Protocol for first dental visit for Neurodiverse Children.

Prepared by Magnolia Venegas DMD, Clinical Associate Professor Pediatric Dentistry at Boston University

The main purpose of this protocol is to integrate the patient’s dental treatment with that of the hospital’s Pediatrics Department Physicians or private office Pediatricians.

Before referring a child to the first dental visit, make sure that:

  1. The dentist is a Board-certified Pediatric Dentist;
  2. At least one parent must be engaged with this visit and participating in the actions of the multidisciplinary group of dentists, nurses, dental assistants, and hygienists.
  3. Parents must be educated using videos, books, and other tools, what to expect from the first dental visit and the best way to participate and help their child deal with a new environment, new situations, and sensations. Thus, parents are key players in helping their child positively experience and pleasant first and consecutive visits in the dental office and schools and while traveling.
  4. Once the parents are comfortably relating with his or her child, able to brush their child’s teeth, even if not well but at least introducing the toothbrush in their mouth, then adding toothpaste, brushing and spitting, and only then is time to call the dental office to make a sequence of dental visits appointments.
  5. The office should recommend that parents buy some books about the dental office or videos from Sesame Street or Mr. Roger’s neighborhood…
  6. The first appointment should be a tour of the office. This should be best scheduled early in the day and before it gets too busy, noisy, and with too many people and stimuli in it. The lighting should be deemed, calm music playing…maybe some butterflies hanging and swinging from the sealing…
  7. The second visit could be the same as the first if the child did not want to be there on the first tour, and repeat it until the desire to sit in the dental chair is shown by the child… The progress will be depending on each child’s abilities to handle the different situations.

Parents and Dentists should do the progress step by step.

To sit in the chair, to open the Mouth, to let the dentist brush their teeth, to accept the placement of the mouth mirror inside their mouth, to clean and wash their mouth with the water syringe to dry their teeth with it or with a gauze, to paint the fluoride on their teeth and so on..( all this is typically involved at a check-up dental appointment).
If extensive treatment is necessary that involves long appointments, it can always be planned to be done under general anesthesia in a hospital setting. If an unpredicted step went wrong or triggered stress on the child, all the previous steps should be reintroduced to the child, up to the point which became unaccepted by the child.

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