Questions to ask a dentist/dental practice

[CaroPhoenix]

I got a referral from my dentist for a dental practice that does pediatric dentistry and who works with special needs kids. (for those who are new to the board, my daughter is Autistic).

I went to the website of the dental practice and found a link saying that I can e-mail the practice. I'd like to send a (small) list of questions and a paragraph or 2 detailing that my daughter is autistic/she has a fear of doctors/etc. What sort of questions should I be asking? I have no clue as 1) I've never been a parent of a child who needs to go see a dentist before (nothing major - I just want her to start getting used to the idea of going to one) and 2) I've never been the parent of a special needs child before either.

Any help would be greatly appreciated! Thank you!

[Banrion]

I think the most important thing to find out is if they handle these kids through 'sedation dentistry' - that means giving the laughing gas for things even as simple as a routing cleaning. If that is how they handle it, you need to make the decision on whether this is a practice you agree with that will benefit your daughter by minimizing the stress, or if you would rather that you DD learned to handle this situation without chemical intervention. I want to make clear, it's not general anethesia, just nitrous oxide which has a calming effect in the appropiate doses.

[digilight]

Honestly, I would contact area schools and daycars and see what recommendations they come up with. Is their a state or county organization for special needs children in your area, they would be great for a recommendation for you're specific case.

But for us (a 3 year old and a 5 year old) we went to a local pediatric dentistry that had been around for years. I also have done their printing for years as well so I was known in the office before the kids starting going their.

I would say that you know your childs comfort level and are allready aware of what would and wouldn't work for your daughter. One question I would ask is do they have much experience working with autistic children (yup obvious no brainer there) and do they feel comfortable doing the work.

I found this link about Autistic children and dentistry (the info is at the bottom of the page) http://dentalresource.org/topic55autistic.html

[CaroPhoenix]

Thank-you for the link digilight.

I think in the e-mail I send to the dental practice, I'll ask if we can come for a tour first.

There is the Autism Society for Northern Virginia (where I live) website that lists resources for parents. The resources list like doctors, dentists, barbers/haircutters who work with autistic children, etc. The dentist I was referred to was listed as one who works with special needs/autistic children.

Baniron - I've never been to a dentist who uses laughing gas. Have you? Have you had laughing gas? I think Kelly might need something like that, but I'm not sure.

[Banrion]

I haven't had it done, but I haven't been to a dentist since my wisdom teeth were pulled in 2000. I just know that around here sedation dentistry is the new big trend, I am seeing signs for it EVERYWHERE, from the ads on TV to billboards to ads in the phonebook. It seems like this is the new way to encourage people that have some apprehensions to go to the dentist. As far as I am aware, there isn't really much of a danger with nitrous oxide, especially when used under supervision.

Heres a brief page from the Academy of Pediatric Dentistry:http://www.aapd.org/publications/brochures/nitrous.asp

[CaroPhoenix]

Sedation dentistry is big here where I live too. However, of all those dentists, there's only one who mentions how they sedate their patients (with 2 little white tablets), but I think that practice is for adults only.

I'm going to compose the e-mail and probably send it off tomorrow. (Yes, I'm procrastinating, but I want to have the message sounding coherent and stuff).

[Seshat]

A lot of dentistry is a judgement call.

Teeth that are going bad develop 'soft spots'. These can be strengthened rather than needing to be drilled and filled right away.

As the soft spot is developing, it becomes a shallow cavity, then a large cavity. Once a soft spot is a cavity, it must be filled.

One dentist taught me how to strengthen soft spots - ever since, I've just asked dentists to tell me which spots are soft, and I go often enough that I can catch and strengthen soft spots before they become cavities.
(How to do it: Use fluoridated toothpaste. Spit out excess toothpaste, don't rinse it out. Or if you feel 'icky' leaving the toothpaste in, rinse, then put a smear of toothpaste over your teeth. The fluoride in the toothpaste will strengthen any soft spots for you.)

Dentists who see a patient with a poor history of dental work and a lot of soft spots and/or cavities will often determine that if they don't fill the soft spots, they'll become cavities before the patient next sees a dentist. Even the dentist who taught me how to fix soft spots told me he does that with patients who he believes would otherwise develop cavities and lose teeth.

If you and your child are going to keep your teeth strengthened and your gums properly massaged, you want a dentist who's willing to say 'toughen these spots and come back in six months so I can check your progress'. If you'd rather cut-and-fill and be done with it, you want a dentist who'll do that.

Speaking of gums: make sure you use a dentist whose interests include whole-mouth health. You want someone who'll watch gums for gingivitis and tell you preventative stuff for that, and who keeps an eye on the tongue and cheeks and visible parts of the throat - even if all he does when he sees trouble there is to tell you to visit your doctor. (I don't know precisely where the specialisations differ, but the dentist is the guy who SEES the inside of my mouth, I want him to keep his eyes open while he's in there.)

See if the dentist is willing to go slowly. Depending on how scared your child is, she might want to simply explore the dentist's office the first time. Maybe have the dentist 'examine' her favourite doll, while she watches. Maybe have the dentist talk to her about how to clean her teeth.

Then next time, the dentist might look at her mouth and tell her what a clever girl she is to clean her teeth so well - and privately tell you about any soft spots or cavities he found. He might take several trips to look at her whole mouth, if she's getting nervous and you and he are interested in going slowly enough.

If she does have cavities, he might use twilight anaesthesia or, as some have said, nitrous. My best friend uses twilight anaesthesia for her dentistry - she has a phobia of getting her mouth poked and prodded - and she says it works for her.

Or again, you and the dentist and your daughter may work better with him demonstrating on a doll or a model, and explaining what he's going to be doing and why, and her choosing to be brave and hold a doll in one hand and your hand in the other while he fixes it with only local anesthesia.

Mostly, I think what I'd want in your position is a dentist who's willing to consult with you at all stages, and let your daughter's comfort level dictate the pace of the work.