Oral care 'need not be nightmare' for special needs kids

Dental centre: Start them young, teach coping strategies
By Linette Lai, The Straits Times, 20 Dec 2014

MUHD Syamil Abdur Rahman, eight, has autism, and brushing his teeth used to be a daily struggle. One family member had to hold him still as his mother cleaned as many of his teeth as possible.

Said Madam Norlizan Mohidu, 40, of her son: "He just refused to open his mouth because he didn't like foreign objects in it."

Syamil's case is typical of parents who have children with special needs and who often fear taking them to the dentist because of how unruly they can get.

Last month, the National Dental Centre Singapore (NDCS) hosted a public forum for around 70 parents of special needs children for the first time.

A survey of the group showed that four in 10 had never taken their child to the dentist, while the vast majority feared that their child would not cooperate while there.

About half said that no dentist would see their child, or that they did not know where to look for one who would.

Paediatric dentist Terry Teo of The Dental Studio - a Singapore Medical Group clinic - said most children visit him for the first time between ages three and five, but those with special needs do so, on average, four years later.

"Very often, they have been turned away by (other) dentists," he said.

He added that others may bring their children in only when they complain of pain, which may not be detected at the outset in children with special needs, because they might be unable to express themselves.

"It is only when these children get older and have possibly tolerated such pain for a long time do the parents become aware that this is affecting them."

But NDCS hopes to drive home the message that dentist visits do not have to be a nightmare if you start them young.

"When you go to a stressful environment that is new, children do not know how to cope," said Dr Tan Wee Kiat, a senior consultant at the centre's paediatric dentistry unit.

"You have to teach them coping strategies to get them used to the environment. With each visit, the child gets better at coping with stress and, therefore, behaves better."

Ideally, she said, all children - with or without special needs - should start seeing a dentist by age one.

In Syamil's case, his mum, a housewife, sought help at NDCS in 2012, after noticing her son's cavities getting worse. There, he underwent an operation to extract eight baby teeth.

But getting him to trust the dentist was not easy. She related how the dentist would perform check-ups by making Syamil laugh, then sneaking a peek at his open mouth.

"She was so patient," Madam Norlizan recalled. "She would play games with him, and introduce him to all the equipment."

This year, they had a breakthrough when Syamil willingly got into a dentist's chair for the first time.

New adult teeth are slowly emerging - and he brushes these on his own.