The Dentist Who Redesigned the Chair: Dr. Yasmin Kottait on Treating Children of Determination

1. You're a certified Autism Specialist through IBCCES and hold a diploma in Cognitive Based Hypnotherapy. How did these credentials specifically reshape the way you designed your clinic and approach for children of determination?

Becoming a Certified Autism Specialist through IBCCES didn't just add a credential to my wall — it changed how I think about every detail of my clinic, from the lighting in the waiting room to the very first sentence I say to a child. The training pushed me to understand the difference between a child who is being “difficult” and a child whose nervous system is genuinely overwhelmed by the buzz of a suction tool or the smell of latex. Once you understand that distinction, you have to redesign your whole environment around it.

The Cognitive Based Hypnotherapy diploma gave me another layer entirely: emotional empathy, language selection and hypnodontics. I learnt how to change a child's physiological response before I've even touched them. Together, these two trainings shaped a clinic where children of determination aren't a special exception squeezed into the schedule. Their needs are built into how I run every single day.

2. What does a “sensory-friendly” dental visit actually look like in practice, from the moment a child walks in, to the sounds, lighting, and even the chair itself?

It starts before the child even arrives. We send families a questionnaire in advance so I know their child's triggers, comforts, and communication style before we meet, and we can offer the quietest slot of the day or let them skip the waiting room entirely if that helps. Inside, the lighting is softer than a typical clinic, we limit how many people are in the room at once, and every chair has a screen so the child chooses what to watch instead of staring at fluorescent lights and instruments.

Sounds are introduced gradually and named before they happen — the suction becomes “Mr. Thirsty,” the chair tipping back is a “magic elevator.” Nothing touches a child's mouth without them seeing it first, touching it themselves if they want to, and hearing exactly what it will feel like. There is also ear muffs to muffle the sound to those completely reluctant to any new sounds.

3. Many parents dread the “first visit” with a new dentist for a child with autism or additional needs. Walk us through how you structure that initial meeting to build trust rather than trigger anxiety.

With any child, but especially a child with autism, I remove the pressure of getting treatment done on day one. The first visit is often what my team calls a happy visit — the child sits in the chair covered by a sensory blanket, holding their favorite toy, and we simply count teeth with a finger or a mirror and take a few photos. Sometimes we don't even get a full look inside the mouth, and that's completely fine.

Before the appointment, I share tools like videos, social stories and visual schedules with parents, so the child has already “seen” the visit in their mind many times before they arrive. By the time we're ready for actual treatment, my clinic isn't a foreign, frightening place — it's somewhere they've already succeeded.

4. You use evidence-based ABA techniques alongside traditional pediatric dentistry. How do you blend these two disciplines during an actual procedure?

ABA gives me a structured way to do what pediatric dentists have always tried to do instinctively: reinforce good moments in a way the child genuinely registers as a reward. During a procedure, I rely heavily on tell-show-do and desensitization in small steps — I might only get the mirror in the mouth for three seconds on the first attempt, and that counts as a full success worth celebrating.

I also build in a clear stop signal, usually a raised hand, and I always honor it. That single agreement, that the child has real control over pausing the interaction, changes the entire dynamic. A child who feels they have no way to say “stop” shuts down or fights; a child who knows I'll listen the moment they signal tends to stay engaged far longer.

5. For non-verbal children or those who struggle to communicate discomfort, how do you read their cues and adapt treatment in real time?

You learn a different language: body tension, breathing changes, hand movements, eye contact or the deliberate avoidance of it. A clenched fist, a foot that starts tapping, a sudden stillness — these tell me something before a single sound is made. I keep my own movements slow and predictable, and I check in constantly, even without words, by watching the child's whole body rather than just their mouth.

6. General anesthesia is sometimes necessary for children with special needs. How do you decide when it's the right option, and how do you prepare a family for that decision emotionally as well as medically?

General anesthesia is never a first option in my practice. It's what we turn to after honestly assessing that a child's medical needs, the young age of the child, the complexity of treatment required, or their level of anxiety mean that completing the work while awake would be unsafe or genuinely traumatic. I review the child's full medical history and their response to previous behavioral approaches, and I coordinate with the best qualified anesthesia team for child care so everything is medically ready in a hospital setting.

Preparing the family matters just as much as preparing the mouth. I walk parents through exactly what will happen, from fasting instructions to what recovery looks like, and I'm upfront that some anxiety on their part is completely normal, especially with a medically complex child. Parents leave that conversation with a clear plan on paper, not just verbal reassurance, because uncertainty fuels fear far more than the procedure itself does.

7. What's a moment with a Child of Determination that changed how you practice dentistry, one that still stays with you?

There was a non-verbal boy who came to me after a previous clinic visit had gone so badly that his mother told me she'd rather let his teeth decay than put him through that again. We spent several visits doing nothing but letting him sit in the chair, touch the instruments, and leave with a small reward. On what became the turning-point visit, he opened his mouth on his own and let me count his teeth with a mirror.

His mother cried in the parking lot afterward, not because of anything dramatic that happened in the room, but because for the first time she watched her son choose to cooperate instead of being forced into it. That moment recalibrated how I measure success. I stopped counting how many fillings I complete in a session and started counting how much trust I'm building, because trust is what makes every future visit possible.

8. If you could give one piece of advice to a parent who's putting off their child's first dental visit out of fear it will be traumatic, what would it be?

Waiting doesn't protect your child from a bad experience — it usually guarantees one, because the longer decay goes untreated, the more likely we are to need urgent, uncomfortable treatment instead of a calm, gradual introduction. Come in before you need anything done. Bring your child for a visit where nothing happens except getting to know us, so the first time they're in the chair isn't also the first time they're in pain.

And look for a pediatric dentist who is genuinely trained for your child, not simply “willing to try.” Ask about their specific experience with sensory needs, autism, or dental anxiety. The right dentist will welcome that question, because it means you're already advocating for your child before you've even walked through the door.

More on Dr. Yasmin Kottait here: https://sunshinelandpd.com