Help! PDD NOS, SPD and Braces on his Teeth - What was I thinking!!!

[pattimomma]

DS got braces back in March. Everything was going fine (he was dealing ok with brackets and wires) until the last visit when they put in spacers. He totally freaked, tried to pull them out and had a MELT DOWN. We haven't had another appointment since then until today. Today he was freaking out before we even left the house. At the appointment he refused to sit in the chair or open his mouth so the appointment got rescheduled. I have no idea what to do other than try and get a script for an anti-anxiety like xanax just to use at ortho appointments. The only other meds he is on is vayarin for ADHD. The orthodontist wasn't very understanding last time so I have left a message for his manager as well.

Suggestions???

[livinglife]

Honestly, there is no way I would put traditional braces on my ds for exactly that reason.  Sorry.  I know that doesn't really help you, but....there you have it.  I also worry a great deal about the stainless steel braces leeching nickel into his bloodstream.  (more things to worry about I know!)  I would rather use an alternative to braces.

Personally, I would get them taken out, if you can do so without great cost.  Then look for alternatives to braces.  I have an appointment next month with an ortho who makes appliances to expand the pallet at the same time gently shifting the teeth back into natural alignment.  He has a great reputation and the good part is that the appliance can be taken out for eating and cleaning and if my son is just having a really BAD day.  Because what kid with sensory issues would enjoy having something in their mouth 24/7. 

Maybe you can find a similar kind of ortho in your area by asking around to other parents.

If you're wedded to your current situation due to expense and time put in you can try to find a homeopathic remedy or flower remedy to calm his nerves.  Rescue remedy is the great all around relaxing flower remedy.  Some calming herbs are lemon balm and dandelion root.  They can relax him into the chair so he can be rational and calm while they work on him

[Linda on the move]

For my DD (autism / sensory issues/ anxiety) we went with Invisalign. http://www.invisalign.com/Pages/Default.aspx
 

We chose this option because they can be removed, so if she really freaked out, she could take a break. They are more difficult for some people because you have to wear them most of the time and not lose them for them to work, but she is such a little rule follow/rigid thinker, that her SN made her the perfect candidate.

Being right in the middle of treatment, though, I don't know if you can switch without losing thousands of dollars.

Can they write a script for pain OR can you use high doses of over the counter meds to reduce his discomfort after treatment? My neurotypical teen had transitional braces, and she had a lot of mouth pain after certain visits, such as after spacers. I think that treating the root cause -- mouth pain -- makes sense as a starting point.

Did the Ortho know when you guys started that he had some issues?

[pattimomma]

We are a year into a two year treatment plan and I can't get out of the contract. When he got the braces I only had his diagnoses of ADHD and LD but I knew that he chewed things up so I was a little concerned about how he would deal with the braces. I just didn't know that it was a SPD or PDD NOS until several months after he already had them. Traditional braces are the only thing that will work for him because he would never wear anything that wasn't literally cemented to his teeth. It was going fairly well until the spacers. We do give him pain meds every time he goes. He also has anxiety issues and non compliance is how they manifest. This was the first time that he reacted to the appointment in this way so it looks like I will just have to make sure we have some meds before the appointment. The orthodontist does know about his issues but that doesn't seem to make a difference. The dental assistant is awesome though. We are scheduled for next Wednesday so I will update then. 

Thanks for the suggestions even if I can't really do anything about the situation it helps to have someone listening.
 

[earthmama4]

This is good to know. Its nothing I would have thought of ahead of time either!  My 11 year old has the same diagnosis and he needs braces really bad. :( I don't think anything but traditional brackets and wires will work for him because his incisors are high up, coming in above his other teeth. They are going to need to attach wires to them and pull them down over time (that is what they did for my sister at least), and I don't think invisalign can do that. Ugh. 

My heart goes out to you! My only suggestion in addition to trying the calming measures before his appt is good old bribery/rewards after his successful appointment. And make it a biggy. Something he loves and is willing to work for (because enduring sensory stuff is work for these kids)...a brand new movie or video game, Lego set, or going to a favorite restaurant (my kids love buffets so we save those for big reward times). 

[livinglife]

Pull up ALF on the internet as an alternative to braces (stands for, I think, alternative light force).  I read about it on another forum on mothering.  It looks very effective and it's a light force technique that expands the pallet to make room for teeth which have grown in abnormally and does not move the teeth.  It is VERY effective.  If you pull up their website and look at their testimonials it is surprising it isn't more well known.  It is used routinely in Ireland and other european countries.  We won't be using it but will use something similar to ALF with an appliance that moves the pallate but can be taken out.  ALF appliances are one long wire rooted into the mouth by brackets attached to back teeth.  The wire is made out of titanium and is adjusted slightly at each visit.  The titanium wire is on the BACK of the teeth, so not disruptive to eating and smiling, and is not abrasive on the inside of the lips the way braces are.  Better yet, since it doesn't move the teeth only the pallate there is no problem with tooth root breakage which can happen frequently with traditional ortho.  It apparently works for all sorts of traditional orthodontic problem spots.  If you are just in the researching phase you should definately check it out!  I LOVE mothering for info.   

[pattimomma]

Update: We gave him Xanax this morning, about an hour before the appointment and it worked like a charm! He was calm, he followed directions and all the office staff came by to encourage him and tell him how great he was doing. The next appointment is in March. We don't usually do meds but we will be using them at his next appointment too.

[Linda on the move]

I'm so glad that you found a solution that works!

I used to have high ideals, but at this point, I'm a big fan of What Work For Now.
 

[BibaDiva73]

My oldest son has severe ADHD and was diagnosed with PDD and possibly a mood disorder. The dentist already says he will need braces-- the thumb sucking that we tried to stop-- thumb guard he used scissors to cut off, incentive charts, etc. failed. He told us that he would take pliers and pull them out if they started to hurt and I believe he would. I don't know what to do when the time comes for him to get them. He's on 50 mg Vyvanse and almost 10 yrs old.