TAKING TIME TO CARE: Dentist tries to put autistic children at ease - News

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Jul. 20, 2009
Copyright © Las Vegas Review-Journal

TAKING TIME TO CARE: Dentist tries to put autistic children at ease

By PAUL HARASIM
LAS VEGAS REVIEW-JOURNAL

Dr. Jeff Kinner hugs 5-year-old Aiden March, who has autism, after a treatment session July 13 at Kinner's dental practice. Kinner reserves Mondays for treating autistic children.
Photos by Gary Thompson.

Dr. Jeff Kinner prepares to examine the teeth of 5-year-old Aiden March in his office on Town Center Drive.

Dr. Jeff Kinner walks around the dental chair where 5-year-old Aiden March lies, making sure he makes eye contact with the child who seems to want to see everything in the room at once.

Once their eyes meet, he tells the boy precisely what he is going to do with the instrument he's holding.

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"I am going to count your teeth now," he said, his calming voice like that of Fred Rogers, the late host of "Mister Rogers' Neighborhood."

"Yes, I am going to count your teeth now ... one, two, three ... you're doing great, you have beautiful teeth ... four, five, six. ... you're awesome ... seven, eight...."

It is a Monday, the day of the week that for the past two years Kinner has reserved in his dental practice for autistic children. He can only see 10 to 12 patients on Mondays, more than 20 patients fewer than he cares for on other days of his pediatric practice.

"You have to spend much more time with these children," Kinner said following the appointment. "But in my 26 years of practice in Las Vegas, I saw a very definite need in this area. I've now got 300 autistic children as patients. I've had so many parents tell me that they're so happy I don't have to sedate their child, or put them in a straitjacket or in the hospital to examine and clean their teeth. It's very rewarding to hear that."

Autism, a biological and neurological disorder, typically appears during the first three years of life. It causes children to have varying degrees of difficulty with communication and interpersonal relationships. It also causes obsessions and repetitive behaviors.

A study by the Centers for Disease Control and Prevention found that the complex developmental disability is four times more common in boys and occurs in 1 in 150 children.

"I've had some children on their first visit who were screaming, holding their ears, banging their heads or kicking the walls," Kinner said. "But later, after several visits, we're able to get their teeth cleaned without a problem."

Kinner, who does not have special-needs children of his own, said he hopes what he learns about treating the dental needs of autistic children can be passed on to other dentists.

"I don't believe I've learned enough yet to see that it is incorporated in the training of future dentists," he said. "But I'm seeing more and more of these children, and it is critical that their needs are handled correctly."

Jennifer Petrillo, executive director of Families for Effective Autism Treatment in Southern Nevada, said parents of autistic children in the Las Vegas Valley are thankful for the 52-year-old Kinner.

"The thing that we love about him so much is that he takes as much time as necessary to make our children comfortable," Petrillo said.

"He's definitely not making a profit working with our children, believe me. Sometimes he'll see them three or four times before he even touches them. He's so proud that he doesn't have to sedate them for an examination or cleaning."

Some fillings can be done using a local anesthetic. Others take sedation or hospitalization.

"That's on a case-by-case basis, on what you can get the child prepared for," Kinner said.

Kinner isn't the only dentist that sees autistic children in the valley, but Petrillo believes he is the only practitioner who sets a day aside for treatment and engages the children through an adaptation of the Applied Behavioral Analysis technique favored by therapists working with autism.

That means, she said, his practice includes establishing eye contact, calmly repeating instructions and praising good behavior while not drawing attention to poor behavior.

"Children with autism typically need a lot of repetition," Petrillo said.

Kinner said he could find little meaningful training on ABA techniques through seminars for dentists, so he learned from occupational therapists.

Despite the fact that autistic children might have a heightened fear of dental instruments and reactions to lights, sounds, touches and tastes and to someone standing close to them, Kinner is confident that if he and parents work together, they can get their children comfortable with a trip to the dentist.

"When a child becomes comfortable with a dental visit, I believe it shows that there is so much more he can accomplish," he said. "I have noticed that early intervention by parents with ABA specialists means so much to the child's development."

Aiden's mother, Meighan March, sat in a corner of the examination room where he was examined. Aiden's 3-year-old sister, Lauryn, sat on her knee.

At one point, Kinner told March that there was evidence that her son was grinding his teeth.

"I see that in 80 to 90 percent of my children with autism, and I don't know why," he said. "I haven't been able to find any studies on that."

March, a single mother who is a registered nurse, said the strides her son has made since he was diagnosed three years ago have been amazing. Her desire to learn all she can about how to work with autism, coupled with the help of ABA specialists, has made the difference, she said.

"Three years ago, I thought I was raising a sociopath. And now this year he's being mainstreamed into kindergarten. I now believe he'll go to college."

March said she found out about Kinner's work with autistic children about six months ago.

She had been preparing her son for his first dental visit for weeks.

"I put my finger in his mouth and rubbed on his teeth so he'd get used to something like that," she said.

To keep Aiden positive about the experience, she told her son, who loves the movie "Transformers," that Dr. Kinner would look for robots in his mouth.

If necessary, she told Aiden, Dr. Kinner might get the Megatron, or the bad robot, out of his mouth.

"It turned out Aiden wanted to go to the dentist, and he did great," she said.

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

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Please enter your name Name: Please enter your email Email: Please enter a comment COMMENTS : (word count limit is 300) You have reached the maximum number of words allowed Current Word Count: Note: Comments made by reporters and editors of the Las Vegas Review-Journal are presented with a yellow background. Narcissa wrote on July 21, 2009 02:50 AM: Goodness, where ere are my manners?! In the previous post, I extolled the virtues of the unlimited access- and, it only stands to reason, the off the charts quality in care-that we American citizens can look forward to when Harry Reid, on Barack Obama's behalf, helps leads the charge for "universal healthcare". But...what I neglected to mention were the 20 plus million illegal aliens who, along with their family members, will also be covered under the bill! How elitist of me. Anyway, I'm all the more reassured that illegals and their families will be covered under the plan because when I called Harry Reid's office last week to inquire, his staffer politely responded that the Majority Leader "didn't have a statement" regarding this matter. I can certainly see why a question to Harry Reid as to whether illegal aliens are covered for free medical care would be one in which there would not be an emphatic, "Absolutely Not". The answer, after all, requires careful deliberation, even though illegals ARE actuall included. PLUS, last week the House voted down an amendment that would specifically exclude illegals from free medical Obamacare. Now, I realize that House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid hardly ever communicate and coordinate their actions to promote the White House's agenda, but still... maybe voting down the House amendment actually means something by way of what Obama and Reid intend the bill to do!! If you are as thrilled and/or curious about what is going on here, you can contact your House and Senate reps toll free. It is important that you educate yourself, find out where they stand, and let them know your point of view as a constituent. Remember to ALWAYS BE POLITE. Narcissa wrote on July 21, 2009 02:17 AM: What a Godsend this good doctor must be for these parents, that arlready have their plates full with probably even more worry about the well-being and future of their children than other parents find themselves experiencing. Prayers to all of these good people. As for you, Baby Daddy, I wouldn't worry too much longer about how to deal with the financial burden of your nine childrens' dental needs; Dear Leader will take care of all. He and Harry Reid are taking steps to ensure that free dental and medical care will be available whenever you need it and without limit. And, the best part is that this free access for 350 million Americans will result in a quality of care the likes of which Americans have never seen, especially for those "newer members" to the program-i.e. the ones whose private carriers went out of business because the bill bans private insurers from taking on new people (see page 15 of the bill), and who must join or face thousands in IRS penalties and an automatic enrollment in the program. The best part is that Harry Reid and Dear Leader will see to it that all this free stuff is helped paid for by increasing taxes on the rich people and small businesses. As a community activist, Chairman Moabama understands how important it is to make these groups give back the wealth for redistribution to it's rightful owners, since, as we all know, the only reason these successfull people acquired their wealth is because they stepped on the backs of others and not because they worked really hard for it. As for Harry, well, he's busy concluding an innocuous business lunch with Billy Walters. Kayla wrote on July 20, 2009 01:51 PM: I love Dr. Kinner. He is a great Dentist. Our other family Dentist, Dr. Isom, referred us to him. They both spoke very highly of eachother and their offices worked very well together. It's so nice to see Dentists that put the care of their patients first. Its a rare thing to find!! BabyDaddy wrote on July 20, 2009 12:33 PM: I wish all my babies could afford to go to Dr. Kinner. He's the kind of doctor the valley needs.... do he take welfare babies? I gots 9, they all need work and braces. JudyB wrote on July 20, 2009 12:31 PM: I believe he is also responsible for making one of the most beautiful perfumes in the world..."Gold Frankincense, Myrrh" quack pipe wrote on July 20, 2009 12:25 PM: Dr. Jeff Kinner prepares to examine the teeth of 5-year-old Aiden March in his office on Town Center Drive. That's a cool name. I wonder if he has a brother named 'Million Man March'? LVResident wrote on July 20, 2009 12:21 PM: We bring our kids to Dr. Kinner. He is an excellent pediatric dentist. Our 2 yo daughter needed some dental work done. Dr Kinner and his excellent staff took the to answer every question and concern we had. I am glad that the Dr and his staff got the press they deserved. Although now i'm afraid that with this story, it will be difficult to make an appointment with him :-) . Mary wrote on July 20, 2009 08:40 AM: It sounds like Dr. Kinner is an exceptionally dedicated dentist, and a very special person. It's hard to find a person in the medical profession these days that truly cares about people more than raking in that "almighty" dollar. Kudos to Dr. Kinner!!!