Dr. Greg Grillo is a dentist who is passionate about working with under-served populations, including people with disabilities and veterans. I interviewed Dr. Grillo about how he became interested in helping autistic children and adults, how parents can help their children through dental visits, and how dentists and dental hygienists can make their practices more accommodating to autistics.
I’m an autistic self-advocate who runs a publication called The Aspergian with over 180 autistic contributors. Occasionally, we have guest contributors who offer expertise and experience we can’t otherwise provide. Thankfully, Dr. Grillo was able to provide great insights!
Me: Why should parents of autistic children think ahead before a first dental visit?
Dr. Grillo: A visit to the dentist’s office is a nerve-racking experience for any child, but for autistic children, it can seem especially overwhelming.
The dentist’s office is a new and scary place and is filled with tons of potential sensory triggers. All this can add additional stress to your child on a first visit and can make the prospect of going to the dentist scary for both parents and children.
As a practicing dentist for the past 17 years, I’ve seen this happen countless times with different children. However, in that time I’ve also learned how to create a successful first visit.
Dental care is important for all kids, so let’s take a look at what I’ve found to be the top tips for taking your child on their first visit.
Me: What caused you to be interested in dentistry for under-served populations?
I first became interested in providing dentistry to under-served populations when I served as a dental officer in the Navy for four years. After treating families of military members and their families as well as receiving advanced training in multiple areas of specialized dentistry, I became interested in what other kinds of populations are in need of the right dental care.
Once I finished my service in the Navy I began my own practice in the state of Washington. I knew that I wanted to use my specialized training for good and dedicated my work to providing care for under-served patients. Many veterans visited me with certain sensory and mental health issues that needed to be accommodated for.
I embraced the challenge of finding what worked for each specific patient, and I always wondered about who else I could help. Whether it was a patient with specific needs, autism, Alzheimer’s, I’ve been determined in learning about patients and how to provide them with the best care based on their needs.
Me: How can parents help prepare their autistic children for a first visit?
Dr. Grillo: Of all the things that go into a dental appointment, I’ve found the two most troublesome for autistic children are meeting new people and the overwhelming number of sensory stimuli. The following tips deal with both situations.
You know your child better than anyone else, so it’s your job to determine how to approach each problem. For example, if your child is scared of strangers, then focusing on a familiarization appointment will be more important than focusing on the new sensory elements that they will encounter. Ultimately, you are going to choose what is going to work best for your child.
A good first step is to practice at home. Me: How can parents practice at home? In what ways can they help their children prepare? Dr. Grillo: Go over what happens at the dental office, and stress why each action is important. This can help take away some of the unknown from the process, which in turn can make it a less frightening experience for your child.
It’s helpful here to use visual aids, as well. Having pictures or even videos can really help the child see that this process is not scary. If your child has a favorite television show or character (like Minnie Mouse or Chase from Paw Patrol), try to find board books or children’s books featuring those characters going to the dentist.
You can even do a mock appointment and practice having your child keep their mouth open wide. All of this can help when it comes to the appointment and your child has a feel for what to expect. The first visit can definitely be challenging, but a little prep at home will take away a lot of the anxiety that comes with it.
Me: One challenge autistic children have can be a fear of new people and places. How can we accommodate for this?
Dr Grillo: Familiarization appointments can be very helpful for this reason. This is a chance to visit the office and meet the staff without the pressure of having to undergo any sort of procedure.
This is extremely helpful for children who don’t like or are afraid of strangers. Having someone they’ve never met poke around in their mouth can be downright scary. The familiarization appointment lets them meet and talk to the dentist and possibly go through what will happen at their appointment.
In addition to the dentist, it’s also a chance to meet the dental hygienist and even the receptionist. It can be overwhelming to meet all these people on the day of the appointment, so doing it in advance can help make things a bit easier.
Me: How can parents prepare to deal with sensory issues while at the dentist visit? Dr. Grillo: Depending on your child, there may be sensory concerns to keep in mind. Loud noises and bright lights are commonplace at the dentist office, and these can be disturbing for some children. If this is your child, think of ways to mitigate the problem. For example, having your child wear a pair of sunglasses can help dim a bright light for their sensitive eyes. A pair of earbuds could also be worn to help muffle some of the dental instrument sounds.
Each child is unique, so think about what might be an issue for your child and come up with ways that you can help alleviate any sensory issues.
Me: Do you have any other tips about being prepared ahead of time?
Dr. Grillo: Never be afraid to voice your concerns and have a conversation with your dentist. We’re here to help and will do whatever we can to make sure each patient leaves happy.
It’s likely that your dentist can provide some guidance and give ideas on how to make the appointment easier for everyone, especially your child. We want to make sure that your child gets the dental care that they need, and to do so without having to be afraid of coming back.
We can also talk through some of the plans for the above tips, and we can help you put them into place come appointment day. Dental care is extremely important for everyone, and it’s every dentist’s goal to provide it in a friendly and comfortable environment.
Me: Recently, there was an expose which revealed dentists in my area actively avoiding autistic patients. Many dentists dread working with autistic children. What advice would you give to parents who are seeking to select a dentist who will be friendly, accommodating, and accepting of their autistic children?
Dr. Grillo: You may be feeling discouraged about finding a dentist that is friendly and willing to accommodate your child. My biggest advice to you is to first, never give up. The right dentist is out there. Secondly, I always encourage patients to ask a lot of questions when speaking with a potential dentist. This is the best way to know if the dentist you choose can accommodate for your child and is willing to do so. If you’re unsure what questions to ask, here are a few to get you started:
- Have you previously worked with patients who are autistic, have disabilities, or sensory issues?
- Do you have any specialized training when it comes to working with patients who have disabilities?
- What kind of accommodations are you willing to make for my child?
- How do you handle meltdowns? Do you allow for time to calm down or reschedule?
These are just a few questions to start you off when talking to dentists. However, any question you can think of is worth asking, and potential dentists should be able to clear and concise answers to any questions you may have. Another tip I like to give parents is to speak with their child’s primary health care provider or developmental pediatrician.
Like you, they know your child’s needs best and also have an extensive network of health care professionals in your area. They can give you their best recommendation. Another great way to find a good dentist for your autistic child is to ask in local online parent groups. There will usually be other parents who have autistic children or children with sensory issues who can tell you which dentists were patient, accommodating, and welcoming and which ones to avoid.
Me: What advice would you give to other dentists to make their practice more accommodating for their autistic clients?
Dr. Grillo: I personally feel like most, if not all dental offices could be more accommodating to the needs of patients with autism and other special needs. One piece of advice I would give other dentists is to offer familiarization appointments for autistic patients.
These appointments give patients a chance to see the office and meet the dental office staff ahead of time. This can help desensitize your child to some of the elements of the dental office and give them a sense of familiarity when they come in for their actual appointment.
I also would encourage dentists to create a more private area for patients that is quieter with less sensory stimuli and allow parents to stay with their child throughout the entire appointment. This can help patients with autism feel calmer.
Knowing what is coming and why is very important to autistic children and even adults. Explaining what tools do and what you’re going to be doing with them, how long it might take, and how it might feel can help them to be less anxious. Just telling an autistic person that it is okay to take a break if they need one can drastically reduce their stress levels.
Distractions are something else that can help a patient get through a dental checkup easier. Dentists should also allow parents and patients to bring items such as headphones, iPads, or any other items that will provide comfort during an appointment.
Vestibular issues that go along with sensory processing disorder can make it scary for autistic kids to lie backwards or recline partially as they can experience a sensation like they’re falling backwards or unstable. You may need to have your chair more in an upright position or recline the chair before the child gets in it.
In my experience, I’ve learned that every patient is different and unique in their needs, and dentists should keep this in mind when working with autistic patients. It’s not a one-size-fits-all solution, and it may be a process of trial-and-error until the patient can comfortably sit through their dental visit.
Me: Do you have any advice for parents of autistic children about managing sensory issues and maintaining great dental health and oral hygiene?
Dr. Grillo: Managing sensory issues isn’t always easy, but there are ways to work through them so you can help your child have great dental health and hygiene. Developing a consistent oral care routine at home with your child is a great way to help them work through any sensory issues and help them have a strong and healthy mouth.
You may have to experiment with different toothbrushes and toothpaste flavors until you find the combination that works for them. There are silicone toothbrushes as well as many brushes with softer bristles that often help children brush their teeth. There are even brushes specifically designed for autistic kids and sensory-friendly, mildly-flavored toothpaste that will hopefully not cause sensory overload for your child.
I always encourage parents to watch dental videos and read storybooks about dental visits as it can be an engaging way for your child to learn about the importance of dental care. Role-playing dental visits and turning it into a fun game can be great, too, and can help your child practice lying down with their mouth wide open and become comfortable doing so. If they know what it feels like in the comfort of their own home, it can help them when it’s time to visit the dentist.
Hopefully these tips have given you ideas on how to help make your child’s first dentist appointment a positive one. It can be a bit scary at first, but with a little bit of preparation, a positive experience can set the trend for a healthy, happy smile.