Navigating Dental Visits as an Autistic Adult

I like to watch “Come with me” YouTube videos. One of my favorites is by a lovely YouTuber who is a wheelchair user and writes about her life as a mom of six. In that spirit, I share my own experience of going to quarterly dental visits as an autistic adult.

Instead of going every six months, I now go for periodontal maintenance every three to four months because I missed a follow-up appointment during a severe depressive episode. When I returned for care, Dr. V—who was visibly frustrated—reminded me that I had not made the appointment I was supposed to. I remember thinking, yes, that was true. I did not say that when one feels like a slug, making appointments is not appealing. I was also told that untreated periodontal disease can lead to losing one’s teeth by the age of forty, which terrified me. Since then, I have increased my flossing frequency and have not missed an appointment.

I have since asked Dr. V, my dentist, whether he was angry with the people who work at his clinic. I also wonder whether autism had anything to do with my misreading his verbal and non-verbal social cues.

I have been going to the same dentist since I was a teenager—same office, same dentist since high school, and now I’m about to turn 31. You’d think that after so many years, the process would feel routine. But the first hurdle is always the check-in desk.

My favorite dental office was the one I went to as a young child. They had a fish tank that must have been a saltwater fish tank that I would stare at for what felt like an eternity, and I looked forward to looking at the fish with each visit. There was a fort area with toys we could hide in, and after each cleaning, there was a treasure chest we got to pick a prize from. I think adult dental offices should have treasure boxes with dark chocolate treats and small bags of baked lays. It would certainly make me more interested in going to the dentist. I have heard that at the Oscars, expensive electronics are put in the goodie bags for attendees, but I have a feeling those might be beyond the budget of most dental offices.

I never quite know what kind of small talk to make with the receptionist. Referencing the weather feels like something someone at least twice my age would do, but there’s also no way to avoid direct eye contact upon entering; the doorway is directly in front of the receptionist’s desk. At my most recent visit, I thought it would be helpful to notify the front desk staff that, on the caller ID, their number showed as a sleep clinic rather than a dental office! When I asked whether they were aware, the young lady said no and seemed less interested. I approach the dentist’s office, and I feel the trepidation of a cat trying to slip past a vacuum cleaner—I greatly hope to avoid loud noises.

Once I enter and awkwardly make eye contact—maybe smiling in a way that can only be described as a child caught drawing on the walls—I check in for my appointment. I’m then directed to sit in the waiting room, which features a lovely mural of a sleeping dragon. The chairs are covered in that special kind of plastic that makes your legs stick to it if you’re even slightly sweaty. I hate the feeling because as soon as my legs warm the surface, I know my thighs are going to make a suction noise when I get up.

When my name is called, my prayers that I’m not due for X-rays reach a fever pitch in my head. I vomited once during X-rays as a child and have dreaded them ever since. At the pediatric dentist, they used to put salt on my tongue to help, but no one at the adult dentist has ever offered me NaCl.

Once I survive the X-rays without upchucking, I go to the hygienist’s room. The chair is covered in that same awful plastic, but now I’m greeted by a new foe: the overhead light. This is not the normal overhead light in most offices and medical offices, but the movable light that dentists and hygienists use to closely examine those pearly whites. The glasses they give me are never strong enough, so I end up closing my eyes against the glare. When the cleaning starts, the compressed air and other dental tools make unbearable noises. I haven’t found the right hearing protection that doesn’t interfere with the glasses, but I’m open to recommendations. I also find the taste of the fluoride abhorrent. As a child, they offered fluoride-infused toothpastes that I never enjoyed, and I always hoped the flavor options would improve by the time I had to visit next. One time, a hygienist asked if I was okay. Honestly, I’m surprised I’m not asked this more often, because my posture in the chair can only be described as ‘human trying to melt.’

The actual cleaning involved in periodontal maintenance involves a lot of scraping. I believe the terms used in the profession are rooting and planing. The scraping often feels like they are trying to scrape all the way into my skull. The plastic chair cover, which I understand is for sanitary purposes, has a worse texture than the chair itself. I have considered what could be a more palliative alternative to dental care. I have thought about sedative dental care. The problem is that I go to work right after these appointments, and I drive myself. I like to drive myself.

With all of these different factors to consider, I have, for now, decided to endure the scraping, bright lights, and awkward social interactions. I have approached this blog post with humor and sarcasm, but I know that access to dental care and the ability to afford it are privileges. I hope, in the future, to help my dental office make the dental cleaning process more pleasant for me and others with autism.