Dental Hygienists Make a Difference

autismIn the spring of 2015, BCDHA ran a contest called “Dental Hygienists Make a Difference”. Members of the public were invited to submit stories of the excellent work done by dental hygienists every day, all over B.C.  Louise Witt submitted the winning nomination based on the excellent work done by Kayla Ragosin-Miller, RDH.

Congratulations to both of you on your prize winning entry!

“Advocating for positive change for children with autism”

Louise Witt knows what it means to advocate.  As a social worker she has spent much of her career advocating for her clients and when she became a Mom to son Jack who has autism, she learned that he too would need an advocate. As Louise describes it, interactions with people can be difficult for Jack and unfortunately often negative. In terms of Jack’s dental care in particular, it was always a struggle to treat him. “Our experiences with dental care have been horrible.  Restraints have been used and he has had to undergo general anesthetic. It was awful and I have spent years trying to figure out how to make this change.”

Through friends and other parents of children with autism, Louise learned about the “Desensitization Program” at BC Children’s Hospital started and run by Registered Dental Hygienist Kayla Ragosin-Miller.  The need for this type of program is high and, as a result, Jack spent quite a bit of time on the waiting list.  A few months ago, Jack finally got his appointment with Kayla.

“Seeing Kayla was a fantastic experience for Jack and me!  Nothing about Jack phased her and she was able to use visual cues, principles of applied behavior analysis, and a small reward at the end of the session to help things go smoothly.  She was patient, caring, focused on Jack’s needs and as a result all of the anxiety Jack would have after a normal dental visit were gone.”

Things went so well that they booked a second appointment. After Jack’s second appointment, he left the clinic smiling!  “As soon as we left that second appointment I sent the story about Kayla off to BCDHA. I think it’s important to recognize the people who do good work, and who do what they can to make Jack’s life, and mine, a little bit easier. Kayla is one of these people. I want all parents with autistic children to know about the Desensitization Program at BC Children’s Hospital and the work Kayla does.”

Louise is a firm believer in paying things forward. Not only does she advocate for own son, but for others with autism as well.  To this end, through the Autism Support Network, she and Kayla are collaborating on an educational presentation to help other parents of children with autism. The plan is that Louise will speak about her experiences as a parent advocating for Jack, a video of Jack in the dental chair will be shown and Kayla will talk about the Desensitization Program and its principles.  The goal is to build awareness of this program, provide support to struggling parents, and help ensure that parents know that their child can receive oral care. “This educational session will be open to all parents in B.C. who have children with autism. Ultimately we’d like to record it and share it on our website.  I also want to acknowledge that Kayla is doing all of this for free. When I proposed the idea, she was right on it, absolutely zero hesitation.  What a credit to her and her profession.”

What’s even more exciting for Louise is that all of this work being done can be applied to other areas as well. “The principles that Kayla works under can be used in other areas too.  People with non-autistic children don’t understand that any and all appointments can be hard, for example doctor visits, hair-cutting appointments etc. Our hope is that the principles used at the Desensitization Program can become more widely established across all areas in order to help people with autism.”

Jack will see Kayla again on August 18th. Jack will know what to expect and will be provided with the tools he needs during that appointment in order to help make the process easier.  Louise knows that her son will get the oral care he needs and that he won’t be traumatized afterwards.  We look forward to hearing about Jack’s experience on the 18th!

Louise Witt is a Director of the Autism Support Network. To learn more please visit

“Providing patient-centred care through the Desensitization Program at BC Children’s Hospital”

Kayla Ragosin-Miller was delighted to learn that she won the “Dental Hygienists Make a Difference” contest run by BCDHA.  “It was a huge honour to know that my work could have that kind of impact on someone! The work I do at the Desensitization Program at BC Children’s Hospital has been something I’ve been involved with for about seven years.  To have an example in writing about how that work has paid off is incredible.”

Kayla’s impetus for starting the “Desensitization Program” at BC Children’s Hospital was borne out of personal reasons.  Kayla’s daughter has autism.  “When my daughter was young I took her to a pediatric dentist thinking that they would have seen all kinds of kids with a variety of needs.  But after two years of taking her we were just having basic exams, my daughter hadn’t even had a polish.”   It was around this time that Kayla began working at the BC Children’s Hospital and saw many children like her daughter that few people knew or understood how to treat.

Because of her personal experiences, Kayla was well-versed in behavioural therapy, relationship integration strategies as well as a variety of other proven therapies.  She knew that there were numerous techniques that could be easily employed in the clinic and asked her boss if her daughter could be entered into a pilot program using some of these proven interventions.  As a result, the Desensitization Program was started in 2008.

In the last seven years the Program has helped hundreds of kids. According to Kayla, there are several keys to success which include starting young, using anticipated techniques so that the kids experience predictability, parent education and understanding that for each child she sees the care they need in that moment is unique and focused on that person.  In her work at the Program, Kayla spends a great deal of time talking to the other health care providers for each of the kids in order to ensure that techniques and strategies that have been working are continued. She also ensures that parents are well-versed on what she’s doing and that ‘homework’ is taken away from each appointment. “My work is about ensuring that the kids get the same techniques they’re used to in order to ensure success. I also work a lot with their parents so that they too understand what needs to happen. What’s critical is that how the child leaves me will set the stage for whether or not they want to come back. It’s my job to build that positive experience for them to ensure they get the oral care they need.”

Working at the clinic has taught Kayla many things, but she points to patience as one of her areas of greatest learning.  She has learned not to rush through things and to stay calm even in difficult situations.  She has also learned that her desired way of treating patients is to do so as a whole by helping them understand that their mouths are the pathway to their entire bodies.  “As dental hygienists we are taking care of the whole person. We know that oral care is one of the foundations for overall health.”

In addition to her work at the Desensitization Program, Kayla is an educator, works in a private dental office and is a Mom.  While splitting her time means she can’t always focus exclusively on the Program, she has opportunity to apply her knowledge and experiences in all areas. As an educator for example she talks to students about the Program and has seen their interest in working with special needs children grow as a result.  Students who show an interest in working with special needs clientele often come to shadow Kayla at the hospital. In her private practice she talks to patients and can spread the word about the Program.  As a dental hygienist she makes people aware every day about the role dental hygiene plays in overall health.

Looking to the future, next year the Pacific Autism Family Centre will be opening in Richmond, B.C.  The Centre will provide complete care to people with autism and will include a research centre. It has been proposed that a dental clinic could possibly open in this facility.  “There is a huge need for this type of Centre. It is imperative that services for people with autism are integrated and that oral care is part of these core services.”

Thank you Kayla for making your dental hygiene colleagues proud by modeling the core principles of patient-centred care.

The winning entry as submitted by Louise Witt on behalf of Kayla Ragosin-Miller, RDH

My 11 year old son, Jack, has classic autism. Dental visits have been horrible for him in the past, from being “trapped” in a Velcro papoose to twice going under general anesthetic for basic cleanings or fillings.

It was not pretty. Jack would be kicking and screaming as soon as we entered the dentist’s waiting room, and I would usually leave his appointments on the verge of tears. Knowing how important life-long dental health is, I was desperate to find something that would work for my son and his challenging behaviours.

I had heard from other parents of children with cognitive disabilities about the desensitization program at BC Children’s Hospital. We went on the wait list and finally got to see the amazing Kayla Ragosin-Miller about 2 months ago. I learned that she is also the mother of a child with autism, which was very obvious in her therapeutic approach to my son.

Kayla saw the need for children like mine and developed a desensitization program that uses positive reinforcement to teach kids how to cope with dental visits.  She also uses visual cards/cues for children to follow along the process. At the end of the visit, the child is rewarded with a small prize.

Jack’s first trip to Kayla went very well. Today at our second visit, he smiled all the way into the clinic and out again. She was even able to scale some of his bottom teeth!

But there’s even more! I asked Kayla if she would be interested in talking about her program to other parents of children with autism. She immediately said yes and we are now working on a presentation to educate others about this important topic. We hope that this will take place in the next couple of months and we began the process today by videoing my son’s visit with her.

Please consider Kayla Ragosin-Miller for recognition of her terrific work. She is truly making a difference in the lives of children who are often difficult to treat.


Louise Witt

(Jack’s Mom)




2 thoughts on “Dental Hygienists Make a Difference

  1. Congratulations. Louise and Kayla!
    It is hoped that because of this successful intervention with dental care the same principles can be applied to many other aspects of health care – not only with autistic children but all others as well. Two caring, intelligent women will have made an enormous difference in many lives!

  2. Congratulations to Kayla on seeing such a deep need for her talents and skills in working with autistic children, and for Louise for persevering in finding alternative care and solutions to Jack’s earlier negative experiences in a dental office. This program is very important and could be used for many fearful /challenging patients, both child and adult who have had such poor experiences with regular dental offices. Care, compassion, cooperation, collaboration with caregivers, imagination, patience and TIME is needed which is not what private dental offices offer. Efficiency, speed often are goals in dentist’s focused treatment and therefore either sedation or a G.A. is the dentist’s preferred option when seeing fearful children with challenges. Just another reason for looking at a parallel delivery system outside of private dental offices where family centered preventive care with ample time to explain, engage and to create a light hearted environment of fun can develop. Those first visits are so critical to a life time of positive experiences and appointments,… or not.

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