Alex Goes to the Dentist

Does anyone actually like going to the dentist? No one I know! Alex’s first dental experience was a complete disaster. But truthfully, I didn’t expect anything different; everything is harder when autism comes into play. I don’t think he understood what was happening or what we wanted him to do, i.e., sit still and open his mouth. We made several attempts for the dentist to look in his mouth but he just wouldn’t hold still. There I was, leaning over in an awkward position, holding him down in the dentist chair. He was screaming, crying, and thrashing around; I was practically dripping with sweat and on the verge of tears myself. By the end of the appointment, Alex was huddled on the floor in a corner, sobbing and exhausted. The doctor had not been able to check Alex’s teeth, let alone do any cleaning. In order to try again, we set up another appointment and the dentist prescribed a drug called chloral hydrate which we were to give him approximately a half hour before. It was a chore to get it into him, but somehow we did it. It worked! He was totally sedated by the time we arrived and the dentist was able to check his teeth and clean them. From then on, we went to the pharmacy for a small bottle of choloral hydrate to use before each visit.

Alex’s love for fruit snacks certainly did no favors for his teeth! That, combined with the difficulty of brushing his teeth adequately, made for an inordinate amount of cavities. (At age 28, he still cannot brush his own teeth; he will simply suck on the brush. So, we have to do it for him. Every day. Twice a day.) I also suspect we have a weak enamel gene in our family. My husband and I both had quite a few cavities growing up, and of our six children, several had lots of caries while another child­­ who was eating the same exact foods ­­had none at all!

Alex has had extensive dental work since he was small; not just cavities, but caps and extractions too. Upon moving to VT, we were extremely apprehensive about locating a dentist who might be willing and able to work with us and Alex. Would they want to use chloral hydrate? Some other drug? Would it be safe? I ended up calling quite a few places before finding a pediatric dental practice that seemed appropriate for our situation.

It turned out to be a great fit for Alex. Dr. B was very gentle and patient, as were all the staff. I have always felt bad for any doctors, nurses, and dentists treating my son since there is no way for them to know if he is feeling pain or discomfort. Novocaine taking effect yet? Does that hurt? He can’t tell us. So, Dr. B’s approach was to save up a lot of cavities, extractions, etc., then do all the work at once at the “Pain Free” unit at a major New England hospital. We took Alex there 3 or 4 times over the years.

While Alex probably did not enjoy these outings, I confess that my husband and I kind of did! Upon walking into the hospital, it seemed more like a mall: restaurants, shops, and wonderful spaces to sit and do nothing . . . but wait. Low lighting, people speaking in hushed tones, it felt relaxing! Looking back now, perhaps it’s weird how much fun I thought those trips were.

To be there at 7 am, we had to leave home at 6, which meant getting up at 4:30­ish. Our older children must have looked after the younger ones because I don’t remember enlisting the help of anyone outside our family. When we arrived, we’d go directly to the “Pain Free” unit and check Alex in. Paul and I stayed for a few minutes until all was ready for them to administer the general anesthesia. It was our cue to leave when Dr. B said, “Okay Mom, give him a kiss and say ‘I love you’.” I’d kiss his forehead and then Paul and I would go to one of their family waiting rooms which were equipped with a TV, refrigerator, microwave, comfortable sofas, and table and chairs. They gave us a beeper so they could summon us back when the dental work was completed, or I suppose, in case something went wrong and they needed us there ASAP.

At that point we could sit and read or watch TV. One time I brought a big craft bag and cropped photos for a scrapbook album. After awhile we’d go downstairs and bring back some cocoa and pastries, or sandwiches and juice. On our last trip there, I remember that we watched the funeral of former President Ronald Reagan. Sometimes other waiting parents would come into the room for a short time, but usually we had it to ourselves. When the procedure was done, they’d beep us and we would go to the recovery area to sit with Alex while he was waking up. He always seemed so confused and disoriented. I’d wipe off the dried blood from around his mouth. They let him watch Disney movies and gave him popsicles, so that part he liked.

When Alex turned 21 years old, the pediatric dentist said he wouldn’t be able to take care of him any longer. (We were grateful that he’d continued to treat him for as long as he did!) The last few years, it was starting to feel strange bringing a 6 ­foot tall, 180 lb. man to an office where all the other patients were preschoolers, elementary­-age children, and an occasional teenager. The little kids would stare at him, confused; their parents would glance sideways, out of curiosity. So Alex became a patient of our regular family dentist. After so many years with Dr. B, Alex has actually become quite a good patient in the dentist’s chair even without the chloral hydrate. Even the smallest of accomplishments when raising an autistic child should be celebrated.

 

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