31. Creating a Positive Experience at the Dentist and Improving Oral Health with Dr. Nidhi Taneja

Apr 15

On this episode, Brittyn welcomes special guest Dr. Nidhi Taneja, a pediatric board certified dentist with a mission to eliminate dental fear and anxiety for every child. She is an advocate for prevention focused, minimally invasive procedures to shift the paradigm from the traditional drill and fill model of dentistry to a functional and integrative approach to oral health.

She believes that early intervention, regular visits, and home consistency are the biggest proponents of a child’s positive experience with the dentist!

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IN THIS EPISODE

What is the functional approach to density
Why prevention at an early age is so important
How to make the dental experience sensory-friendly for your child on the spectrum

TRANSCRIPT

Welcome to the Nourishing Autism Podcast where you take a deep dive into the research on autism and dietary changes, nutrition supplements, and lifestyle modifications. Every week, we break down nutrition topics and an easy-to-understand way for you to feel less overwhelmed and feel confident on your nutrition journey with autism.

Creating a Positive Experience at the Dentist and Improving Oral Health with Dr. Nidhi Taneja

[00:00:00]

Brittyn: Hi, everybody. Welcome to the Nourishing Autism Podcast. I'm your host Brittyn Coleman, the autism dietitian. And today's episode is a very interesting one.

I'm talking all about oral health with Dr. Nidhi Taneja she is a pediatric board certified dentist with a mission to eliminate dental fear and anxiety for every child. She is an advocate for prevention focused, minimally invasive procedures to shift the paradigm from the traditional drill and fill model of dentistry to a functional and integrative approach to oral health.

Dr. [00:01:00] Nidhi specializes in oral health for children and individuals with special needs. And she was also a dentist in India before getting her dental degree at UCLA and specialization training at the University of Connecticut. She currently practices at home and in office dentistry in Orange County, California. It was such an interesting interview.

I love chatting with her about oral health and kids on the spectrum and how to create a positive experience at the dentist office. She provides so much information for us, and I know this will be so helpful for you. If you have a child on the spectrum who has a fear of the dentist office or has had past traumatic experiences.

If not, I still know that you will gain a lot of information from this podcast episode. I hope you enjoy.

Thank you everyone for joining us for the nursing autism podcast. I'm so excited to be accompanied by Dr. Nidhi and she is a dentist. Connected on Instagram and she has so much to bring to this population.

I'm just so excited to chat with her. So thank you so much, [00:02:00] Dr. Nidhi for being here.

Dr. Nidhi: Thank you for having me over. I've heard your podcast and I hope that it can help a lot of your audience. There is a lot of need I know, and I'm so excited that we were getting a chance to do.

Brittyn: Me too. And like I shared with you, I've had a lot of clients, who've actually had some dental issues recently. And so I know that my clients will really benefit from this too.

Dr. Nidhi: Thank you.

Brittyn: So, tell us about yourself and your work as a dentist and share a little bit about your mission, your philosophies.

Dr. Nidhi: Sure. And yeah, so I am a dentist in Southern California in Orange County, and I have practiced for last five years in pediatric dentistry. So I'm a specialist in children, but I see a lot of those with autism neuro developmental delays and other special needs. So my goal and my philosophy of work is usually based off of early intervention and minimally invasive dentistry.

What I really like to focus on is for children [00:03:00] to have positive experiences at the dentist and those who've had any bad experiences or traumatic experiences in the past.

So we want to make sure that no child growing older is ever afraid of going to the dentist. So it includes children with special needs, but also honestly every child who's being exposed to a dentist at a younger age. It's a new experience. So my approach is very prevention focus. That they don't need invasive procedures later on.

And nowadays there are so many different modalities of minimally invasive dentistry that don't involve surgical interventions and to don't have to be sedated. They should never be restrained for doing dental work. And I call my practice mostly a functional dentistry practice where we want to go into the root cause of why a child is experiencing dental decay, or it could be of dental fear.

So I really enjoy going into the depth of that.

Brittyn: That's incredible. And I think [00:04:00] is so huge. I practice a functional approach to looking deeper and trying to figure out why is this happening? Why is there this recurring issue? And let's not just put a bandaid on it, but let's figure out why. So I think that's really important, especially for dental health.

That's amazing.

Dr. Nidhi: Exactly.

Brittyn: So I know that it's really common for kids on the spectrum, to the scared and anxious and the mouth is so sensitive anyway, but can you share a little bit about that and your approach and you know, when you're in their mouth, what that looks like or preparing kids for the dentist office?

Dr. Nidhi: Yeah, I'll go from the beginning. So let's say that our number one constraint is when we see a child who is on a spectrum and we see them very later on in life. So. Advice, whoever to all the listeners who are listening is if you know that your child has autism and you are able to detect it early, bring the child to the dentist as soon as possible.

We start seeing children at [00:05:00] six months to a year and not wait till three years, which a lot of pediatricians still recommend. I think there's a shift in letting parents know that sooner, the better we recommend as soon as the first tooth erupts, which is six months, that's a good time to start seeing the dentist.

And at that stage, every child is same. They will be pre cooperative. What that means is. That they will not have the ability to cooperate. So we don't expect them to sit in a dental chair. So we literally do something called to us knee to knee exam, where it's focused on quick evaluation, but talking to the parents a lot about prevention and what goes on, how does a cavity happen?

So once they understand that process, that's really helpful, helpful in the rest of their journey. Now coming back to like, if a child is seeing us at a later age and they're already very sensitive in their oral area. What I usually do is we practice a lot of [00:06:00] desensitization visits. So we don't directly go in their mouth and start counting teeth or checking the cavities.

We take a step back and I spend a lot of time talking to the parents before the child comes to the dentist. We do this video call and we try to understand how, what has happened in the past. If there were any bad experiences or if they have special accommodations that they need. Sometimes children really, really don't like the loud noises or they don't like to see any bright lights.

So we make sure that our rooms are dim or we don't have extra sounds. And we prefer bringing them to the office or early in the morning when they're fresh or doing a lunchtime where the office is really quiet or literally any time of the day when they are more comfortable. Something really unique in my practice is if, if we are in orange county and I'm seeing a patient in person then I do home visits with them.

What that does is I can go to their home or a [00:07:00] place where the child is really comfortable and sometimes with the ABA therapist, because they're already in a very safe space, so there's not extra stimulation in a dental office. So. We guide the parents. Step-by-step we just show them the toothpaste or toothbrush, which is like more familiar.

And I recommend parents to just use that while watching the TV or when the child is outside, not just restricted to the bathroom or the routine. So yeah, just bringing the toothbrush clothes and , making it easier for them to accept the toothbrush is something that is really helpful for children when they're not desensitized, but everything is in stages.

We slowly help the parents to understand that dental health is important, but what they will do at home will be the most efficient at the dentist office.

So they have been used to that motion in the home, we will be able to work better and in [00:08:00] the office.

Brittyn: That's amazing. And I'm there for kids who have had posts or past traumatic experiences at the dentist, meeting them somewhere where they're familiar and taking these really slow and gradual steps. I'm sure it was incredibly helpful for them to gather these more positive experiences at the dentist, and eventually tip that scale back in the right direction where they can come into an office, but without having that, you know, traumatic feelings.

A lot of anxiety. So I love that you do that. And I'm sure that's a big reason why for kids who have had past traumatic experiences,

Dr. Nidhi: Yes. And I think something that's really key over here is for parents to never feel ashamed that their child has autism, because I've seen so many parents who feel that the dentist won't understand, or they feel bad for that the child is not cooperating at the dental office. But I never want them to feel that way because once the dentist understands that there is [00:09:00] something underlying that's happening and being very open and honest with beforehand that this is what's going to happen or what to accept or what to expect. It, it would be worth finding the right dentist or for the child to be comfortable with. And consistency is obviously the key. So we try to make sure that it's the same assist in the same room as much as possible. My long-term goal for these patients is not to just be stuck to a dentist or stuck to me in particular, if they're doing good.

My goal is that they can eventually graduate and be just so easy with the dentist and be able to take care of their home care of themselves. And the parents to feel more comfortable and not have to think about dental health and extra expenditure that comes along with it when they're later in life.

So early intervention, regular visits, and home consistency are my three biggest things that I tell parents.

Brittyn: Huge I'm. Sure. Well, if parents are feeling worried about talking to their [00:10:00] dentist about their child being on the autism spectrum or not quite sure if their dentist is going to be accommodating. I mean, I wish there were more people like you who are just very outwardly accommodating to these needs.

It's very clear that you specialize in this population, but it feels people like you are very few and far between. So how would a parent ask for their dentist to be more accommodating or anything that they should know to ask?

Dr. Nidhi: Sure. That's a great question because I feel that there are a lot of good dentists, but something the parents can do to find them is. So there's a difference between general dentists and pediatric dentists and general dentists who see kids. So it's very important that there are a lot of general dentists who could be possibly seeing children with autism and special needs and they were, would be very good.

But I would also say that if they haven't found one yet, then going for a good pediatric [00:11:00] dentist who has specialization in seeing children is one good way to start. On top of that, I think another good thing to see is that the office is not too busy. Like you can ask beforehand how many kids are going to be at the office at the same time, because usually how a pediatric practice works it's pretty busy. And when it's busy, it's hard to accommodate a longer appointment. You can in advance ask I would like an hour appointment or hour and a half. I would like it to be at this time, or instead of demanding that actually you can just gauge if the office is able to accommodate after you mentioned that my child has autism.

And if they haven't, if they're not able to accommodate that, then you have a better chance of understanding that that won't be possible. Something I really like to do is jump on a quick call with the doctor or on a video call just to understand what the doctor's personality is. And something I do in our practice is we give them social stories and I make a [00:12:00] custom video for the patient, not as a dentist, but as a friend.

I introduce like, Hey, mommy told me that you liked dinosaurs or you like trains. So just bringing some points of commonality so the patient also feels welcomed to the practice before they come. And I think it's just time. Now these things that are a little bit hard if we are seeing a child when they're already in pain.

So we do need to be a little bit more aggressive to get them out of the pain at that time but then again, we go back to the cycle of how to remove that trauma that happened to them.

Brittyn: I love that you make those custom videos for kids. I mean, that's so special to take that time. I'm sure that makes them feel so welcome and so much more comfortable. Also just seeing a familiar face. And I think that's really special. I've never heard of somebody doing that. That's just going.

Dr. Nidhi: I feel that this is something new and I wish that a lot of parents can understand that this kind of dentistry exists and can be possible. So the more, [00:13:00] and thank you Brittyn for bringing me on here, because I want parents to understand that there is a new dimension in dentistry. Dentistry doesn't always have to be fear or drills or cavities. There's a whole new brand of preventative dentistry and holistic and functional. And these words are not just to be thrown around, to be in a controversial topic, but really prevention at the root cause. If we can prevent these disease from getting worse it's so easy to help a child maintain that habit as an adult. And it would give me so much joy, but no child ever is afraid of dentist and never has a cavity of this world.

Brittyn: Definitely,

Dr. Nidhi: Thanks for having me and letting me express the philosophies that we have.

Brittyn: of course I I've learned so much from you and I guess as a takeaway question, I would love to ask, you know, any mistakes that you see, parents making that that you'd like to share that could help some parents. I know that getting ahead of it as one thing and bringing them in, as soon as they break that [00:14:00] first tooth, is there anything else that you'd like to share?

Dr. Nidhi: Yes. I think something really important for younger kids is diet to help them. And your whole podcast is about it. So I don't have to go in detail, but I would love to explain to parents and really a minute that how does cavity really happen? Because once they start understanding how it happened, they would automatically start taking the cues during the day and understanding it.

So the diet plays a really important role in a cavity development. It's not always what you eat, but how your tooth or your microbiome is digesting it. So if a child, and this is going to be a bad example, but really a real life example is that if a child eats candy all day or a child eats chocolate all day, it's still is possible for that child to not get a cavity.

And the reason is if you don't let that chocolate or candy stickiness stuck to the tooth. So if you brush it off after they've eaten, [00:15:00] not that I'm recommending them to eat it because that's not good for their health, but just from a teeth perspective and cavity process perspective. The way cavity happens is any food particles and it could be right it could be crackers, could be chocolate, any food that sits on a tooth for a long period of time that bacteria started degrading it. And when that happened in the 20 minute time period, the pH of the saliva changes it. And that's when the cavity happened. If parents can start brushing their teeth right after growing them to a habit of rinsing their mouth after meals, that would be really helpful. Bringing them early, like you said, is really important and home care and not feeling overly cautious that the child has autism. And that's why they're not brushing the teeth. This is a problem for every child, no matter what. So I hope that it can help parents take off that stress from themselves.

Just make sure that they reach out and I'm happy to just [00:16:00] like we're doing, I would love to go on a video call and help them and help them find a dentist if that's needed for them.

Brittyn: Definitely. And I love that you say that cavities can appear for more than just candy. I think a lot of people don't realize it's something, you know, quote unquote, healthy that's still broken down and sugar in the mouth. Cause I mean, your digestion does start in your mouth. Your saliva breaks down your carbohydrates and even if it is something like rice, you're still breaking it down.

And if it stays on the tooth long enough, then it can you know, a cavity and a lot of kids that I work with have really limited diets anyway. And the foods that they navigate toward are those foods that are more starchy and you know, perhaps could be more likely to create a cavity. And then they have these oral versions, which is the reason they're picky or selective in the foods they'll eat and then they also don't want a toothbrush. So then it's this combination of things there. And I had mentioned to you, I've had a few clients who are working with me because they [00:17:00] have limited diets. We're working on expanded, but all of a sudden there was actually two in the same week, in the same group that all of a sudden their appetites went away.

They didn't want to eat foods anymore. And usually when I see something happens like that, I say, okay, it's either some gut issue that has popped up and they're really uncomfortable. Maybe they're chronically, constipated or it's a dental issue. Those are usually the two immediate reasons why kids will stop eating.

And so they both were like, well, you know, they're still having regular bowel movements. Let's take them in to the dentist. One had an abscess tooth, the other had two loose teeth in the front and all of his foods that he eats require those frat two teeth to eat, and then the cavity in the back. So it just made a lot more sense once we resolve those issues, their appetites came back, they began eating again.

Dr. Nidhi: Amazing that you were able to identify that. And I think we see that a lot of times that loose teeth is really a cause of just this discomfort, but on the term of if a child does have a cavity I [00:18:00] want every listener to also know that if we detect a cavity early on, we do have options now where we don't have to drill a hole and make a big, big filling out of it, because that could be really hard for these children.

So there, if we can detect it early, we do have medicines. So with diamond fluoride is like a topical paint that we can put to buy some time till the child's tooth falls out, if it's the right case. So I want parents to know that there are options out there. Dentistry is not one size fits all. Not every cavity needs to be filled and not every child who has autism will act out at the dentist.

Brittyn: So then for kids who don't enjoy getting their teeth brushed, what is a good way for parents to gradually start easing into toothbrushing?

Dr. Nidhi: Sure. This is a great question because this is the most practical way parents can't understand when they come to the dentist or they hear, oh, you should be brushing your teeth. Everybody says that, oh, brush your teeth. But how so? I think it's important to learn the right [00:19:00] technique, right? Toothbrush and toothpaste are important.

Some parents ask me if electric toothbrush is more important or better than manual. And I say, no, it depends on what works best in their hand. Some kids actually don't like that vibration feelings, so they don't like to do it. So test it out. What's, it's important to get those two minutes and all surfaces of the teeth.

You can just put the toothbrush and have them chew on it and understand. Okay, the toothbrushing brushing is done. Because then that mechanical brushing hasn't happened in some food chunks are going to stay. In addition, introducing flossing early on, somewhere around age three is really important when their teeth are starting to get closer, tongue brushing is important and, and it's really important.

Sometimes if parents are having a hard time having their child use a toothpaste or a flavor to. Don't use it, just use a plain water brush, at least till the time that they're able to brush better. So if a child is giving you [00:20:00] a resistance in brushing, don't stop brushing, try it in the best possible way and know that doing a good job at home and in a more consistent fashion is going to be way more important when the child comes to the dentist as well to make our job easier.

Brittyn: So the last question I have for you is how can people find you and work with you?

Dr. Nidhi: Yeah , my practice name is Nurture Smile and gmail.com so they can email me there or Dr. D R dot and I D H I T a N E G a is my Instagram handle and they can directly text me over there and I would love to get any messages if they want to reach out, they can send me a message on my websites.

It's nurturesmiles.com and yeah, I'm available.

Brittyn: That's great. And we'll link your Instagram,, website everything in the show notes so that

Dr. Nidhi: Awesome. Thank you.

Brittyn: as well. Well, thank you so much for joining us. This was incredibly informational for me and I know [00:21:00] my clients and my listeners will love this. So thank you so much for coming on

Dr. Nidhi: Thank you Brittyn for having me. It was great to talk to you.

Brittyn: Thanks everybody!

This podcast is brought to you by the Autism Nutrition Library, a one-stop hub and community for all things autism nutrition created to help you explore evidence-based nutrition approaches that have proved to be effective to help individuals with autism feel their best, do their best, and be their best.

Join now by clicking Autism Nutrition Library or by stopping by my Instagram @AutismDietitian. See you next week.

Transcribed by Descript

ABOUT Brittyn Coleman, MS, RDN/LD, CLT

I’m a Registered Dietitian, Autism Nutrition Expert, and the Creator of the Autism Nutrition Library.

I work with parents of children with autism to optimize their child’s diet, supplements, and lifestyle based on their unique needs. I help expand accepted foods for picky eaters, improve digestion and gut health, find the root causes of many symptoms, and ultimately help them feel their best so that they can do their best and be their best.

Not only do I relate to families on a professional level, but also on a personal level. I have been a part of the autism community for over 20 years, as my younger brother was diagnosed on the spectrum at a young age.

I look forward to working with you to uncover the root cause of your child’s symptoms and help your child be the best version of themselves!