Thoughts on dentistry & autism...

[minkydog]

Wellity, wellity...it's that time of year again. Time to pack Christian off to the dentist. We missed our fall appointment--we usually go every 3 months to keep him in practice. So yesterday was the big day.

Christian was fine until he saw the big chair and then he wanted no parts of it. We used out standard bag of dental tricks: hand rubbing, warm back massager, music, hug breaks. Didn't matter. He kicked and scratched and generally let us all know how much he was not enjoying it. After an hour I was sweating bullets and finally I just threw my body over his and told the hygenist, "Now's your chance.Get to it". Surprisingly, Christian stopped fighting and lay there just as peaceful while she cleaned his teeth. Of course, he was pinned...

Afterward, the hygenist showed him the Big Teeth and the Big Toothbrush and let him pretend to brush the teeth, which he liked, and she let him choose a new toothbrush, a turtle one. I was worn out, but we had to go to Walmart. While walking in the pharmacy section, Christian spotted a row of toothbrushes and let out a happy gasp! What? You want a toothbrush? Knowing that he likes vibrating things, I took him to the Spin Brushes and he immediately picked out one--a space man with the brush sticking out of it's head He carried it around and showed it to Daddy when we got home.

You never know what's gonna captyure his fancy. If anybody has any ideas about making his visits better, I'm all ears (no sedation--he doesn't tolerate sedatives AT ALL.)

 

[Huggles]

Do you have a dental school nearby? If so, ask if they could let you visit one of their surgeries on a two weekly basis ( every week even better). We got over this by letting our child just stand in the room for a short while and then look at the chair ( make it go up and down, back etc). The next week, if there are no melt-downs doing the same as last week, then let him sit in the chair. Gradually get him to sit in the chair, play with the water/ air blaster thing....if you can cope, let him be 'the dentist' and look at your teeth.
We did this with our child and now she has had her teeth fissure sealed, impressions taken for braces and she doesn't get at all anxious. It's a long slow process, but well worth it.
In fact the dental hospital might be quite grateful as the experience could be mutually advantageous.The students will have to get used to dealing with people with anxiety disorders and even some special needs patients.


Good Luck and hang on in there

 

[rascalmom]

DH is a dentist & I have worked in his office on & off for years. He has seen many children and adults with special needs, but I don't think we have ever had a patient with autism. I can make a few suggestions & maybe we can learn together.

Is nitrous oxide an option? This is also known as laughing gas and is administered with a nasal mask. It helps a lot of nervous & dental phobic patients & the benefit is that once the patient is again breathing regular air, the effect of the gas is gone.

Time of day is important in scheduling appointments for children & special needs patients. You don't want to go at a time of day when they are tired and cranky. For some, this is first thing in the morning. For others, it might be after a nap.

How old is your son? We have had a few children actually sit in a parent's lap during treatment. The reassurance helps them make it through. Is it being in the chair that bothers your son? The hygenist might be able to clean his teeth without him sitting in the dental chair if this helps.

The spin brush & his fascination with vibrating things might be something that you could work with to help him. There are some dental chairs that have a massage feature now, the prophy cup (the tool the hygenist uses) spins & sort of vibrates. Lots of other little tools & gadgets that might provide a distraction or a break for him - which might be enough to get him through an appointment.

Does your dental office offer headphones, dvd players, or anything like that? Some kids get so absorbed in what they are watching that they forget all about what is going on with their appointment. A familiar dvd might be a help to him.

There are lots of tastes, smells, sounds & sights involved with dental visit. Many can be adjusted or tweaked to help make your son more comfortable. Does he prefer a certain flavor - prophy paste comes in spearment, peppermint, grape, pina colada - just about everything imaginable.

A good rotating brush used at home will also help keep his oral health in better condition. That may help those hygiene visits go more smoothly. Hope some of this is useful - I will talk to dh tonight & see if he has any other ideas or tricks that he uses. I stay in the business office when I am there, so they may have some little secrets that I know nothing about.

 

[rascalmom]

Another thing I would highly recommend is getting dental sealants for your son as his permanent teeth erupt. This helps prevent cavities in the occlusal surface of those sealed teeth later on.

 

[rascalmom]

Do you have a dental school nearby? If so, ask if they could let you visit one of their surgeries on a two weekly basis ( every week even better). We got over this by letting our child just stand in the room for a short while and then look at the chair ( make it go up and down, back etc). The next week, if there are no melt-downs doing the same as last week, then let him sit in the chair. Gradually get him to sit in the chair, play with the water/ air blaster thing....if you can cope, let him be 'the dentist' and look at your teeth.
We did this with our child and now she has had her teeth fissure sealed, impressions taken for braces and she doesn't get at all anxious. It's a long slow process, but well worth it.
In fact the dental hospital might be quite grateful as the experience could be mutually advantageous.The students will have to get used to dealing with people with anxiety disorders and even some special needs patients.


Good Luck and hang on in there

This is good advice - you wouldn't even need to go to a dental school to do this. I would imagine your dental office could let your ds do this too - I know my dh would.

 

[minkydog]

Do you have a dental school nearby? If so, ask if they could let you visit one of their surgeries on a two weekly basis ( every week even better). We got over this by letting our child just stand in the room for a short while and then look at the chair ( make it go up and down, back etc). The next week, if there are no melt-downs doing the same as last week, then let him sit in the chair. Gradually get him to sit in the chair, play with the water/ air blaster thing....if you can cope, let him be 'the dentist' and look at your teeth.
We did this with our child and now she has had her teeth fissure sealed, impressions taken for braces and she doesn't get at all anxious. It's a long slow process, but well worth it.
In fact the dental hospital might be quite grateful as the experience could be mutually advantageous.The students will have to get used to dealing with people with anxiety disorders and even some special needs patients.


Good Luck and hang on in there

This is a very good idea. There's not a dental school near me, but the dentist is nearby and is a long-time friend of mine. I'll call them and talk to the hygenist and see if we could do this.

Just teh thought of braces..Oy!

 

[welovedis]

I was just thinking about posting here for some tips for DS (9) and his upcoming cleaning appointment. We have about 4 weeks until we go & I'm trying my best to come up with some good strategies. He has a really bad gag reflex on top of the usual Aspie issues and sometimes will throw up at the dentist's office. They are helpful there, but not able to do much when he won't let them touch him.

D, L & K's mom, if you're around, who do you use for dentistry in the Rochester area? Just curious as I know you mentioned something about it once in a thread. Also if anyone else has some good ideas, please let me know-I really appreciate it.

OP sorry to highjack your thread!

 

[minkydog]

I don't think we can use Nitrous Oxide on Christian. He just doesn't do well with any kind of sedation. He had an MRI once and had to be sedated so he could hold still--took him 6hrs to stop vomiting & wake up. Another time he needed a hearing test. The only way to get accurate readings was to do it under general anesthesia--vomited for 12 hours, covering every surface in the recovery suite. Then he had to have sinus surgery. I told them and told them about his past history. No one believed me. So after he had vomited 8 times I suggested that *perhaps* they better call the doctor 'cuz I wasn't taking him home like that. We had to admit him overnight with IVs and just let him sleep it off--24hrs That's right; he slept 24 hrs!

So you can see why I'm not keen on sedating him. Even Benedryl makes him so he can't walk. He sits and cries for 8hrs straight. I'd rather just hold him down and get it all over with in an hour. I don't give him anything but Tylenol

 

[mamacass]

We just got back from the dentist yesterday and it was the best experience we've had in years. My son had been going to a pediatric dentist that deals with a lot of special needs patients but my son was scared to death of him. For some reason this dentist did his own cleaning. We decided to see if switching to a different dentist would help. We took him to our family dentist - the hygenist cleaned his teeth and was so patient and wonderful with him! For my son I really talked it up about him going somewhere new and that it was going to be so much better and how this lady was going to be so nice to him, etc. I think he really believed it was going to be better so maybe it was just mind over matter. Whatever the reason, it worked for us. Just wanted to share our positive experience - good luck to you.

 

[mbb]

Another thing I would highly recommend is getting dental sealants for your son as his permanent teeth erupt. This helps prevent cavities in the occlusal surface of those sealed teeth later on.

What are these?
And how long do they take to "apply"?

Our two boys have ASD, and our first trip to the dentist was successful, *phew*....the hygienist was able to clean their teeth, and no cavities

If there's something that can help prevent them, I'm all ears too

TIA!!

 

[Huggles]

They don't take too long to do and are painless but the use of the water spray thing and the air blast can upset the child if they are not used to the noises. Our minor problem was the use of the cotton wool wadding which keeps the cheek away from the tooth and keeps the area around it dry. The sensation was unpleasant and was something we hadn't anticipated. However after the first one was done and she was aware it only lasted a minute or so we got the rest done no problems and we've never looked back.
They also have to keep their tongue away from the site whilst they're working on the tooth but that's easy in comparison ( suppose it's just like us with something stuck in your tooth....can't resist prodding about with your tongue)

Go for the desensitisation routine I mentioned and then it should be no problem.

 

[SueM in MN]

Lots of good hints here.

He has a really bad gag reflex on top of the usual Aspie issues and sometimes will throw up at the dentist's office. They are helpful there, but not able to do much when he won't let them touch him.

I have a really bad gag reflex. One of the things that has helped me is Lamaze breathing (they should have a slogan: Lamaze; good for more than childbirth). When I worked in Psych, we taught it to a lot of our anxious patients. We called it "Relaxation Breathing", not Lamaze, but it's basically the same thing.
Concentrating on the slow breathing and relaxing helps to decrease anxiety and take the mind off of the possibility of gagging.

 

[MN Dis Fans]

I have an idea but I'm not sure if your family will cooperate. Anybody interested in going to medical school?
My DH has an uncle who is a dentist. DS was comfortable around him and DU has been very patient with DS's gag reflex. It took 6 years before they could actually do a flouride treatment on him and 7 years for x-rays.

 

[PatMcDuck]

My son is 16, 140 pounds, and STRONG. My family dentist used to work on him, by signed off when he was 13, he could not handle him. Will not cooperate with dentist. Out of desperation I "let it go" for a few years..... By 16, no pediatric dentist would take him, he was "too old", and I called several. FINALLY I found a dentist also certified as anesthesiologist. Sean was asleep for 3 hours under general anesthesia, for an exam, x rays, cleaning, removed 3 baby teeth, one impacted "extra" tooth, and one impacted wisdom tooth, one small filling, and sealants. Luckily, almost no decay.

It was worth all the trouble, but I wish I had other options. You guys are doing the right thing, getting your kids used to the dentist. For anyone in my situation, there are options. I am fighting now with my insurance company to pay for this however. (I asked before hand, and was assuredt hey would cover the anesthesia under medical, now they are trying to weasel out of it)

 

[DAG]

Our little one will have four cavities filled next month. The dentist is going to use valium and two other drugs to sedate him. The dentist mentioned that he could use anesthesia, if the procedure is done at a hospital, but the insurance company would only cover a small portion of the anesthesia and won't pay for any hospital fees.

I did receive a lot of advice from the members on this board, which was really helpful.

thanks