room setting. This decision is made by the anesthesiologist. When the dental procedure is finished, the child stays at the
facility until safely aware. This usually requires a minimum of 30 minutes. Post-anesthesia side effects are sleepiness,
sometimes nausea, and in some children, aggressive behavior or agitation. When dental sedation is done by an
experienced anesthesiologist with modern monitoring equipment and medications, the rate of major complications
should be low.
Mercury in Dental Fillings
Amalgam fillings, also called silver fillings, are made of mercury, silver, and other metals and have been used by
dentists for more than a century. But their use has dropped in recent years as more and more doctors switch to resin
composite fillings, which are considered more appealing because they are white. Some advocacy groups and dentists
have long contended that the mercury in fillings can leach into the body and cause harmful neurological effects,
including autism.
American Dental Association (ADA) supports the use of such fillings and assures the American people that dental
amalgam is safe. The ADA claims that since mercury amalgam has been used for over 150 years, its safety should not
be disputed. While its position remains largely unsupported by scientific evidence, the ADA challenges those opposed to
the use of amalgam fillings to produce scientific evidence that its use is harmful to humans.
This challenge has been accepted. The anti-amalgam movement has been given new life by the widespread claims
associating mercury with autism. Those involved with anti-amalgam have countered by challenging the ADA to
demonstrate that safe levels of mercury in human tissues exist before endorsing its use. The ADA has yet to respond.
Both sides do, however, agree that mercury is one of the most poisonous elements known to man, and mercury
amalgam may cause ill effects in those people who are mercury sensitive.
Mercury Contamination
Infants and young children that are not autistic, normally and commonly exhibit a degree of mercury contamination that
is directly related to the number of mercury amalgam fillings in their mother’s mouth. The more amalgams mom has,
the higher the mercury in the infant. Mom's blood and breast-milk carry mercury to the baby. The more she has, the
more baby gets. Whether this is viewed as good, bad, or insignificant, it's a fact to be kept in mind. Root canals, metal
crowns, implants and fluoride may be doing more harm than good. Another source of mercury for children is the
mercurial preservatives that have been used in vaccinations for many years; third major source of mercury is diet,
especially fish.
Children with amalgam fillings were no more likely than other youngsters to suffer neurological problems, researchers
said. Autistic children somehow lack the normal mechanisms to rid the mercury of their bodies. That strongly suggests
that autistic children are unable to detoxify their mercury, build up higher body tissue levels of mercury than the non-
autistic children population. The higher tissue levels of mercury toxicity may then result in neurological changes seen as
symptoms of autism.
Visiting the Dentist
Finding a dentist can be a challenge. It is often difficult to find one that has experience in treating children with special
needs, try to searching for a pediatric dentist. Many children with autism are resistant to visiting the dentist. Some
amount of preparation is recommended for your child to have a positive experience with the dentist. The amount of
preparation depends on your child's particular emotional and physical needs.
• When you call for a dental appointment, ask for an appointment time when the child is most rested.
• Go at a time when the office is least crowded.
• Inform the dental office of your child’s special needs.
• Describe any behavior problems.
• Develop a social story about visiting the dentist.
• Take favorite toys, music or books.
• Daily brushing helps prepare the child for the dental visit.
When making your dental visit try asking that the appointment is the first of the day. Ask if you could visit the office
prior to the appointment. This way your child can get meet the staff and get familiar with the equipment. For some the
experience is so distressing that sedation may need to be considered. If you feel this is the case you need to talk this
through with your dentist and a medical professional to discuss the options. Tell the dentist about any problems with
chewing or any pain observed in the child. Talk to the dentist about any problems with oral hygiene.
eruption, moderate to severe misalignment between the upper and lower teeth when the jaw is closed, resulting in a
faulty bite poor bite, and oral infection. To achieve and maintain good oral health, people with developmental disabilities
often require a special approach to dental care. Proper diagnosis and treatment of the dental patient presenting with
autism may be challenging to the knowledgeable dental practitioner. The initial examination may be very difficult to
perform, and the medical history may present a variety of issues that can impact on the materials that can be used. It is
important to find a dentist who has experience in treating children with special needs. With some adaptation of the skills
dental professionals use every day, most people with special needs can be treated successfully in the general practice
setting.
Obsessive routines, repetitive behaviors, unpredictable body movements, and self-injurious behavior may all be
symptoms that complicate dental care. Communication and behavioral problems pose the most significant challenges in
providing oral care. The assessment of the patient’s diet may also present a complex resolution between adequate
nutrition, medical complications, and prevention of tooth decay. Above all people with autism experience few unusual
oral health conditions.
Sensory Triggers
The dental office probably is one of the main areas that may trigger a large amount of anxiety for a child with an autism
spectrum disorder. One of the areas being tactile (sensitivity to touch) and auditory (heighten sense to noise). Mouths
are extremely sensitive places and for a person with an ASD someone putting cold instruments into their mouth could
be very painful. In addition the noise of the drills and the cleaning of the instruments could also be a problem.
Sometimes the taste of the mouthwash or the paste used may be an issue.
Dentists are one of the few professionals who invade everyone's personal space. Most people find this uncomfortable
but are aware of why the dentist has to be so close, to examine your teeth. For individuals with an ASD they may find
this close proximity extremely distressing. A common issue for many children with autism is oral sensitivity around the
face and the mouth. This sensitivity can affect eating, nutrition, speech, tooth brushing, dental check-ups and oral
health. Some children with special needs, especially those with autism, have an oral sensitivity that makes tooth
brushing difficult. They may resist having their teeth brushed by a parent or caregiver and refuse to brush their own
teeth.
Children with autism have greater difficulty accessing dental care. Some of the risk factor for children with
autism includes:
• Sensitivity around the face and mouth which can make tooth brushing and dental check-ups more challenging.
• Use of candy as reinforces or feeding issues which may lead to more frequent consumption of sticky and sweet
foods.
• Sensitivity to light and sound common in the dental office and sensitivity to touch that may make obtaining
regular dental care more difficult.
Autistic children requiring anesthesia for dental procedures
There is no evidence that anesthetic drugs have cause or worsen autism, nor is there any published data on preferred
drugs for anesthetizing autistic children. Dental anesthesia is usually performed in the dentist’s office. The mandatory
requirement is that an anesthesiologist experienced in dental and in pediatric anesthesia does the anesthesia care, and
that standard hospital operating room monitoring instruments (e.g., pulse ,ECG, and blood pressure), and resuscitation
equipment (including a defibrillator) are present in the dental suite.
If the child has serious medical problems (e.g., heart problems, breathing problems, seizures, or airway problems) it is
sometimes unsafe to give anesthesia care in the dental office, and the dentist will need to do the procedure in a hospital
room setting. This decision is made by the anesthesiologist. When the dental procedure is finished, the child stays at the
facility until safely aware. This usually requires a minimum of 30 minutes. Post-anesthesia side effects are sleepiness,
sometimes nausea, and in some children, aggressive behavior or agitation. When dental sedation is done by an
experienced anesthesiologist with modern monitoring equipment and medications, the rate of major complications
should be low.
Mercury in Dental Fillings
Amalgam fillings, also called silver fillings, are made of mercury, silver, and other metals and have been used by
dentists for more than a century. But their use has dropped in recent years as more and more doctors switch to resin
composite fillings, which are considered more appealing because they are white. Some advocacy groups and dentists
have long contended that the mercury in fillings can leach into the body and cause harmful neurological effects,
including autism.
American Dental Association (ADA) supports the use of such fillings and assures the American people that dental
amalgam is safe. The ADA claims that since mercury amalgam has been used for over 150 years, its safety should not
be disputed. While its position remains largely unsupported by scientific evidence, the ADA challenges those opposed to
the use of amalgam fillings to produce scientific evidence that its use is harmful to humans.
This challenge has been accepted. The anti-amalgam movement has been given new life by the widespread claims
associating mercury with autism. Those involved with anti-amalgam have countered by challenging the ADA to
demonstrate that safe levels of mercury in human tissues exist before endorsing its use. The ADA has yet to respond.
Both sides do, however, agree that mercury is one of the most poisonous elements known to man, and mercury
amalgam may cause ill effects in those people who are mercury sensitive.
Mercury Contamination
Infants and young children that are not autistic, normally and commonly exhibit a degree of mercury contamination that
is directly related to the number of mercury amalgam fillings in their mother’s mouth. The more amalgams mom has,
the higher the mercury in the infant. Mom's blood and breast-milk carry mercury to the baby. The more she has, the
more baby gets. Whether this is viewed as good, bad, or insignificant, it's a fact to be kept in mind. Root canals, metal
crowns, implants and fluoride may be doing more harm than good. Another source of mercury for children is the
mercurial preservatives that have been used in vaccinations for many years; third major source of mercury is diet,
especially fish.
Children with amalgam fillings were no more likely than other youngsters to suffer neurological problems, researchers
said. Autistic children somehow lack the normal mechanisms to rid the mercury of their bodies. That strongly suggests
that autistic children are unable to detoxify their mercury, build up higher body tissue levels of mercury than the non-
autistic children population. The higher tissue levels of mercury toxicity may then result in neurological changes seen as
symptoms of autism.
Visiting the Dentist
Finding a dentist can be a challenge. It is often difficult to find one that has experience in treating children with special
needs, try to searching for a pediatric dentist. Many children with autism are resistant to visiting the dentist. Some
amount of preparation is recommended for your child to have a positive experience with the dentist. The amount of
preparation depends on your child's particular emotional and physical needs.
• When you call for a dental appointment, ask for an appointment time when the child is most rested.
• Go at a time when the office is least crowded.
• Inform the dental office of your child’s special needs.
• Describe any behavior problems.
• Develop a social story about visiting the dentist.
• Take favorite toys, music or books.
• Daily brushing helps prepare the child for the dental visit.
When making your dental visit try asking that the appointment is the first of the day. Ask if you could visit the office
prior to the appointment. This way your child can get meet the staff and get familiar with the equipment. For some the
experience is so distressing that sedation may need to be considered. If you feel this is the case you need to talk this
through with your dentist and a medical professional to discuss the options. Tell the dentist about any problems with
chewing or any pain observed in the child. Talk to the dentist about any problems with oral hygiene.
| ________________________________________________________________________________________________________________________ Copyright © 2004 Bright Tots® Inc. - Educational Toys & Resource Guide to Child Development - All rights reserved. ________________________________________________________________________________________________________________________ |
| Oral Care and Autism |
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