teeth

After the personal trauma of posting about our eating woes yesterday, I couldn't handle talking about potty training quite yet. So I chose to talk about teeth instead. I'm not sure that's any less stressful. But I feel like if I get this all off my chest, maybe I can just post a week's worth of happy holiday chatter after this. Or maybe I'll be in this morose blogging mood for the remainder of the winter. (I can hear the collective groan!)

OK, so, we all know that kids with Autism and the Dentist is not exactly a match made in heaven. In fact, we avoided it for years. We built up a steady, progressive dental care program at home, and Jacob really came to enjoy tooth brushing and us messing around in his mouth in general. He would run screaming from dental floss, but we figured if we brushed thoroughly twice a day, at his age, what difference would it make. (I don't remember flossing until I was in my teens, and I was cavity-free until about then, and I wasn't even GOOD about brushing -- same with The Map Man, tho I'm guessing he was more attentive to his teeth than I was to mine.) I figured we were made-in-the-shade -- good genetics, good tooth care plan, why bother with the dentist.

When he was 5, I decided it was time to take him in -- that's the age my sister first took her son in, and we'd had a year of RDI under our belts, so I thought maybe Jacob could handle it if I found the right dentist. I located a Pediatric Dentist who has a grown son with Autism, and has many, many clients that have ASD -- AND that had an actual Autism Protocol. I liked the sounds of that! We tested him out with Zoo Boy (who DID have significant dental problems due to a congenital defect in his tooth enamel), and were impressed. We discussed Jacob with him and set up an appointment.

In March of 2006 we brought Jacob in for his first actual appointment. In January we had brought him just to play with the toys in the waiting room, and in February we met with the hygienist that works with the ASD kids, and she gave him a tour of the "special room" where he got to play with the chair, and the dental implements. She sent him home with various and assorted pieces of equiptment for us to familiarize him with at home. Methodically over the next month, we prepared him for his dental visit. We switched him to an electric toothbrush, we got him used to us touching his teeth with the scaler, we got him drinking out out the straw that sucks water away from his mouth (what IS the name of that thing??).

What I wasn't prepared for was just how successful this approach was going to be, or how truly skilled with kids with Autism these folks were. Armed with his own Tigger electric toothbrush, they swept him away from me the moment we stepped in the office, making it clear that I was to have NO part of this. I sat with massive trepitation on the edge of my seat, waiting for screams and crying from down the hall. What I heard was giggles, shreiks of delight, and laughter. 45 minutes later, the dentist came down the hall with a slew of digital photos showing a very happy, joyful Jacob having the time of his life while they examined, cleaned, scaled, and polished his teeth. HOW did they do that??? I was just amazed. And grateful. And relieved that our dental cleaning program had resulted in no visible cavities, tho the dentist warned me that until he feels comfortable taking x-rays with Jacob (he didn't want to push it this visit), he wouldn't know for sure if there was anything going on down deep. I brushed it away, jubilant in the positive exprience he'd just had. They sent him home with a book about his visit to the dentist, with pictures of him, the hygienist, and the dentist. It became one of Jacob's prized possessions. Every time we drove anywhere near the office, Jacob would talk about his friend the dentist and all the fun things he did there. Every time I mentioned going back at some point, he got excited and talked about how much he liked going to the dentist. Heck, I'd wished we'd taken that approach to his Doctor's visits (which NEVER go like that!).

The dentist had reccommended that we come back with Jacob every 3 months, so that he remembered his positive experiences and that we kept on top of anything that might develop in his mouth. But, here's the thing -- we don't have dental insurance, and this guy is EXPENSIVE. Well worth the money, mind you, but EXPENSIVE. And, um, we're broke. Beyond broke, actually, we're in debt beyond our wildest nightmares. Spending money for a dentist with a kid with a healthy mouth just didn't seem like a wise use of our widening debt load. So, we didn't.

Flash ahead to this past week. I tell Jacob we're going to the dentist, and he does backflips of joy (well, not literally, but he's pretty excited about it). He RUNS in, can't wait to get to the "special room". They review his picture book with him, whipping him into a frenzy of delight. Off he goes with his "friends" for his cleaning. The dentist comes out in a bit to yell at me for not bringing him back every three months like he told me to, but that everything looks good, and that they're in the middle of doing a flouride treatment on him (without my permission, mind you, which irked me a little, but in retrospect I probably would have allowed it anyway, since Jacob will not let us use Flouride toothpaste on him -- but still, if you're going to load a kid's mouth up with a controversial poison, don't you think it's a good policy to ask the parent's permission first??). He said he wanted to get a couple of x-rays too, if Jacob would allow it, and tried to send me on a guilt trip for not bringing him in every 3 months LIKE HE SUGGESTED so that he could have prepared him for the x-ray room and proceedure. I refused to feel guilty, and he went back to work. They got the x-rays no problem.

After the appointment, a happy, singing Jacob came skipping back down the hall to play in the waiting room. I chatted with the hygientist, she said everything looked great, and that they wanted to schedule him for sealing of his 6 yr molars, as they are particularly prone to decay, and we certainly didn't want Jacob to have to have cavities filled. So we started setting up the appointment (scrambling in my head trying to figure out where THAT money was going to come from), when the floor fell out from underneath me.

From the other room, the booming voice of the dentist "Wait, this kid's got two cavities." I became paralized with fear. My breathing grew short as he came out, showed me the two ugly spots, deep between a couple of molars. He explained that they are not permanent teeth, but the location required filling, since they could effect both the bone growth of his jaw, and the development of the permanent teeth beneath. They were going to be involved proceedures, with novacaine. They'd do the sealing of the six year molars in a couple weeks, and decide, based on how he tolerates that, what the course of action will be. I choked back tears as I schedule the sealing appointment, whispering "but we've been so good about brushing". The hygenist said "It's not lack of brushing that causes those types of cavities, it's lack of flossing". ARGHHHHHHHHHH!!!!!!!!

I recently had a lot (and I mean a LOT) of dental work done. While sitting in that chair for hours at a time every week for over a month, all sorts of sensory insults going on inside my mouth, one persistant theme kept running through my brain "Thank heavens this is ME and not Jacob. How would he ever be able to put up with something like this", the whole time patting myself on the back for being so attentive from the start to his dental care, waiting for the right time and the right dentist to work with. Building up all those positive memories of the dentist office.

And now that's all about to be undone, because of a lack of flossing. And of course, now Jacob is perfectly happy to have me floss his teeth. A little too late....

As I walked out of the Pediatric Dentist's office, feeling numb, the dentist's voice trailed behind me "you may as well get used to it -- he's got big teeth inside a small mouth, there's going to be a lot of orthodontic work in that kid's future."