Lasting Impressions | Fall 2014

24 © LASTING IMPRESSIONS “What we are doing is finding new ways to educate dentists on how to treat children with ASD and also providing a service for children on the autism spectrum,” said Padilla. HOW IT WORKS Padilla says that the approach at the clinic, with the expertise of the behavior analysts, uses techniques that fall more in line with what works better across the board for children with autism. In the clinic, ABA students have created a “task strip” that displays the steps of treatment, from beginning to end, to show children that their dental care involves a routine that has an end- ing. “We go through the first block on the strip, and when we complete that task the child turns it over,” he said. The last strip shows a treasure chest, where the child picks out a prize. “They know when the treatment is completed they can get a reward,” said Padilla. The tech- niques involved are a way to make the child com- fortable, plus, gradual desensitization is utilized. “We do everything at a very slow pace here; there is no specific goal in one visit,” he added. The university facility, of course, has an edu- cational-research component. “We have children who have been coming here for two or more years, therefore, we can quantify what is working, and also what might not be working,” Padilla said. A GROWING NEED It is highly likely that the dental residents going through the CDM program will encounter a patient with special needs in their professional practice. According to the Centers for Disease Control, autism affects 1 in every 68 children, and 1 in every 42 boys in the United States. Experts say that there is a growing de- mand for dentists with this specialized training. Research shows that children with special needs have higher rates of poor oral hygiene, gingivitis, and periodontal disease than the general pub- lic, according to the National Institute of Dental and Craniofacial Research, Practical Oral Care for People with Developmental Disabilities. The same research also showed that medications and special diets can cause oral health problems for many children with special needs. Increasing the number of providers who can care for children on the autism spectrum is an important objective of the HRSA grant, according to Padilla. To be eligible to use the MSC dental clinic, children must be enrolled in one of the programs for children with autism at MSC, either Baudhuin Preschool or the Starting Right program. Rachel Golubchik, of Fort Lauderdale, said that the dental clinic inside her son’s school made the first trip to the dentist easier than it might have been for four-year-old Silas. “People from the dental clinic would come to his class at Baudhuin and talk about teeth and what it was like to go to the dentist. Then, when we took him to the clinic, the dentist talked to him and explained things the same way that they did in class,” said Golubchik. There are many potential sensory challenges for children with autism at a dentist’s office— tastes, smells, textures, sounds, lights, and the closeness required to perform even the simplest procedures, such as a checkup. “Silas doesn’t like a lot of touching—although he has gotten better with that. I was happy this clinic was available to us because I don’t think he would have been able to handle going to a dentist’s office that would not have understood children with ASD. With children with autism, you have to be aware of what their triggers are going to be,” she said. CRITICALLY IMPORTANT Paola Pellerano, D.D.S., another second-year pediatric dentistry resident, says she learned about working with special needs children during her rotation at the clinic. That experience, she said, “carries over to working with typically developing children. At the clinic, it’s about patience and Oscar Padilla uses behavioral techniques to help treat his young patients. continued from page 21