Wednesday, March 11, 2009

Considering a New Dentist

Shark Teeth image by DrMama from Creative Commons

We have had the worst luck with dentists. Because of Gus's Asperger's and MM's general skittishness about dentists we've been careful to make sure that we're seeing a pediatric dentist who has experience treating children with autism. Of course, when you call, everyone says, "Oh sure! Dr. So-and-so has loads of experience treating all kinds of children! Bring them in!" Then it turns out that Dr. So-and-so has the patience of a fruit fly or some other issue that makes him unacceptable.

The first dentist we went to…I should have known something was wrong because he smiled too much. There's happy, and then there's unnatural. He was definitely unnatural. As a matter of practice, he did not allow parents into the exam room. I shrugged and washed my hands of the whole situation – I know what my son is capable of. Within minutes he was all over the office and the dentist finally accepted that Gus would not allow an electric brush of any sort into his mouth. So basically, we took him to the dentist to have his teeth brushed. MM had an unpleasant experience getting her first cavity filled, and Dr. Impatient was not happy that the 'happy gas' didn't trick her into happiness for a moment. But the worst part of that whole experience was that he charged us two arms and a leg for the most basic of services. Silly me, I went to a dentist out of our network.

The next dentist – in our network – was amazing. He pulled 2 of Gus's teeth with no laughing gas and zero drama. Gus watched a video fish tank the whole time and was calmer than I'd ever seen him. He took pity on MM and even though she had a cavity, he put a sealant on it in the hopes that it wouldn't worsen too quickly. He could tell that she wasn't going to have an easy time with a filling. I thought we'd struck diamonds.

He left the practice. Didn't even bother to wait for a replacement. Bye-bye!

Last week we found ourselves again in search of a dentist – this time for MM's cavity, which started to hurt. Several dentists listed on our plan's website were no longer accepting the plan, but one referred us to someone who is supposed to be the best in the county. The assistant was very nice and managed to get MM to give her a couple of x-rays, but I could sense her getting a little irritated. Because, of course, a five-year-old who can barely fit the film in her mouth isn't going to move…or gag. I could totally see where she was coming from. We got through it, but I had a twinge of unease; if they were getting a little miffed with MM, Gus would likely have someone's head spinning. But I could have been over-reacting. So I thought we might stick with this doctor, even though he was out of our network. Then I saw the out-of-pocket estimate. Considering that MM has cavity prone teeth, and Gus has shark teeth, if we start spending that kind of money on dental work now, we'll be living in cardboard boxes before they hit adolescence. I kept looking.

Finally, there was someone in our network again, who seemed workable. MM went in today to have that tooth looked at; it needs a root canal now. That will be an adventure, but I'm not sure if Gus will be able to handle this particular office. It is huge! There are about 7 or 8 dentists, some for adults and some for kids. I nearly lost MM in the maze of rooms. The children's area was friendly enough, but I could just see him running into each and every room. The lights are very bright, and while it isn't loud, it also isn't very soothing. I really think he needs a much smaller office, one that's tailored to special needs children. So now the question is, do I at least try him with yet another dentist, or do I follow my instincts and keep looking?

How do you handle your special needs child's dental care?


  1. If I recall correctly, there was some reason I was unhappy withour first pediatric dentist. I can't recall what it was. We ended up going to the pediatric dental clinic at a local teaching hospital. He is treated in a seperate room, although they do have a big room with just partitions. We have always gotten very good care there, and when we had to have some work done under general, the proper care was taken.

    General Anasthesia is nothing to fool around with, but I think that for some kids it may be the best way to go - they do everything at once. I was really hesitant, but pleased with how careful the anasthesiologist was before the whole thing - I had to go bring my son to see him first - and also impressed that the next time, he had gotten bigger enough, etc, that they were able to do what they had to do in the dental chair and without even sedation. My child's issues are different from yours, and your mileage may differ, but I am happy with my decision and my normative child goes to the same place.

  2. :) Just followed your new "home" and updated my links! Alex had/has the shark teeth too when new teeth come in they always do before the other teeth fall out - it freaked me out at first.

    We've had dental issues with finding a dentist that was patient enough to deal with him and the sensory issues of the whole dental ordeal. Needless to say, we should go there more than we do but thankfully he's not had cavities or required anything outside of routine cleaning (so far).

  3. Welcome to you both! :-)

    I think the issue with general anesthesia with Gus is that sometimes when autistic kids come out of it, the disorientation can really freak them out. I remember when Gus had his ear tubes put it, he was more upset coming out than going in. I think that sense of being even more out of control of his body than he usually is really did him in. Knock on wood, we won't have any more 'major' issues with him - I'm letting the teeth fall out when they are ready. MM on the other hand...

  4. Looks great! I love the baby pic up there...and nice bloody job on the button!

  5. :-) Thanks, Chris! Still a work in process, but I'm feeling pretty good about it! Unfortunately, not Gus's teeth - I doubt he'd keep his mouth open long enough for me to snap the pic. :-)

  6. We're trying my dentist now.
    My oldest with asperger liked his collegue better.

    Right at the moment I'm trying to get them to organise a morning all for autistic kids.
    Lights dimmed, straight from the front door to the treatment room, less equipment on the sidetable, better programs on the TV. (They installed one for every treatment room when I pointed out patients would relax better). No electric brushes, etc etc.

    Keep your fingers crossed too.


Welcome - thanks for sharing your insights!