Autism Watch: 2007

Autism and the Dentist

Posted on: December 19, 2007

My seven-year-old son is a really bad teeth grinder. He’s always ground his teeth. It’s a noisy sound, a nails-on-the-chalkboard sound that makes me attempt to stick my fingers inside his wired-tight jaws and pop them apart, but it never works and sometimes I get bitten as his teeth snap back together like a gator’s might. Snap. At his dental check-up/cleaning last month, we learned that the dentist was afraid he was wearing down a crown to the point it would require replacement. We hoped it wouldn’t, but learned on Monday that it does.

Next week, he goes in for another root canal, as there’s a definite crack back there and a serious risk of infection. They’ll put a new, non-amalgam-related crown in his mouth. He knows it’s going to happen, and so far, he’s not freaking out about it. But I worry, and not just because of what he might incur during the appointment but because of what happens afterwards: regression.

Almost two years ago, he had three root canals and a couple of fillings. He was a reflux baby, and the enamel was worn off those teeth, so they became problematic early. He also was, as many autistic children are, really averse to brushing his teeth, and it took a lot of effort that wasn’t always successful. The first appointment…well, I will remember it vividly forever. It was the first time one of my children has ever had a tough time in the dentist’s chair, and it was messy. The dentist had to do her work, and help calm him and hold him still, while the assistant also helped hold him still while holding her tools, and I laid in the chair, leaning on him, trying to hold his hands out of the way. We had chosen nitrous, and he hated the hissing sound. By the end of the appointment, he had some rash on his face and neck from all the movement and he was so badly stressed out and frantic, I refused to take him to the next of the three appointments he needed to finish all the work. Dh, out-of-state on a business trip at the time, got a lovely phonecall from me, where I proceeded to tell him that all his traveling for work would have to be on hold long enough for him to do the next appointment. He agreed. Anyway, it took days and days until ds was back to himself, well over a week. He hated the idea of another appointment, and so did I. Yet, dh got him there, and to the next one (rescheduled for first of the day, when the office wasn’t even officially open so no one else would be waiting, listening or needing any help) and the process was completed without the mess of the first one. Was he more used to it? Was dad’s presence better than mine? Who knows, but we won’t push it — dh is doing this appointment next week, too.

We’re lucky — we have a wonderful dentist who has a lot of experience with kids on the spectrum. She has one of her own. When our regular dentist said we needed to find a pediatrics dentist, she was one of the numbers we were given, and I did grill the receptionist heavily, knowing not just any peds. dentist would work. It paid off. Her office is built around children, with flat-panel TVs on the ceiling above the chairs, children get to choose what to watch, and the walls are covered in relaxing but eye-catching murals. After the appointment, they get coins for use in the toy machines, and the goodie bag must cost the dentist office a pretty penny each month with the spinbrushes and other items each includes. So, if your child needs a dentist and you’re iffy about yours, look around. Better ones are out there. Don’t settle for one that makes you uncomfortable or doesn’t listen to your concerns. Ours knows our issue with mercury, and doesn’t hassle us. We’re given a lot of options, and above all, she’s understanding with our son. When he can’t take a routine cleaning because the cleaning gel bugs him, she works with him to find a better solution. (New special gel that’s not gritty and comes in a better flavor.) When a machine is new to him, she lets him play with it so he knows exactly what it is before she puts it in his mouth, and better yet, she does that without us having to suggest it. She knows that approaching him slowly is best, and getting in his face takes advanced warning. When he can’t take the smell, she does what she can to dissipate it. (Last cleaning, a new hygienist was in the room and didn’t seem to be aware of his ‘issues,’ until he bit her and I explained. He was crying, the dentist came in, calmly took over and it was done in minutes. Not many dentists will handle things this way.)

Does that mean I’m okay with just signing him up for more work? No, but I also know that an infection can wreak havoc on his system and make things worse, and an infected tooth will bring a whole lotta pain and still need to be fixed. He won’t wear a mouth-guard, but maybe when he’s older he’ll be more willing. Right now, we’re just thrilled that he’s actually sleeping in his own bed…for almost 14 days now!

Know your dentist. Ask questions. Research and if your current dentist doesn’t like it, find a new one.  Dental work is too important to put off yet you don’t want a child who is so afraid to ever return. (And all this coming from me, a major wimp at the dentist’s office, particularly after a root-canal tool broke IN my mouth and had to be surgically removed. But I’m still up-to-date on my appointments, so if I can do it after what I call The Fiasco, so can you!) 

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3 Responses to "Autism and the Dentist"

This is an excellent piece. Our fights with the dentist are even more painful: strapped into a chair, puking, loose bowel movement, hives, etc. It is horrendous but, like you, we also have a great dentist who understands. He does his appointment only once a year and he makes sure no other appointments take his time. There is no waiting and it’s in and out. Any extensive work needing done is done under anesthesia.

Good luck with your upcoming procedures 🙂

wow, I hope our upcoming apointment goes well. We are seeing someone new and were assigned but they said it was a specialist who has experience with our type of situation. Our last appointment did not go well and the only thing they were able to do is check his mouth with a mirror while sitting in my lap.

It’s almost January and most people time for “New Year Resolution.” I have researched many places online and haven’t found much about “dentist New year Resolution.”(Funny!!) Just thinking of many ideas to get individuals who don’t see dentists on regular basis to invest some “times” and visit a local dentist. Your ideas will be appreciated. Thank you

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