Nothing to Smile About
April 27, 2009 by Jill Cornfield
Filed under Health
My biggest fear for Alex right now is that one day he’s going to open his mouth and display a horror show of missing teeth, yellowed stumps and strange misshapen gums to the world.
Yesterday morning, I was watching Alex brush his teeth. His usual method takes him about 10 seconds, so I started singing the Alphabet song to him to make him brush longer. Impatiently, I took the brush from him and did a little brushing for him. His back gums, which seem very overgrown to me, seemed a little puffy. Then his front gums began to bleed a little.
Maybe we haven’t delved deeply enough into special needs dentistry. So far, Alex has had annual checkups with the special needs clinic of an agency in New York City, and it seems kind of lacking. A few dentists have already come and gone during the last few years. One suggested we bring Alex in every few weeks just to get used to going there and sitting in the chair, but she left. I liked this idea – and think they should partner with their occupational therapists to teach kids to sit in the dentist’s chair. I hate to think of Alex being “papoosed” – a term they drop casually, like it’s just a hit of nitrous oxide.
Don’t know what the papoose board is? On this site, I see a caution against going to dental practitioners that use it or other restraints – which makes me uneasy and unhappy. What kind of subpar dental care have we been subjecting Alex to?
My answer to what might be an incipient gum problem (and I hope it works) is the Water Pik. (An aside: I’ve had my own adventures in dental issues, and I’m a recent convert to the Water Pik. “Your gums look great!” my hygienist said, a few months ago.) So yesterday I filled it, got one of the extra heads, and set the dial on the lowest setting. I let Alex feel it on his finger. So far, so good. A few giggles. Then I tried getting him to put it in his mouth. Not so good. However, he did give in eventually and let me put it against his gums for a few seconds.
We did it again last night and this morning, and my plan is to just keep doing it over and over, using threats and bribes as necessary. (I have cookie dough ready to go, even as we speak.)
Jeff sent me a link to a video that shows a dentist helping a child with autism get use to the dentist’s chair, and I can see it’s going to take a while. Will it be difficult? Sure. But, all I have to do is recall a man I see on the bus now and then. He’s developmentally disabled. He’s always with his mother. His mouth is one of the saddest things I’ve ever seen, and I’m sure it’s because he was frightened of the dentist when he was small, and no one was able to find a way to make him unafraid to open his mouth.
Boy, have we been there! My 23-year-old son had his first cleaning this month that didn’t involve sedation, restraint or being completely knocked out. Most of his dental work has been done under anesthesia – that includes cleanings – and neither our dental or health insurance or Medicaid will pay for it. Anesthesia is not medically necessary, although the dentist may disagree if she wants to keep her fingers.
David apparently brushes his teeth about as thoroughly as Alex, so he’s had to have a lot of work done – root canals, extractions and fillings. I now help him brush, but at 23 he has finally begun to understand the consequences of his poor dental hygiene. When he allowed the dentist to do his cleaning with him totally conscious and unrestrained, I felt we may have turned the corner.
He still doesn’t brush at all well, though, even if he does realize he needs to. His idea of brushing and mine are worlds apart.
My advice is to keep working at it at home and keep trying out dentists in the hopes he’ll eventually accept the cleanings. Restraining will just break your heart and scare him. I only allowed that once, years ago, and I still feel guilty.
Your son can’t understand why he needs to take proper care of his teeth. It’s likely that his mouth will be a horror show by the time he’s 25 unless he’s restrained in the dental chair. You have to choosing the lesser of two evils. If he can’t brush and floss and he can’t sit still while the dentist works on his teeth he’ll need to be papoosed or sedated.
My brother is a dentist and he sees a few kids with disabilities. They all freak out when they see the chair. He’s patient and kind and he plays videos for the kids and they still act like he’s about to torture them to death.
My kids are normal and while they don’t like going to see their uncle in his professional capacity they put up with it in the interest of having healthy teeth. I’m sorry you’re having this problem.
I have a son with developmental delays. My 8 year old son was terrified of the dentist because of being papoosed. I have very strong feeling against it. After much searching, we found a wonderful ped dentist who lets my son be her last appointment on a Friday – we come often – worked our way from having her looked at his mouth in the waiting room to going into the exam room. He will now open his mouth and let them brush, floss and scale his teeth. We are working our way up to getting him to sit on the exam chair. Keep looking for someone who will work with you and your son. Someone who celebrates the achievements with you. She doesn’t take insurance – we pay and sent the stuff to insurance to see what they will pay – but she is worth every penny! Good luck. You are not alone! Lori
Thanks for the advice – I hope to avoid some rough dental situation in the future by paying very close attention now… MUCH closer than we’ve been paying, I admit. We thought it was good he was willing to do his own brushing, till I realized his teeth looked a little scummy and it came home to me that he’s actually doing a pretty bad job. I think the water pik is going well: his teeth and gums look a bit better. He is only 11, after all. Not too late! I think the increased attention to all things dental also sends him a message about how important we think this is.
He can’t understand the reasons for dental care, but I think he already gets that it feels better to have a clean mouth. I think using the water pik is making him notice a difference. I’m glad to hear your brother is patient with kids who have disabilities – I think this is one of the great, unsolved areas of special needs, really good and effective dental care without restraint and fear. I think occupational therapists could be doing much more to help desensitize kids to sitting in a dentist’s chair and opening their mouths.
I used to take “papoosing” as a given, but after you and other people have written I think there is another way. Your instincts were right on! Thanks for writing… my son is just 11, so I don’t think it’s too late to try to get him used to sitting in a dentist’s chair. Increasing the amount of attention we pay to his teeth at home is also good, I think. It sends a message that we’re not going to give up!