Some of your dental patients are on the autism spectrum. A trip to the dentist can be extremely stressful for an autistic person. Here are some tips on adjustments you could make before and during treatment.

  • Try to minimise waiting time, as this can lead to increased anxiety.
  • Always explain what is happening (for example, 'I will be checking your teeth to make sure they are in good condition') and what you are about to do ('I am going to put a small mirror inside your mouth to check your teeth. The mirror might touch the edges of your mouth'). People on the autism spectrum often need extra time to process information, and some may prefer information to be presented visually.
  • Some autistic people do not like to be touched. If you need to touch them during the course of your treatment, give them plenty of warning. Clearly explain what you will be doing.
  • Some autistic people have high sensitivity to light and noise. See if you can find out about potential issues before your appointment, and adapt the environment. For example, turn the radio off if they find it hard to deal with this kind of 'background' noise. You may not be able to alter lighting or the noise made by equipment so if this is an issue, stress balls or visual distractions may be useful. 
  • Rinses and chemicals may smell or taste more intense to people on the autism spectrum. Where possible, can you offer alternatives? For example, offer a very mild mouthwash, or none at all.
  • Be aware that injections and drilling, especially if accompanied by noise or other sensations such as cold water, may be particularly painful.
  • Some autistic patients have very low sensitivity to pain, so may not respond if you are testing for pain.
  • If your patient is accompanied, it is usually best to allow their companion to be present during treatment, assuming the patient is happy with this. A companion may make communication easier for you and for the patient.
  • It may help to book a double appointment, or spread treatment over several visits. This means you can take things one step at a time, and possibly help to manage a person's anxiety.
  • Autistic people can take things literally, so make sure you say what you mean. Avoid metaphors. Check that the person has understood you, but avoid being patronising.
  • Do not rely on gestures or body language to convey information. Humour may also be misunderstood.
  • With some patients, you may notice unusual body language and eye contact. Some people find it easier to avoid eye contact; others may find it difficult to know how much eye contact to make.   
  • When anxious, autistic people may make sounds or use repetitive movements. This may be a way of coping and should be respected.
  • Anxiety, sensory overload and communication difficulties can mean that a person’s behaviour becomes challenging. Allow the parent or carer to take control, as they will know the best way to support the patient.

Further information and resources

Making dental practices more autism-friendly, Malcolm Hamilton for Network Autism

Preparing for a visit to the dentist

Easy read and audio information about dental care, Easyhealth

Meeting needs and reducing distress: Guidance on the prevention and management of clinically related challenging behaviour in NHS settings, NHS Protect 

British Society for Disability and Oral Health

Advice for parents of children with autism, British Society of Paediatric Dentistry

   

Last reviewed 30 November 2016.