Strategies for Successful Dental Encounters for Children with ASD: A Qualitative Study

Background: It is well established that oral care is an important component of pediatric healthcare. Many barriers to treatment have been identified for the ASD population, but few high-quality interventions have been designed and implemented to improve care for this population.

Objectives: As the prevalence of ASD increases, dentists are increasingly more likely to encounter children with ASD in their practice. Therefore, the purpose of this study was to gather information on the current strategies implemented by dental professionals and by parents of children with ASD to facilitate successful oral care encounters.

Methods: To document dental practitioner and parent strategies utilized to facilitate oral care challenges in the dental office and home four focus groups were conducted, two with parents of children 5-18 years with ASD and two with dental practitioners who treat children with ASD. Each focus group lasted 2.5-3 hours in duration and were transcribed verbatim. Thematic analysis following a grounded theory approach was used to describe parent and dentist implemented strategies to address children’s oral care challenges.

Results: In the parent focus groups, three themes emerged. The first theme, What Makes a Good Dentist, focused on dentist knowledge, understanding and experience, which were all reported to be essential to a positive dental care encounter. The second theme, Tricks, Tactics, and Diversions, described different techniques and strategies the dental practitioner could use to help make dental visits successful. These included: (1) the strategic use of scheduling for visits, (2) the coordination with other professionals, (3) the implementation of adaptations as needed, (4) the search for sugar bugs, (5) the use of positive reinforcement, (6) the creation of a child- and sensory-friendly dental environment, and (7) the utilization of drugs. The last theme, Preparation, Preparation, Preparation, explored strategies caregivers could implement to increase the chance of a successful dental encounter including: (1) how to “warn” the child about the visit, (2) how to practice for the dental visit, (3) how to use visual schedules and/or social stories, and (4) items to bring to the dental visit.

Dentist focus group data analysis is currently in progress.

Conclusions: Parent findings provide insight into the techniques perceived to lead to successful dental care encounters for children with ASD. Combined with the perspectives of dental care practitioners, this information has the potential to improve care for this population by identifying areas for accommodation to create the optimal experience for children with ASD and their parents.