Dr. Kristen Fitzgerald on Dentistry, Specialising and Autism

Dr Kirsten FitzGerald, Consultant in Paediatric Dentistry with Dublin Dental Hospital discusses dentistry, the challenges of finding your area of expertise and autism

Photograph of Dr. Kirsten FitzGerald

Where did you study?

I studied dentistry at Trinity from 1995-2000. I then worked with the HSE services. I went back to do my masters in Texas to specialise in paediatric dentistry between 2004-7. With a few other certificates and diplomas along the way.

Why dentistry?

For most of my teens I wanted to study medicine, possibly surgery. But I noticed the problems for women in the industry of balancing work and family. There was a family friend who was an orthodontist which interested me as they seemed to have a lot of freedom. It’s a career that allows you to travel around the world and pick your own hours in your practice. There’s lots of choices to make depending on where your interests lie?

Why paediatric?

I was working in the primary care centre in South County Dublin and was enjoying treating children in a non-specialist sense. I decided I wanted to continue to treat exclusively children but with increased knowledge and expertise that would lead me to a specialised career. The days where I was only treating adults were a lot more draining.

I’m sure you hear this all the time; I would assume it’s a lot harder to treat children.

There’s two jobs in paediatric dentistry: one is getting the dentistry done and being excellent at that but the other half is managing the child. I probably didn’t quite have my eyes open to the emotional labour. You move on to learn the pros and the cons of it, but I still find it very rewarding. Early intervention is crucial for good oral health and paediatrics gives me the opportunity to mould good oral health in young people in early in life. My particular work I do now is with children with significant health problems such as cancer, heart problems etc. Dentistry becomes overwhelming to them so I guess learning to overcome this appeals to my problem solving skills.

If you had to give younger generations of dentists one piece of advice what would it be?

Not to discount the emotional labour that’s involved in providing dentistry. It’s not like going to the hairdresser! No one really wants to be in the dentist. There’s discomfort involved and it’s very much an invasion of your personal space. You need to provide empathy and care to help this process. Dentistry is about being hands on and problem solving but it’s even more about interpersonal skill.

How do you feel about going to the dentist?

I always have feelings of anxiety about them finding something negative or embarrassing that I hadn’t spotted. I tend to choose someone I know but not too well to keep things separate. My husband briefly treated me, but it was a bit weird and I must move on to someone else. The procedural part is still uncomfortable of course.

How often do you encounter autistic patients?

20% of our patients have autism or a related disorder.

 

What kind of challenges does that bring?

The challenges are as varied as the autism spectrum itself. It depends on the child themselves, the  family environment, the support services available to them in their community. I’m not sure if I can give a balanced view as the patients referred to me are usually referred to me in a negative way; i.e. people with bad decay or physical trauma. I have a skewed view of the patients in that sense but of course colleagues with different practices to me have reported nicer experiences such as check ups.

Do you think autistic dentists are common?

As I look around at my colleagues I’d consider the possibility.  I think you can look at it a couple of ways. On the one hand, as I mentioned that emotional labour in this job can be trouble: if you’re spending the whole day dealing with other people’s emotions while struggling to maintain your own it could be harmful for your mental health. However, autism is of course a varied disability and what’s true for one person not be for another. People with an autism spectrum disorder, if they’ve received treatment early, will likely have communication methods in place that’d be very helpful for a dentist. Attention to detail and a meticulous approach, if that’s a feature of the individual could also be very helpful.

Could I ask about your daughter?

She’s eleven and was diagnosed at seven with ADHD and atypical autism. It’s been helpful to get the diagnosis and supports. She struggles with anxiety and changing routines. She’s reluctant to separate from us when it comes to environment like saying goodbye and the school gate. She gets on well with her friends but did struggle socially in the past. She’s interested in art, science and music: no singular focus but several special interests. I work with the Disability Service (partially because of my daughter) as I’m keen to do whatever I can to push university access forward for students with autism. I also do have a professional interest in learning about autism for my work. The main thing I’ve learned is it’s far more common than I thought!