Avoiding the dentist? I was, too.

I don't think anyone loves going to the dentist but for neurodivergent folks, it's a whole different beast. If you can't remember the last time, you were in the dental chair, no shame, I was there, too.

But why exactly is it such a struggle?

• Sensory Overload: The dental office is a sensory adventure, and not a particularly pleasant one. The noises, lights, smell, taste, feeling, and sensation of being inverted can leave anyone feeling dysregulated. For neurodivergent patients, this can be downright intolerable or even traumatizing.

• Executive Functioning: Getting to any healthcare appointment is truly a feat of executive function excellence. Just showing up to that first appointment requires prioritizing, initiating, planning, decision making, scheduling, completing paperwork, time management, follow-through, the list goes on. You also have to convince yourself that the value of the appointment outweighs the immediate discomfort that scheduling and attending may cause.

• Home Care: Oral hygiene is boring and it's super easy to slip into less-than-ideal routines. No one wants to think that they'll be judged, or worse, scolded for their imperfections. Showing up to the appointment means possibly subjecting yourself to rejection and humiliation.

So, how can we keep our teeth and our sanity, too?

• Sensory Supports: Ideally, look for a dentist who understands and prioritizes sensory differences in their care. If you don't have the luxury of this (yet), make your current experience better by advocating and coming prepared. If you feel comfortable, try discussing your sensory needs before they tilt back the chair. Ask them to make a note of this in your chart so you don't have to readdress the accommodations at each appointment.

Here are some accommodations to request:

1. Ask them to schedule a time buffer to allow you to take breaks when you need it.

2. Ask to keep the lead apron on your lap for deep, calming pressure.

3. Ask if they have sunglasses you can wear (or bring your own).

4. Ask if they have any chairs with heating or vibrating abilities (you'll be surprised how many do!)

5. Ask them to play music or bring noise cancelling ear buds to play your own.

6. Ask if they have something you can squeeze or use to fidget (or bring something from home).

7. Ask them to reposition your head in the chair if you become dizzy when inverted.

8. Ask them to let you know when they're changing tools so you can anticipate the changed sensation.

9. Finally, you can ask if laughing gas may be an option for you.

• Executive Functioning:

  1. Ask a loved one to schedule your appointment for you!

  2. Schedule your next appointment and put it in your calendar (with an alarm!) before you leave.

  3. Set your reminder 30-minutes early to make sure you show up on time (and can complete the paperwork you might have missed online).

• Home Care:

  1. Switch to an electric toothbrush (if you can tolerate the feeling). You get a more thorough clean in less time and they have fun timers and buzzers that let you gamify the chore. The really fancy ones even give you feedback on how well you're brushing (great for competing with others).

  2. Brush with someone else and have a dance party.

  3. Treat yourself to a fun video while you brush.

  4. Switch up your toothpaste often to keep it exciting (and tasty!)

  5. Just do your best.

  6. Finally, anticipate that the dentist will say something along the lines of..."it looks like you haven't been flossing," "have you been eating or drinking lots of sugar? You know that will lead to cavities," etc. Know this going in. It's not personal. Your teeth are surely not the worst they've seen. They're probably not even bad enough to be memorable. They're definitively not judging you. And if they are...YOU NEED A NEW DENTIST! Most cases, they're just doing their job.

I avoided the dentist for years. My life and was changed by finding the right dentist and advocating for myself using these tips above. I hope they can bring you some relief, too.

Now go schedule the appointment you've been putting off.

-Rachel Robertson, OTR/L