Thursday, November 19, 2009

In which it takes six hours to fill a cavity

I have a good dentist. A really good dentist. After years of seeing not so good dentists I can tell the difference. But even my really good dentist couldn't make the dental experience trouble free with my fair boy. Teeth brushing has always been a challenge for us. When Oliver was very young it was downright traumatic. It was so traumatic that I negotiated with my husband: Look, I'll do all the breastfeeding -- I'll take care of nourishing our son -- if you would only just brush his teeth every day.  Somehow he agreed and when it was time for the brushing of the teeth I always left the room.

We started taking Oliver to the dentist every three months at around age 2.5 for "happy visits" so that he could get used to the experience. I also bought a set of dental instruments at a local pharmacy so that he would get used to the tap tap tap of metal against his teeth. Those things, plus maturity, seemed to have helped.

Teeth brushing has gotten easier but a combination of sensory defensiveness and genetics led to Oliver's first cavity, which I noticed a few months ago as a small dark spot on his last right molar. When I brought it to the attention of the dentist he told me that even though he loved having our boy as a patient, there was someone in town that was better suited to work with Oliver. Based on his sensory issues, he told me, a cavity probably meant that the work would have to be done under anesthesia at the local hospital. Today was that day. 

As much as I love our really great dentist, I have to say that this new, pediatric dentist who specializes in special needs kids, was totally, incredible. His staff, his office and his entire demeanor set Oliver and I at ease when we met for the initial consult. The one time when Oliver started to get agitated I offered a suggestion and the dentist, only allowing the teeniest bit of annoyance to show on his face, changed his approach. When my suggestion worked he was quick to earnestly thank me for my help in making it a successful interaction. I knew right then that he would do a great job with Oliver.

Today Oliver did fantastic. He wasn't allowed to eat before the procedure and even though I had explained that to him the night before, I was surprised when my ever-hungry boy didn't ask for breakfast this morning. Everything went without a hitch except that he vomited the sedative all over me after I forced him to drink it despite his adamant refusals. Every time I do that I regret it. (Note to self: don't do that!!)

I also asked three staff members to get me one of the face masks that he would have to breathe through after they took him to the operating room and all of them acted like it was too difficult. Finally, I asked the dentist himself and he replied: "Great idea! Let me go fetch that for you!"  A few minutes later he returned with one and I was relieved to see that Oliver thought breathing into it was very amusing. Later the dentist congratulated me for thinking of it and said he would offer the same to other parents in the future.

When they finally wheeled Oliver away from me through the operating room doors I let myself realize just how emotional the whole experience was. The nurse standing next to me said: "There's just no two ways about it -- being a mom is hard." And he was right. It is hard sometimes. I went to the cafeteria for a cup of coffee and a yogurt and felt so weepy that I had to keep reminding myself: it's just a cavity!! In the grand scheme of all the reasons why someone might wheel my child away toward the operating room it was a very small thing.

Still, after the quarter incident early this year, I earnestly hope we don't see the inside of a hospital again any time soon!!


  1. Anonymous9:27 PM

    So glad it went well. Hugs.

  2. Oh man! We are scheduled for this same exact situation on Dec. 4th. GULP! Well, that is the scheduled date right now, but we have been trying to get approval from insurance. Like you, we take Andrew to a "special" dentist who is also good, but two cavities filled in hospital under general anesthesia is what is planned and our medical insurance is saying they won't cover it. We are now talking with Brian's HR department, so we'll see.

    But, Andrew had surgery when he was 18 mos. for an undescended testicle and he also had his frenulum (piece of skin under tongue) clipped at the same time. I remember how hard it was to watch them wheel him away. I am DREADING this dental surgery. And yes, I know, it's just a cavity. Count our blessings, but I will be very emotional I am sure.

    Glad it all went so well for Oliver. Oh, and wait, did it really take 6 hours??? The lady at hour dental office said the most and hour in surgery. I guess you are talking about the whole day start to finish? Right? Oh man, the no eating thing in the morning is going to be a huge issue for my boy!

  3. Sure, just a cavity, but I'd be weepy, too! Glad you at least had an awesome dentist. I have been traumatized by several dentists in the past, so I sure appreciate the good ones.

  4. So how did you resolve the sedative thing? Did he have to drink it AGAIN after vomiting? Henry will also vomit if forced to drink something.

    I'll never forget when Henry had his ear-tube and adenoid surgery. So hard to drug your kid and send him off. We were in a room full of parents (this place was like an ENT factory) and I felt like I was the only mom who was upset. Maybe the others just hid it better :-)

  5. Gretchen, I DID have to make him drink some more. The next time though they let me dilute it a bit with some ginger ale to make it more palateable. He still only drank about 1/2 of it but I guess that was enough.

  6. Sounds like your dentist is at least willing to work with you. (Wish I could find one like that!)

    I can tell you, having watched nik being taken to the OR more times than I ever imagined or even want to think NEVER gets any easier. It just gets easier to hide the emotions until you're alone. I *still* cry when Nik has a simple procedure like ear tubes done.

  7. Anonymous11:18 AM

    That's an amazing story. My three kids are neurotypical (that's the P.C. word for "normal") and they actually like going to the dentist, even the oldest boy who had to wear braces.
    I used to teach autistic kids and I noticed that some of them had HORRIBLE teeth -- brown and crooked and breath that would knock over an elephant. I guess their parents couldn't get them to brush.
    General anesthesia poses a danger in itself. I know it was necessary in this case but are you going to have him knocked out every time he has a cavity? What about if he needs braces? He can't be knocked unconscious for three years, what will you do then? I've read about autistic kids who actually pulled out their braces!
    I'm not criticizing, I'm just curious about what must be a very difficult process to go through to make sure your boy's teeth are healthy.

  8. Anonymous, Oliver has really great teeth -- straight and healthy. So I hope we never have to go through this again. But you never know. And yes, I would do the exact same thing for every cavity if I had to. It probably sounds extreme to someone who has never been to the dentist with a really sensory defensive kid but it is most definitely kinder and gentler than the alternative.