The Angel in the Engine: Reports of Restraint, Seclusion and “Special Treatment” in Special Ed—Part 2
Best of AoA: Age of Autism Awards 2008 Galileo Award: Dr. Andrew Wakefield

Darlene Oakley on Autism and Dentistry: Dental Challenges for Families and Treating Dentists

Tooth Below is a preview of a post on EmpowHer about autism and dentistry. Share your dentist visit ideas in our comments and pop over to comment at EmpowHer, won't you? Read the full post at EmpowHer Women's Health HERE.

Autistic patients – and patients with similar behavioral and intellectual difficulties – present a unique challenge for dentists. Dentistry involves bright lights, loud instruments and touching a very sensitive part of the body. Many “normal” people are uneasy about dental treatment, imagine what it’s like for an autistic person.

Autistic patients are usually hypersensitive to their environment and may react out of sensory overload. They don’t take well to a change in their schedules, new noises, smells, sounds, and activities.

Fortunately, dentists are becoming more aware of the needs of special needs patients.

Comments

Step 1 USMLE

It's nice that you come up with this topic. This will surely help parents out there to understand their child with autism to have more patience ans tender care in dealing with dental issues on them.

Justine

I have been a patient at this Tustin dentist, http://www.davidmguyotdds.com/index.html, for over a year now. My sister-in-law recommended him and I am so grateful that she did. I have never had to wait for an appointment especially if I call them with unbearable pain. The office staff is very cordial, pleasant, accommodating, and easy to talk to. http://www.davidmguyotdds.com/crown/index.html

orange county dentist

well this is a nice article, dentist should be well aware of this common problem, autistic patient should require a highly trained staff and state-of-the-art facilities.

dentist

Ah, interesting. I came across something similar some time back.

Lillith

I have taken my son to several different dentists and none of them are willing to work on him without IV sedation. My insurance won't cover sedation even though he had autism and the cost of sedation is over $1000.00, so he has to suffer in pain until I can find the money to pay for the sedation.

Howard

Nitrous Oxide is properly administered with typically 3x the oxygen one gets during normal breathing. Also, the drug is cleared out of the body quickly enough that it has to be continuously administered during the visit.

However, let's put that aside and assume these studies are applicable to amount of nitrous oxide consumed in the length of a typical dental visit.

Are the risks of nitrous really worth allowing a serious dental infection to take hold?

SC Rankin

Ms. Oakley,
In the comments to your article (linked to this post at AoA), you stated that reactions or side effects to nitrous are not very common."

Maybe you should read this article.

When Nitrous Oxide is No Laughing Matter
Victor C. Baum, M.D. http://www.ncbi.nlm.nih.gov/pubmed/17683399

And BTW, based on an earlier post on your blog, you seem to have no problem with mercury amalgams. Why would anyone put a toxic metal in a child's body?

nhokkanen

Reports and studies on mercury toxicity:

"Mercury in Medicine: Taking Unnecessary Risks"
Three Year Investigation - A Report Prepared by the Staff of the Subcommittee on Human Rights and Wellness, Committee on Government Reform, United States House of Representatives (May 2003)
http://www.generationrescue.org/pdf/burton.pdf

Mercury toxicity from dental amalgam: Studies assembled by Boyd E. Haley Ph.D., Professor and Former Chair, Department of Chemistry, University of Kentucky, Lexington, KY
http://www.iaomt.org/testfoundation/amalgampage.htm

"Amalgam Illness Diagnosis and Treatment: A book on how to cure mercury poisoning" by Andrew Hall Cutler, PhD, PE
http://www.noamalgam.com/

nhokkanen

Read about the potential adverse effect of nitrous oxide on ASD children with the MTHFR gene deletion and/or deficiency of Vitamin B-12 (cobalamin).

"Severe Methylenetetrahydrofolate Reductase Deficiency, Methionine Synthase, and Nitrous Oxide — A Cautionary Tale" by Richard W. Erbe, M.D., and Robbert J. Salis, M.D., New England Journal of Medicine, Volume 349:5-6 July 3, 2003 Number 1.

"Adverse Effect of Nitrous Oxide in a Child with 5,10-Methylenetetrahydrofolate Reductase Deficiency" by Rebecca R. Selzer, Ph.D., David S. Rosenblatt, M.D., Renata Laxova, M.D., and Kirk Hogan, M.D., J.D., New England Journal of Medicine, 349;1, July 3, 2003.

A letter in Arch Dis Child 2001;85:510 (December) from Isabel Smith, Clinical Audit Department, Great Ormond Street Hospital in London states: "Nitrous oxide inactivates cobalamin, the active derivative of vitamin B12 and essential cofactor for the transfer of the methyl group from methyltetrahydrofolate to homocysteine to form methionine. For subjects with good body stores of cobalamin this effect is unimportant, but no-one using this agent should remain unaware of the potentially devastating complications in the nervous system of using nitrous oxide in subjects who are of borderline or deficient vitamin B12 status. Onset of subacute combined degeneration affecting the brain and spinal cord is a well documented event when individuals with low body stores of cobalamin are exposed to nitrous oxide."

Benedetta Stilwell

Speaking of teeth, does any of you all have a child that has no permanent teeth under the baby teeth. My son still has two of his baby teeth and he is 23. I blame the phenolbarbitol he had when he was a baby for seizures. I know that when he was 17 years old they put him on Dilantin, he developed bright white spots that the dentists said were de-enamaling of the teeth. Oh, and his gums wanted to swell all the time while he was on Ditlantin. Once he got off of Dilantin though the white spots disappeared. Just wanted some anxious parent out there that might be in this same situation to know that.

My son gets his braces off next month. He has had them on for THREE LONG YEARS. We should have done it when he was younger but there was no way that was going to happen. I must say that all the dentist he has been have all been very patient and did okay by him.

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