Episode #486: Transforming Lives: Treating Patients with Autism, with Karen Raposa, RDH

Imagine having a toothache, but you're unable to communicate. In fact, you may have patients like this in your practice. Autism affects many children and adults — and you can have a positive impact on their dental experience. And to teach you how, Kirk Behrendt brings in Karen Raposa, author of Treating the Dental Patient with a Developmental Disability, to explain the misconceptions about autism and ways to educate yourself and your team. Every person deserves great dental care! To start helping these patients today, listen to Episode 486 of the Best Practices Show!

Episode Resources:

• Karen’s website: http://www.karenraposa.com/
• Karen’s email: [email protected] 
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Main Takeaways:

• Autism is not a monolith.
• Educate yourself and your team about autism.
• Become an advocate for patients with disabilities.
• Everyone deserves compassionate, life-long dental care.
• Get involved with organizations like AADMD to learn how to help.

Quotes:

• “When it comes to autism, if you've met one person with autism, that's it — you've met one person with autism. So, there can be misconceptions that, ‘Oh, I just do the same thing for everybody, and it’s going to help everybody who has autism.’ But every individual with autism is entirely different.” (2:37—2:53)
• “Unfortunately, a lot of [misconceptions about autism] is because of the media. What the media tends to show is people who are higher functioning with autism. Because there are people who maybe are not comfortable socially, but they're brilliant. They're savants, and they can play instruments amazingly, or they can go through life, when it comes to their education, very easily. But it’s a spectrum.” (3:36—3:59)
• “People don't realize, ‘What does that mean, “spectrum”?’ Well, it means that some people with autism may be extremely intelligent, and some people may be severely impaired, intellectually. And socially, some people may be able to communicate well and get along with others, and other people may not have that ability at all. And some may need someone to care for them for their entire life, and other people may be very independent. And I think the misconception is that it’s just this one image that you might have in your mind. And most of the time, individuals like my son, you don't hear about on TV programs or in the news, unless something really bad happens.” (4:01—4:44)
• “In general, most people go into dentistry because they want to help people. What tends to happen with the autism population is, most of the time, a dentist, a hygienist, an assistant, wants to help. They're just afraid they might do the wrong thing. And so, instead of trying something, very often, they choose not to help. And people with autism are human beings and deserve that valuable, life-long dental health just like everybody else does.” (5:01—5:35)
• “I can understand. I didn't know anything about autism. I was a hygienist. Prior to my son, I probably would've done the exact same thing and been like, ‘Oh my goodness. I don't want to do something wrong and have this end up being a bad situation. So, I'm just going to see if I can find another place for this patient to go.’ And the reality is, there really are not places for these individuals to go. Everybody needs to chip in and help a little bit to make a huge impact.” (5:37—6:06)
• “You're working with this person; you've learned that this person doesn't speak to anybody. Imagine if they speak to you because they’ve learned how you value them. They’ve learned how much you care for them. I love this phrase: people don't care how much you know until they know how much you care. So, at the end of the day, as a dental professional, most of the time, you're exhausted. Imagine how exhilarated you would feel if you helped someone who no one else was able to help, and you helped them feel better, and not have to have major dental care because you're helping prevent major problems in their mouth. You can change somebody’s life. You can have a major impact on somebody’s life by keeping them out of pain.” (6:24—7:14)
• “Imagine being somebody who can't speak, and you have a toothache. And you're banging your face because you're trying to help somebody understand. And you're suffering every day. As dental professionals, we can prevent that from happening to somebody.” (7:15—7:30)
• “Most of the time, these individuals were sent to — even if they were adults — a pediatric dentist because they could do some in-office sedation. And if they couldn't do it in-office, they'd take them to the hospital and sedate them. And I consider that a form of restraint. And that's really where the good news is — dentistry is changing. There are some amazing organizations that are advocates for this population now.” (7:52—8:20)
• “We talk about protective stabilization today because you are protecting that person. When you say “restraint”, that's when you're doing it because you don't have good intention. But protecting and stabilizing someone so that they can have regular dental care and they can be healthy for their life is a totally different concept. And there's a lot of good conversation happening around that, because there are risks in sending somebody to a hospital to be fully sedated for dental care when you know that a lot of that could have been prevented by taking some simple steps to help that person.” (8:42—9:19)
• “Every one of us is one step away from [a disability]. I mean, I could have a stroke tomorrow. You could have a bad car accident tomorrow. Think about the way you would like to be treated if you couldn't communicate well anymore. That's really what it’s all about.” (10:07—10:23)
• “The first step is to get involved with an organization like AADMD, because you're going to be surrounded by other dentists and doctors who are helping people in this population. You do need to go beyond your DMD or DDS, generally, because you're going to need a little bit more skillset in working with people who have different impairments. So, whether it’s a GPR specialty or at least AGD, a little bit of an advanced education is going to be really helpful. Because in these cases, you're going to want to be good at the dentistry, but you've got to know how to help that person, in general. And if you're good at the dentistry, then you can concentrate on the other pieces of it a little bit more.” (10:54—11:45)
• “You don't really know what you don't know, and you never know how you can impact a person’s life in a major way.” (17:08—17:17)
• “If every dentist and dental hygienist in this country decided, ‘I'm going to help one person who has a pretty significant intellectual impairment. I'm going to be an advocate for that one person,’ someone who may have no one else in their life who advocates for them, imagine how you can change their life, and in that process change your own.” (17:27—17:53)

Snippets:

• 0:00 Introduction.
• 1:18 Karen’s background.
• 3:18 Big misconceptions about autism.
• 4:45 Why this is important in dentistry.
• 6:06 Clinicians can make a positive impact.
• 7:32 Protective stabilization versus restraint.
• 9:19 How to get started helping patients with autism.
• 13:32 Karen’s book and where to find it.
• 16:55 Last thoughts on helping patients with autism.

Links Mentioned in this Episode:

AADMD: https://www.aadmd.org/

Treating the Dental Patient with a Developmental Disorder by Karen A. Raposa: https://www.wiley.com/en-us/Treating+the+Dental+Patient+with+a+Developmental+Disorder-p-9780813823935

Karen Raposa, RDH, MBA Bio:

Like many of us, Karen Raposa had poor dental experiences in her childhood. During her 20 years of private practice, Karen helped thousands of patients overcome their fears about dental treatment.

Karen’s clinical success fueled her desire to take her career in a new, challenging direction. She decided to get an MBA, knowing that a business degree would allow her to meld her clinical experiences with the challenges of sharing valuable information about both products and procedures with fellow dental professionals.

Karen has authored articles on a variety of dental subjects and has co-edited a textbook titled Treating the Dental Patient with a Developmental Disorder, which was released in the summer of 2012. In addition, her work has been published in both Dr. Esther Wilkins’ textbook titled Clinical Practice of the Dental Hygienist, as well as the Dental Clinics of North America, “The Special Care Patient” publication. She also has extensive experience in the academic world as a former assistant professor in Boston University’s Department of General Dentistry.

At the ADA Annual Session in Hawaii in 2009, Karen was awarded the Dimensions of Dental Hygiene’s Professional Achievement Award. This award recognizes one corporate council member each year who, through their work, professional involvement, and/or community service, has clearly advanced the profession of dental hygiene. She is the first recipient of this award, and a commemorative brick has been engraved with her name and placed in the courtyard of the National Museum of Dentistry in Baltimore, Maryland. In September of 2013, she was awarded the title as one of the “Top 25 Women in Dentistry” by Dental Products Reports.

Karen’s role in corporate dental hygiene as Senior Manager of Professional Relations for Colgate Oral Pharmaceuticals allowed her to interact with dental professionals all over the country. Her current role as Clinical Education Manager for Hu-Friedy Mfg. Co. continues to provide her with opportunities to present a variety of course topics in dental and dental hygiene schools in the northeast region of the United States. Because of her vast array of clinical, academic, and marketing experiences, she has become an expert presenter on a variety of topics.

But perhaps Karen’s greatest contribution to our body of knowledge is her passion for helping us learn more about working with special needs patients, most specifically those with autism. Her personal insight into autism, her compassion for people stricken with this disorder, and her extensive product knowledge, coupled with a real-world understanding of both clinical challenges and the corporate world, provide a unique perspective that we can all learn from.  Get ready to laugh, learn, and perhaps even cry a bit as you spend time with Karen in her courses.