Our experiences at both our local dentist and the community dental service at the hospital have shown me two things: how overwhelming a dental appointment can be for someone with additional needs, and how much better that experience can become when the right support is provided.
My daughter is autistic, and we have had quite a few trips to the dentist. The difficulties have not always been about the dental treatment itself. The unfamiliar environment, waiting, bright lights, different sounds, tastes, smells and uncertainty about what will happen can all place enormous pressure on her nervous system.
A child or adult who cannot enter the room, open their mouth, remain in the dental chair or respond to instructions may be described as uncooperative. However, what we see as behaviour may actually be someone communicating:
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I do not feel safe.
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I do not understand what is happening.
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The environment is overwhelming.
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I need more time.
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I need you to stop.
When we recognise this, we can begin to change the experience.
Going To The Dentist (Editable & Printable Word Template) Social StorySmall adjustments can make an enormous difference.
People with additional needs do not necessarily need complicated solutions. Often, it is the small and thoughtful adaptations that allow someone to feel safer, participate more fully and remain engaged with their dental care.
Preparation can begin before the patient enters the practice. Dental teams can:
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Provide photographs of the waiting room, treatment room and dental chair.
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Send a social story explaining the different stages of a dental visit.
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Ask about sensory needs and communication preferences when the appointment is booked.
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Offer a quieter appointment time or the first appointment of the day.
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Arrange a short familiarisation visit without any expectation of treatment.
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Let the patient know who they will meet and what may happen.
Knowing what to expect can reduce some of the uncertainty surrounding the appointment.
Show me before you do it
One of the simplest adjustments is to explain and show each step before beginning.
Let the patient see the mirror, light or other dental equipment. Explain what it is, what it does and what it might feel or sound like. Avoid introducing several unfamiliar items at once.
Some people may need extra processing time after being given information. Others may find spoken instructions difficult when they are anxious or overwhelmed. Pausing and allowing time for a response can make a significant difference.
The aim should not simply be to complete the appointment as quickly as possible. It should be to build trust so that future dental visits become more manageable.
Going To The Dentist (Editable & Printable Word Template) Social StoryCommunication must remain possible
Speaking can become extremely difficult when someone feels anxious or overwhelmed. This does not mean that the person has nothing to say.
Before beginning, the patient and dental team can agree on a clear signal for stopping or taking a break. This might be raising a hand, making a gesture or pointing to a symbol.
A dental communication board can allow a patient to communicate important messages such as:
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Stop
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Wait
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Show me first
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Yes
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No
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What happens next?
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It hurts
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Too bright
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Too loud
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I need a break
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Sit me up
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I need my grown-up
These choices give the patient greater control and help the dental team understand what support is needed.
Consider the sensory environment
A dental surgery contains many sensory experiences that staff may barely notice because they encounter them every day.
There may be:
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Bright overhead lighting.
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The sound and vibration of dental equipment.
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Strong tastes and smells.
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Unfamiliar textures inside the mouth.
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Close physical contact.
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Movement of the dental chair.
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Several people speaking at once.
Not every autistic or neurodivergent person will experience these things in the same way. The most helpful starting point is simply to ask the patient or their carer what may make the environment easier.
Possible sensory supports could include headphones, familiar fidget items or a weighted lap pad for someone who finds deep pressure calming. A projector showing a favourite programme or calming visual on the wall or ceiling may also provide a familiar point of focus while the patient is in the dental chair.
Sensory equipment should always be offered as a choice. It should never be used to restrain someone or replace communication, preparation and appropriate adjustments.
This is not only about children
Although our resources were originally created with neurodivergent children in mind, these approaches can also benefit adults and anyone with learning disabilities, anxiety, dementia, sensory differences or communication needs.
Everyone deserves to understand what is happening and have a way to communicate discomfort, uncertainty or the need to stop.
Creating a more autism-friendly and sensory-aware dental practice does not mean having one approach for every patient. It means being willing to listen, adapt and recognise that fair treatment does not always mean treating everyone in exactly the same way.
What I would love dental practices to do
I would love to see dental practices:
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Send preparation resources with appointment confirmations.
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Offer a social story to patients and families before their visit.
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Keep a printed copy of the social story in the waiting area.
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Place a printed or laminated communication board in every treatment room.
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Ask about sensory and communication needs before beginning.
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Agree on a stop or pause signal with every patient.
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Allow additional processing time and breaks where needed.
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Consider simple sensory equipment that could make the environment more comfortable.
These are not huge or expensive changes, but they can transform someone’s experience.
Dentist social story and communication board
Drawing on my experience as both a parent and part of the Learning SPACE team, I created a Going to the Dentist Social Story and accompanying Dentist Communication Board.
The social story explains what someone might see, hear and experience during a dental visit. The communication board provides simple words and symbols that a patient can point to during their appointment.
Dental practices can share the download link with patients and families, include it in appointment reminders and keep printed copies available within the practice.
A successful dental appointment should not only be measured by whether treatment was completed. It should also be measured by whether the person felt heard, respected and safe.
With preparation, communication and a few thoughtful adaptations, people with additional needs can have much more positive dental experiences and become more actively involved in their own care.
Dentist Set Role PlayAnd if you want to practice at home first with some role-play to go along with your social story - you can order yours here
This Dentist Set Role Play Kit encourages imaginative play, which is ideal for social stories, pretend clinics and nurturing role play. Predictable role play actions support calm exploration and reduce anxieties around real dental visits.
By Mary Leonard, Learning SPACE
