Autism Watch: 2007

Posts Tagged ‘crown

Phew. Done. Started at 8am, and by 8:40, dh was on the phone, updating me as he headed home. And this is big, as dh hates to talk on the phone as he’s driving. (Why aren’t there more people like that? My drive-time home could be cut in half if I didn’t have to sit behind 10-20 people a day who don’t want their call interrupted by measly green lights and turn signals.) Ds was unhappy, he’d been crying, but he was talking. Another phew. He had a roll of gauze in his mouth, preventing him from speaking too clearly and racking up drool points, but he was talking. We’d chosen to use nitrous, despite the concerns with problems with it, because the problems with general anesthesia really aren’t necessarily better. And no medication isn’t an option. He arrived home shortly afterwards, red-faced and pale at the same time, unhappy yet happy that it was over with. Bag of prizes/rewards from the dentist balled up in his hand, along with the purple nitrous nose-piece.

Apparently he had cried some during the visit, and dh spent the time trying to calm him. The dentist was wonderful as always, very attentive to ds’s needs and fears, yet hurrying through the work to get it done as fast as safely possible. Thank God for that. Not all dentists have the patience she does, and I’d recommend her in a heartbeat. (And her experience with a son on the spectrum really helps, too.) He had to deal with the nose-piece, the brace to hold his mouth open, and two strangers in his face. Bravery. He can be so easily overstimulated, yet despite it all, he gets through it.

A few hours later, hours where we’d cuddled, he’d played Wii, and we didn’t get more than three feet away from him, he decided that the ice cream we’d mentioned the day before sounded good. Off we go, the three of us, into the car. I sat in the backseat next to him, leaning into him, arm around his little neck. He cried on the way there, pain from his tooth as the numbness wore off. He cried as we ordered, as I held him up to see the ice cream choices, and he cried as we walked to the car, carrying our cups of root beer float ice cream, while daddy paid the nice man who really didn’t know ice cream from the scoop from the register, though he at least smiled throughout the cluelessness that made it take twice as long as it should have. He cried the ride home, in between bites of his ice cream, because the tooth pain increased. We gave him Tylenol meltaways, and he seemed to feel better as time went on. Today, you wouldn’t know it had happened — regression? Not like the last times! There’s more stimming going on — his left hand is flapping and sitting oddly, and he’s grabbing himself and his hair way more than usual, but he’s talking more than he’s yelling, and he isn’t obsessing with talking about the horrible visit. Many, many reasons to be thankful as we go into the New Year.

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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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