This will come as no surprise to those of you who have been reading with us for a while now, but Tony doesn’t like dentists any more than he likes doctors. We’ve not really discussed specifics much for his dental visits, in part because we’ve had years of experiences to talk about and I struggle to boil that down into one concentrated post. He’s been seeing the same dentist his entire life, and they have done such an amazing job of working with him and our family that I wouldn’t even consider taking him anywhere else.
When we first started taking Tony to dental check-ups, we couldn’t get him in the office without a stroller. By then, his terror of medical procedures and facilities was extensively rooted, having grown into a thickly trunked tree, so he would scream and thrash the entire time. He would stay slightly calmer in the stroller and we could at least get him in the building that way. Anxiety poos were a given. Then there were the visits where he ended up on my shoulders, one of which the receptionist kindly completed our paperwork updates for us while I bounced him up and down in that position. And, although our sweet son generally isn’t aggressive, he did intentionally kick a dentist who was getting ready to examine Hannah during one of her appointments with their team a couple of years ago.
Certainly there is no magic wand that renders him compliant with dental exams, cleanings, or procedures given the severity of his fears and sensory differences. To put it bluntly, if awake he will absolutely not cooperate with any of those things and will fight to get away as though his life depended on it if anything more than sticking a mirror in his mouth is attempted (and there was a time he would have fought even that with as much force as possible)- so he still requires either sedation or anesthesia to get them done for the safety of everyone involved.
A couple of years ago our little man needed two crowns and some other dental work, and this had to be done at the local children’s hospital for him. I think that particular experience has a lot of value both from the standpoint of therapy strategies and as a matter of general education for our loved ones and community. The length of those explanations will certainly require a separate post at some point in the future, so for right now we’ll just be delving into our latest dental visits.
Tony’s regularly scheduled bi-annual check up was April 1st. He’s far too big for a stroller these days, and had definitely mastered the art of using the back wheels to propel himself out of areas he didn’t want to be in shortly before growing out of the last one we used with him. Thankfully, years of consistent desensitization work has dramatically improved his tolerance of their office. For the last few visits he has successfully gotten out of the car, walked in, and waited without attempting to flee from the lobby.
When we visited for his most recent check-up, our little man stepped on the scale (that is the most cooperative he’s been on an attempt at getting a weight for the dental hygienist). This was pretty much the last of the cooperation, although he did stay calm about it. He insisted on going into the first dental exam area (rather than the room indicated). He plopped himself down on the corner seat (not the exam chair) and refused to get up. Nothing I offered him as a reward for moving enticed him to budge so much as an eyelash much less his entire cute self. The hygienist did an amazing job of just rolling with this and I will forever be grateful for her supportive and gracious handling of this situation.
calmly waiting 
getting more anxious 
not leaving this chair!
I had to scoop him up and lift him into the exam chair, and he definitely wasn’t interesting in letting the dentist or the hygienist put anything in his mouth, including a tooth brush. Emily, Whitney (before she moved), and I have been working on desensitization to dental tools with Tony for many months now. Currently, he will let both Emily and I insert a dental mirror in his mouth and look, and we can lightly touch his teeth with one of the scrapers. Recently Stephanie (the clinical manager for his ABA programs) and Cecy (the new assistant clinical manager) have started helping us by asking if they can look in his mouth with these tools during our bi-monthly meetings so that he can begin to tolerate this from individuals he doesn’t see as regularly.
One of the things I love about our kiddos’ dental team is that they are mindful of Tony’s quality of life. In addition to his fear level for these types of experiences, he struggled with a lot of non-dental related setbacks after the last procedure under general anesthesia. Since there have been no visible problems with his teeth, their office has demonstrated a great deal of sensitivity to these factors and let us space out the cleanings. The dentist we saw on April 1st was the one who put in the crowns, and he indicated that as our little man hasn’t had any new medical complications, they might be able to do his cleanings in-office under sedation this time. He did, however, want me to meet with the dentist who would be administering the medications first to get his opinion on the case.
So this past Tuesday we loaded up into the car and headed back into their office. That means between his most recent visit with his fabulous developmental pediatrician and the two dental appointments, this was his third medical visit in roughly a week. I made sure to inform Tony repeatedly that there would be no poking during this occasion because that usually makes for a calmer and more cooperative visit these days, however I was still pretty nervous because each medical trip over such a short period of time usually ratchets up his fear substantially for the subsequent one.
waiting again 
where I’m supposed to be 
playing! 🙂 Yes, the wall really curves in that room
Words are insufficient to express how proud I am of how well he did. He waited patiently, walked to the room he was supposed to, and when Tony tried to leave the room while the dentist was talking to us, our sweet boy stopped with only a verbal cue and raised hand. We were able to redirect him to another room for scheduling after being given the all-clear for performing the cleaning in-office under sedation, and our little man actually sat and played with a bead toy while we were working out the details. That is the first time I have ever seen him engage with anything other than a movie at their office.
Typically medical appointments are so stressful for our little man, we don’t attempt any other public outings on those days. For the past few months, I’ve been trying to push and stretch that, and sometimes it ends up as a flaming disaster if I’m being perfectly honest. But on Tuesday, we successfully went to the community pool right after the dentist. There were far more people than expected, including a group of elementary-aged school girls energetically singing “London Bridge is Falling Down.” All of this evoked some anxiety, and it took him about ten minutes to work up the courage to enter the water with so much noise, but once he did there was nothing but dimples and giggles for over an hour. This is a huge milestone for him to remain regulated in another public setting after a visit with any sort of medical provider.
The noise is a bit scary 
selfies & being brave 
working up courage to go all the way in…
We’ve worked very hard and he’s come such a long way. I know, however, there is so much more he and our team need to accomplish together as we continue to help Tony overcome his fears. I hope that maybe next time he needs a cleaning he’ll be able to tolerate it without the sedation. However, if we’re still not quite there yet, I know at least he’s in good hands.
