Teeth.

The forceps were shaped like scissors.  No sharp edges.  Just goldish, browish rubber over the ends of the steel metal device.   They were forced into his mouth as he was coaxed to say, “AHHH” which turned into a scream of terror in that instant.

His legs were held down by one assistant.  One ABA tutor held his left arm.  Another held his right leg.  At his head, wearing rubber gloves was the dental assistant, manipulating the forceps to hold open his jaw.  I was at his right, alternately holding, stroking, and kissing his tiny little right hand and arm.

Despite the forceps holding open his jaw, he was able to let loose with “O-U-T!!  Dinosaur!  Green, blue, yellow. NO!” and various other words between ear-piercing screams louder than I’d heard in a long, long time.

Once he realized he was trapped, the tears came.  They fell down the sides of his eyes and headed toward his ears.  I had tissues with me, and wiped them away, over and over.  His hair, just freshly washed, less than an hour before, was soaked with sweat in less than a minute.

The muscle relaxant I’d given him did not have time to work before he was laid flat by the team.  I had elected not to give it to him on the way down because he’d seem so well prepared for the visit.  ABA programs, reading a book, knowing where he was going.  Smiling, talking on the way down.  Happily playing in the waiting room.

In the dentist’s private room, just before it all began.

It was all gone in an instant.  The instant he was told to lay on his back facing the ceiling.  And that is when I got the relaxant and gave it to him.

There was a TV on the ceiling, playing Bubble Guppies.  Didn’t matter.  He was not distracted by it.  He could not cooperate.  He was terrified.

My heart bled for him, and fell out of my chest on the floor in a puddle.  Instead of holding his hand down or away when he slapped and squeezed at my face, I let him do it.  He did not hurt me.  He was grasping and squeezing to help regulate some aspect of himself as the rest of his body was held down, restrained from getting free.

I know the others around me may have thought I was crazy or weak not to hold down his hands as he grabbed and squeezed my face and mouth but I needed to let him have that outlet.

The x-rays were done with a portable gun.  Those old fashioned films that used to gag me, were still placed in his mouth.  There were so many.  It felt like it would never end.  With each x-ray, he screamed bloody murder at decibels I did not know were possible.  I noticed the dentist wore ear plugs.

Everyone else in the room was calm.  They were encouraging.  They would cheer when he finished each x-ray.  All but me.  I was barely holding it together, being squeezed and grabbed.  I was dying inside with pain for him with each blood curdling scream.  I do not think there could have been more dramatic exhibition of pain were they to operate on him without anesthesia.  It was unparalleled.

That was just the x-rays.

Next, came the counting and exam of the teeth.  Each time that dental probe made contact with his tooth, he let loose with a scream that would make Janet Leigh in the original Psycho, pale in comparison.  I kept hoping the med would take effect and he would fall asleep.  He did not.

Nothing compared to Tootles’ screams…

I knew the worse was yet to come.  The dentist was about to brush his teeth with the electric tooth brush.  As he brushed away the yellow plaque, the screams continued.  Blood now joined the party.  Eyes wide open, as they dabbed his mouth with the gauze squares, he could see the blood, further terrorizing him.  Add to that the suction, and well, I could not imagine a worse reaction.

It felt so surreal.  I could not stop the procedure.  It had to be done.  I knew physiologically he would not suffer.  Emotionally, he was beside himself.  The dentist had set aside his time, and that of four of his staff.  Two ABA tutors had been assigned to help.  They were all calm and kind as they held him.  The cleaning, the insertion of the rubber dam forceps, the taking of x-rays was done in the least intrusive, most gentle of manners.

But from the perspective of this six year old autistic boy, it was not.  It was sensory hell.  This was the first regular dental appointment of his life.  He’d been before when we thought his teeth might have broke in a fall.  That was how we found this true special needs dental practice.

We all did what we could to prepare him for this visit for six months.  But none of that prep worked mattered when it came to the real deal.  There was no program, no pretend that could mimic the real thing.  We just had to live through it.

His teeth are horrible.  He has multiple cavities.  A molar is pushing its way to the front of his teeth, preventing the adult teeth next door from coming in.  He will require an appointment under general anesthesia to do the work necessary to correct what is happening to him.

He hates to have his teeth brushed. He likes to brush them himself because he barely touches them.  He does not have a great diet due to his many problems eating and so this is no surprise.

Could I have done things differently?  Not the diet.  Not the tooth brushing.  I did the best I could.

Could I have done something differently with the appointment?  I don’t know.  I could have medicated him a half hour before we arrived but I did that with his EEG and he woke as soon as his head was touched. I think the traumatic nature of events like the EEG and the dentist are just too adrenaline-inducing for him to relax until they are over.

Sure enough, he fell asleep afterward.

And now, as I write this honest account, hoping I am not dubbed the worst mother in the history of special needs, he is playing Wii.  He is smiling with bright, white teeth.  He is happy. And yet, I continue this low level of shaking.  I still feel it in my fingertips.

I’m sickened that he now faces general anesthesia again. I hate general anesthesia more than anything else for my son.

It’s just another challenge to overcome here.  Life is different in our house.  It’s just different.

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About solodialogue

I'm a lawyer and the mom of a 6 year old boy with autism. I work part time and spend the rest driving here and there and everywhere for my son's various therapies. Instead of trying cases, I now play Pac-man and watch SpongeBob. I wear old sweaters and jeans and always, always flat shoes to run after my son. Yeah, it's different but I wouldn't change it for anything. The love of my child is the most powerful, beautiful and rewarding aspect of my life.
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16 Responses to Teeth.

  1. Lana Rush says:

    Oh Miss Karen. What a crappity-crap day. Poor Tootles. And poor Mama. There is not one thing worse to me than watching my child lose her mind right in front of me and being helpless to stop it. Some things just have to be done and there’s no great way to do it – you just have to grit your teeth and push through. Judging from T’s beautiful smile, he seems to have recovered. Now get yourself a vanilla chai and do the same – you deserve it! xoxoxo

    • solodialogue says:

      Lana, you know me so well. After that appointment, he passed out. I snuck out and got my tea! That did help a bit to calm the nerves but… you know. It took a good 24 hours before I felt calm again. His teeth are quite white now. I wonder how long that will last!

  2. Lisa says:

    It is different, this life we lead. Please don’t beat yourself up. You did everything right…special needs dentist, 2 ABA tutors, wiping his tears and understanding the sensory hell.

    I applaud you for prepping well and facing the challenge.

    Hugs…I know too well the feelings you are grappling with right now.

    • solodialogue says:

      It’s hard not to beat ourselves up, isn’t it? Thanks for the hugs. Today, he is singing and asking for toys but he’s also begun requesting to brush his teeth repeatedly…We’ll see what happens.

  3. I am so sorry you and Toots had to go through this. I have been there with both of them. I had to lay in the chair and hold her on top of me while they tried to get the x-rays. They still had to do it twice. We are on our third dentist because of her issues. The last dentist started to take a “tone” with her and she refused to even open up her mouth for him. We had to change because she didn’t trust him. I can’t say that I blame her. I could tell he wasn’t happy with having to try to treat her, so we switched again. I am still trying to find the perfect dentist. This is one of the hardest issues for us to deal with. I am sorry you had that experience. You really did the best you could. I am sure the dental staff was just seeing a loving mother, don’t be too hard on yourself.

    • solodialogue says:

      I can’t say I blame her either! We had our share of dentist shopping until a friend who has a son with autism told me about the one we go to now. I’ve found that dentists will advertise that they do special needs but don’t have the slightest idea what it really is. It’s frustrating and a waste of time for everyone. It is a difficult issue. Other than the EEG, I know of no other procedure that caused such sustained, lengthy terror for him. Thanks for your encouraging words. They are very appreciated. xo

  4. Oh… wow. God, Karen. I am so sorry.

    But I want to jump in with the others who told you that you are doing the right thing. Dental hygiene may be hard for Toots, but it has to be done. I don’t think a mother could do more than what you did either — creating the best environment possible, making multiple preparations, understanding things from your son’s point of view… no… there is nothing more you could have done.

    Hopefully the rest of the dental work will be taken care of swiftly without too many visits under anesthesia. ((hugs))

    • solodialogue says:

      Thanks Karla. I wish there was more I could have done. I know he will be much better off under the anesthesia – it’s just that I won’t! I hate the waiting while he’s under. (sigh) What can you do? We just have to get through it knowing that it must be done.

  5. kellykrei says:

    You’re not a bad mom, this story mad my eyes leak as my wife and I also experience this every time we take Kyle and Hunter to the dentist which is once a year. We take them to Childrens Hospital so they can go under anesthesia and I cringe at the thought, but I know in my heart we are not bad parents, we only do what we must. Take care Karen.

  6. Teresa says:

    Ah yes. The dentist. We’ve had years and years of experiences. Most you don’t want to hear about… like the time we went to the third dentist only do discover that she also would not take care of such a difficult patient and then to make matters worse I bought juju’s as a prize on the way home and it stuck to Matthew’s crown pulling it off… On. The. Way. Home. Oh yes. (Let it be said that the same dentist was very nice when I called crying about his crown (which very fortunately he had handed me instead of swallowing), ordered some knockout drugs and had us go back so she could put the crown in.)

    Matthew has always been like a cat held upside down… he doesn’t like it and especially dislikes sitting in the dental chair tipped back. We finally found a dentist who was willing to take the extra time and work with us. Our first visit was just to go sit in the chair… We also go for a teeth cleaning every three months. I would go monthly if it weren’t such an inconvenience to our schedule. The familiarity and routine helps greatly. After many traumatic experiences we discovered halcion. It works well enough to at least get Matthew in the chair without general anesthesia. It’s a strong drug but it works for us.

    We also got an electric toothbrush. One with a timer. (I can’t say how much improvement Matthew had but his dad was looking at some major gum work and after faithfully using the electric toothbrush (Sonic brand from Costco) for six months he didn’t need the work.)

    One thing I am going to try but haven’t yet is xylitol. It sounds too good to be true. But seems an inexpensive thing to try. Here’s the website where I learned about it: http://www.drellie.com/Xylitol.php

    I have friends who just take their child to a special needs dentist, the child is given some drugs and put in a papoose then treated. We went to such a dentist but I was not comfortable with this plan. Yes, it does make more sense than having a screaming child who suddenly grows octopus arms but I still didn’t like it.

    Continued strength to you!

    • solodialogue says:

      Oh my goodness, Teresa! The crown and the ju-jus! That’s quite the story. I feel so bad for both of you!

      You describe not just Matthew but Toots too, when you say he’s like a cat held upside down at the dentist! I’m also going to try the electric toothbrush with the timer – Toots should think it’s a cakewalk now that he was under the electric toothbrush of the dentist! I have heard of xylitol from our dentist! I’ve been thinking of trying it too.

      Thanks for sharing your stories. It makes me feel better for some reason – to know I’m not alone. xoxo

  7. Mary says:

    I think we’ve all been there.Freckles wouldn’t let my dentist even see her teeth. Forget counting them. Then we switched to a children’s dentist with a cool office and a small door for the kids. The rest is history. She has gone back by herself every time. I don’t even know what the place looks like back there. 🙂

    But I know we could have to put her under at any time for dental work. We’ve just been lucky so far. I don’t know how. She barely ever brushes. The dentist knows that. He has offered to see her more often for cleaning if it gets to be a problem. I’m trying to remember what he told us. I want to say sugarless gum. I think drinking through a straw helps, too. You can also wipe (or let him wipe) his teeth with a soft cloth like a washcloth. I also let Freckles brush without toothpaste for a while. Now she likes the Crest for Me toothpaste. It’s for “big” kids, you know.

    She has a pretty big overbite so she may need braces. Can you imagine? He did say that that could wait a while because she has been growing so quickly. Overbites fix themselves sometimes, right? Yes, she still sucks her thumb.

    The last time we tried to draw blood, there were 3 of us holding her down. We did not get it, but everyone knew we were there.

    I know about feeling like the big bad mommy, too. My older DD was 3yo when she had allergy tests. I’ve had them many times and never thought of them as a big deal. Well, this time they did all the little sticks and then took something that looked like the tweezers from the Operation game and TWISTED each spot. They did it so fast that I didn’t have time to react. But the child was screaming bloody murder. I felt so bad that we went straight to Walmart and spent $50 on Barbies.

    Next time we went to the allergist, they denied that they would ever do such a thing and haven’t tried it since so maybe they fired that tech(?). But man, I would knock someone down if they tried that again.

  8. Erin says:

    Been there. My 5 year old just had 7 cavities fixed under general anesthesia. She loves her sweets and hates to have me brush her teeth. :/ If it makes you feel any better, having them do it all under GA was much easier than the cleaning. She slept the whole time, doesn’t remember any of it, and they were able to fix everything at one time. I do feel like a terrible mom when she shows off her new “jewelry” – what I told her the shiny stainless steel caps were! She’s at least proud of it…
    Hang in there mama.

  9. Sue says:

    Hugs my friend. You are a wonderful Mom. You handled a difficult situation with love and understanding for your dear little boy.

    M. thankfully always did okay at the dentist and luckily she did not have cavities when she was younger. Still, getting her to brush her teeth was a challenge for several years when she was little. She finally told me that she hated the taste of the toothpaste. I let her use baby toothpaste for several years and that helped. Later we tried several different brands before she found one that she liked.

    I recently saw an extra soft toothbrush on Pinterest that I repinned under great sensory ideas. It is called Radius Totz. It might help. Just rinsing his mouth with water after eating is better than nothing if all else fails.

  10. Oh, man – it’s been quite a week. Dentists just freak out my kiddos too. My 6 year old only just started sitting by himself this year. And you did so well to anticipate T’s needs with all the preparation, and truly understanding why T would be so upset. You are a wonderful mom and I really admire all that you do.

    Henry has a lot of sensory issues related to his mouth. Our OT had a lot of suggestions to help desensitize – Masgutova method (Babkin Palmomental) and OTT (Oral Tactile Technique). I can send you some info if you’d like. It’s similar to massage technique on the hand and in the mouth. I found it to be non-invasive and Henry got to the point where he didn’t mind it so much. It did help with his sensory challenges though I don’t think anything would really make a dental experience easier for us at this point.

    An electric toothbrush is a great suggestion. We tried it with our older son and it helped him get used to the ones at the dentist. He LOVES using it now. 🙂

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