Nothing with Jonathan is easy. I didn't even attempt to take him in for regular dental check ups until he was four. I took him to my family dentist. I had my oldest son, Joshua, sit in the dental chair first so that Jonathan could see what he could expect. While he was fascinated with what the dental hygienist was doing to Josh, Jonathan wanted no part of it.
He sat in the chair, clutching his "Shake," his stuffed dog, and refused to open his mouth for the hygienist. No amount of begging, bribing or prodding was going to get him to open his mouth. The dentist suggested that I take Jonathan to a pediatric dentist in the area who specialized in working with people with special needs.
We went to this dentist. She had a live bird in her office, drawn and photographed pictures from all her patients taped all over her walls, and lots of stuffed animals. She has stickers stuck to the dental lights and mirrors over the kid's heads. She has a dozen sunglasses for the kids to chose from before they go under the lights. All her stuffed animals have a set of human teeth and she has toothbrushes and dental instruments for the kids to brush the animals' teeth.
She's older, probably has grandchildren the age of some of her clients. She's very calm and talks the entire time the children are in the chair. She comments on their security blankets and toys, she talks to her bird, who often talks back, and she talks to her employees and parents.
For the first year or so she just talked to Jonathan and didn't push him. I think it was about that long before he even opened his mouth to let her count his teeth. Eventually, he allowed her to clean his teeth with a regular toothbrush. When he needed more dental work, she prescribed something to give him to make him relax before she did any work on his teeth.
This year we started seeing a psychologist because Jonathan had some regression issues. We decided upon a multi-pronged approach on treating him. He gets behavioral training, some counseling and a couple prescriptions. One was for anxiety. The first time he saw the dentist after being on the anxiety medication for a few months he didn't whimper all the way to her office. He jumped up into her chair, opened his mouth without prompting and he even let her use mechanical dental instruments for his cleaning. Wow!
One of his sealants was coming off, so we went back to have it repaired. Since he was doing so well, we decided against the additional anxiety medication she had given him in the past. We went to have the sealant repaired and it went wonderfully. She was even able to take bite wings for the first time in his life.
Unfortunately, the bite wings revealed a cavity that couldn't be seen upon regular inspection. Since he did well with the sealants we decided again to skip the additional anxiety medications.
The day that Jonathan went in to have the cavity filled, he'd eaten a meal just prior. With the other medication, he wouldn't have eaten for four hours prior to the dental work. Needless to say, as soon as the dentist started the gas, administered the Novocaine and prepared his mouth to fill the cavity, Jonathan started vomiting.
Again, I really appreciate this dentist. Even though her face showed how ticked she was, her voice and response didn't change from her normal quiet, calm and easy going demeanor. The dentist and staff got Jonathan and all the instruments cleaned and sanitized and attempted again. Jonathan started vomiting again.
The dentist called off the cavity filling that day, cleaned Jonathan up again and helped us walk out to the car. She told Jonathan not to bite on his lip, which felt funny because of the Novocaine. She told me to take him home and let him sleep off the effects of the gas and keep him out of soccer camp that night.
At dinner time, Jonathan showed me his lip was swollen. I was debating about what to do when the dentist called to check on him. I told her his lip was swelling. She tried to call in a prescription for an anti-biotic, the the pharmacies had closed. She said she was leaving the country beginning at 3:00 a.m. but she'd call me as soon as her airplane touched down.
The next morning I walked out of my room and saw Jonathan's little butt hanging out of the bathroom door. I could tell he was standing on the sink. As I got closer I could tell that he was examining his mouth in the mirror. His lip was now twice the size and green with pus.
What was I going to do? The dentist was on a plane and couldn't be reached. I know she called in an anti-biotic, but was it going to be enough to take care of this? I'll summarize the rest of that day. We stirred up Jonathan's orthodontist and got him all panicked. He called a local surgeon every 10 minutes until the surgeon agreed to see us. The local surgeon took one look at Jonathan and said, "Ah, yes, this typical of children who chew their lips after Novocaine." And he prescribed the exact same thing as our dentist had called in.
This is a long lead into how Jonathan responds to something like this. Because his lip was so fat, he decided that he couldn't swallow his spit regularly. So he started this slurping sound in the back of his throat. Even he noticed how the sound was like the vacuum the dentist uses to clear out the mouth while they are working in it (she calls the instrument "Mr. Thirsty"). Both the dentist and oral surgeon didn't want him eating anything that required chewing. If you know Jonathan's diet, that eliminates the small menu of food that he does eat. We ended up feeding him pudding for every meal for nearly a week. Jonathan also decided that he couldn't talk, so he started off using his finger to write in the air, but switched to paper and pencil after a day. I think he slept for almost two and a half days straight. Now mind you, Jonathan is hyper-active. He has to be medicated to be able to sit down at the table through a meal. If Jonathan willingly crawls into his bed or lays on the couch, I know a call to the doctor is necessary.
When Jonathan was about three or four, he cracked his head open and needed stitches. He only wore Hoodies for about a month because he was afraid his brains would fall to the ground. The stitches were gone within a week, but it took over a month to get him to stop wearing a Hoodie. When he got a cold, he'd develop a cough which would last three or four months after the actual cold. The specialists told us that the cough became a sensory input that he enjoyed. When Jonathan started the "Mr. Thirsty" slurp, I wondered how long it would take to go away after the swollen lip.
How long will it be before he lets the dentist back in his mouth again? How long before he starts talking again? Just this year working with Kennedy-Krieger Institute, we got Jonathan drinking out of a regular glass. Before he'd only drink from his sippy cup, a juice bag or stick his face in under the bathroom sink. Just when we got him drinking out of a glass, he had to switch back to a straw because his lip was so fat. How long before he's drinking out of a cup again.
The psychologist had already fussed at us because Jonathan lost three pounds between his two last visits. The doctor didn't want him losing any more weight. And yet for a week all he ate was pudding. Then it took awhile to get him eating "normal foods" again....
Jonathan had just gotten "spacers" in to begin some orthodontic work. Fortunately, his orthodontist has treated our older son for five and a half years. He was the man I called when I didn't know who else to call. His office also followed up after a couple of days and asked us to come back in to see him. When we got there the orthodontist pulled the spacers out of Jonathan's teeth. "I don't want you to bring him back here for six months. I want this nightmare to be a distant memory before we try and put braces in his mouth."
The good news is that Jonathan got back to "normal" in just a couple of weeks. Drinking out of a regular cup is coming slower, but every once in awhile he surprises me by showing off an empty glass. We haven't tried to fill that cavity yet. I'm not sure what that office visit will be like....
Read more...