Filling a gap: A-typical dental care – inclusive dentistry for patients with autism
Tracey Cope is a dental hygienist and therapist and co-owner of One44 Dental in Rotherham. Here, she outlines the practice team’s initiative to be inclusive to patients with autism
Visiting the dentist can be a daunting experience for most people. For those of our patients with autism, the dental experience can be even more challenging – and this is something we fully recognise and appreciate.
Inclusion is about offering the same activities to everyone, while providing support and services to accommodate people’s differences and, at One44 Dental, we have been working hard to help autistic patients and their families to prepare for their dental visit.
By working in conjunction with families prior to their visit, we can help each other make the appointment as relaxed and enjoyable as possible for their child.
With this in mind, we have even produced a welcome pack designed for the families of autistic children – something we can adapt for adults, too. It helps each family to prepare and support their child prior to their visit and for each family to help us to prepare for their visit. By understanding a little about their child’s individual needs before we meet them, it allows us to approach the dental appointment is a way that is specifically tailored to each child. The pack is a work in progress and we are more than happy to receive feedback from our families should they feel we need to add, omit or change any of our information.
The idea of an autism pack came about after a mum contacted me via our practice Facebook page asking if we had experience of treating patients with autism, as she was looking for a practice for her daughter. As a mother with friends with children on the spectrum, I wanted to help and the pack is the result of that. The mum was thrilled and her daughter coped amazingly well with her appointment! She said she was going to tell the local autism group about us, because there is such a struggle to find care.
We take a caring approach to try to understand each individual patient’s needs before they attend our practice. This involves discussions over the phone or in person. We send out an autism pack before the patient arrives, allowing them to become more familiar with the dental setting and routine before arriving including pictures of the practice and the staff. We also can coordinate the timings of the appointments to suit each patient’s needs.
We reduce stress through preparation for the visit and with an open and friendly approach, maintaining excellent communication before, during and after appointments. We try to consider specific needs for any patients and work with our scheduling staff to aim to achieve this. Sometimes, we allow them more time in surgery and we can even split this over multiple visits to allow for familiarisation over longer periods of time. We use a number of patient management techniques to ensure that everyone is comfortable with the treatment we can provide. Each patient is different and we try to understand these environmental issues before the patient arrives.
In a busy NHS practice, it can be difficult to make significant changes to accommodate patients at the more severe end of the autistic spectrum. However, there are changes that can improve the experience for autistic patients, such as this welcome pack, that require little extra effort to implement.
Fear of the new and unknown can also be overwhelming. If a child has learning difficulties, they may not understand what is planned. This will mean extra care is needed both in preparation for – and during – the dental visit.
Children with autism often process sensory information differently and they can be either less sensitive or extra sensitive to sights, sounds, smell, taste and touch. Having your teeth brushed and visiting the dental surgery can really challenge the senses. We are looking at implementing the BSPD’s advice leaflets for children with autism. This lays out how to help choose products and how to use them in a really clever way.
|Autism – and a warm welcome|
‘The mother of the patient initially contacted me, as she was experiencing problems accessing care for her daughter and knew this was a widespread problem many other parents faced in relation to dental care. She said that, on a local online autism forum, many other parents had expressed the same issues with regards to accessing appropriate care and people were generally happy to pay privately if necessary, as the problem was so big. She knew we were a fully private practice and asked if we could help. I devised the pack reworking it to fit our practice after taking inspiration from a similar initiative I found online at a practice in Ireland. The pack grew and developed from there. We make sure that, on the appointment day, staff are in the roles depicted in the pack photos. So, Anna and Will, who are the dental nurse and dentist pictured in the pack photos, are working together in the surgery, and Chloe, our dental nurse who is pictured at the reception desk in the pack, is the one on reception when our patients arrive for their appointment and leave again after treatment. We ensure this happens every time – even if this means shuffling staff accordingly for the duration of the visit.
‘We invite families to visit us prior to their appointment should they wish – just for a look round in their own time. Or, we offer to meet them when the practice is closed at lunchtime or at the end of the day, so they can familiarise themselves. We understand that the hustle and bustle of busy practice life can be incredibly daunting for patients with autism, who often process sensory information differently.’
|Rabbit rescue remedy|
When we took over the practice five years ago, we felt we needed to make the beautiful existing garden a feature of the overall care we offer our patients. The whole dental experience is one that historically patients do not usually enjoy, so we wanted to change this as much as possible by making our practice friendly, calm and tranquil. The garden is very much left untouched, other than the gardener who keeps it well looked after. This makes it a perfect habitat for wildlife. There were already wild rabbits living in the garden, so we developed the space further to add hedgehog hides, bird feeders, a butterfly feeding station, bat box and bug hotel. The rabbit rescue release came about after a chance reading of a post on Facebook by a wildlife charity that had hand-reared some abandoned baby rabbits and were looking to rehabilitate and release them back into the wild. I contacted them and offered the rabbits a home alongside the native rabbits in our practice garden. Releasing them into our wildlife garden means that we can keep a close eye on them and offer additional food and water if necessary whilst still allowing them to live as wild animals. Now, whenever an injured wild rabbit has been nursed back to health, and the rescue centre feel they would fair a better chance of survival with us, we get the call to collect and release another one. As animal lovers, this is a delight and it’s something that our staff and patients love. Our patients often sit waiting for their appointment on rabbit watch! The large surgery windows also mean patients can spot the rabbits from the dental chair too. It helps take their mind off the treatment and they love it – especially children!
Author: Tracey Cope