Dental work on autistic child

[Steph C.]

Back in November, my 2.5 year old ds had major tooth decay and had to be put under general anasthesia to get several crowns and several cavities done. He is autistic and mentally retarded due to a chromosomal abnormality. He nurses A Lot still, day and night. He also has severe sensory issues, so that any touch, particularly to his face and mouth are extremely traumatic to him. I'm really at a loss as to what to do, because I know he needs to be getting his teeth brushed, but the trauma we have to put him through every day(holding him down while he flails and screams in panic and terror), is so terrible. I feel so bad because I know it is not just that he does'nt like the tooth brushing, but he is literally terrified by it. It does'nt help any that I can't really explain to him what I'm doing and why because his understanding of speech is almost none. But I'm also very worried that he is going to have more tooth decay and I cannot bear the thought of putting him through that again. I am looking for any advice on ways to make the brushing any easier or other possible ways to clean his teeth.

[Smilemomma]

Hi, Steph, welcome to the boards!

You do have a challenge with this issue, I know. I have some specific info for sensorially challenged children, including those with autism spectrum, but it's at the office. I'll check it out and let you know what I come up with! I have a therapist that I work with who does a great job in helping to prepare these children, she has some info too.

In the meantime, there is a thread on here about "where's the straightjacket for brushing her teeth?" that has some tips on making it fun; I don't know if any would apply, but it's worth a look. There is also one in the Dental Archives.

Good luck, and congratulations on sticking with it; as difficult as it can be, I see that you've recognized it as the lesser of two evils.

[Ravenmoon]

My dd is almost 5 but she has very limited speech and comprehension.She is not quite autistic but is on the spectrum.I have read through the archives but i need a little more specific help for my dd.She has two major cavities in her bottom two teeth and they gave her nitrous to do the work but it didn't calm her down enough for them to do the work.I can not explain to her what they are doing to her because she doesn't get it.They delayed the work until August and they are going to try again with the nitrous.The dentist refused to use non amalgem fillings because of her age and the depth of the cavities.Is there anything i can do to convince him otherwise?Is this really true that he can't?He is the only dentist i can use because of insurance.Is there a better sedation method for my dd and is there a good way to prepare her for the procedure?Any input would be great,thank you!

[Ravenmoon]

Anyone?

[queencarr]

A friend of ours has a 6/7 yo child who is very axious, etc. to an extreme about dental procedures. Her dentist gives a script for Valium (4 tablets!) to be taken ahead of time, then uses nitrous, etc for the procedure.

We have a pediatric dentist who specializes in special needs children--CP, autism, etc; those with oral sensitivities; severe anxieties, things like that. You would not believe how well kids respond to him! I believe he does conscious sedation; many of his procedures are done in the hospital with an anesthesiologist. There is a way, don't remember the specifics at the moent, to "layer" the meds so that thye start with something oral, then when they are calm and almost out, switch to the more heavy meds. Is your dentist familiar with working with kids? They should know how to do this...

You may also want to petition your dental insurance for an out of network approval because of extenuating medical circumstances if you can find another dentist, especially if you have a diagnosis. A pediatric dentist, esp one who specializes in difficult situations, sounds right up your alley. Are you by chance near Dallas/Fort Worth?

Carrie

[Smilemomma]

:(

[khrisday]

I agree with the other posts, try to see another dentist and definately ask for a pre-med to calm her. My son who has Asperger's Syndrome had a mild sedatitive prior to out patient surgery and it made it SO much better for all of us.

[Ravenmoon]

Bumping to see if Smilemomma found some info!

[beanma]

boy, if it was my kid, i would NOT have amalgam fillings put in. i'm sure smilemomma will correct me if i'm wrong, but that bit about the decay being too deep and having to use amalgam just doesn't sound right to me. i've had a ton of dental work this year and they replaced many of my old amalgams and dug out deep decay underneath them and i've got the "tooth colored" composite fillings (and crowns) now. i've read here on the boards about other kids getting composite fillings, too, so that would seem like age wouldn't necessarily be a factor. if your child is on the autistic spectrum i'd be extra cautious about adding fillings with mercury to her body. that whole mercury/autism possible connection scares the bejeezus out of me. i know the insurance is a hassle, but even if you have to scrape the $$$ together to pay for it out of pocket, i'd go that route. you might could work out a payment plan. queencarr's advice sounds excellent. good luck with it all.

-beanma.