Dental drama

[smallworld]

husband took difficult child 1 to the pediatric dentist for a regular cleaning yesterday morning. difficult child 1 refused to get in the chair for the cleaning, despite 45 minutes of both the dentist and husband trying to convince difficult child 1 to cooperate. Afterwards, difficult child 1 told husband that he didn’t like the dentist poking his gums, the light shining in his eyes and the taste of the toothpaste, among other things.

About a year ago, the dentist also had no luck cleaning difficult child 1’s teeth. The dentist called me today to let me know that she didn’t think she could treat difficult child 1 any longer. She feels he needs sedation for a cleaning and treatment if necessary (dental hygiene has also been a problem at home in the last year or so).

At this point, difficult child 1 has not had his teeth cleaned by the dentist in about two years. He has not had blood work for drug monitoring since December 2005. difficult child 1 is behind on his immunizations (Tetanus, Chicken Pox booster and others). His neurologist has recommended an MRI, which would also require sedation.

Has anyone else had to resort to sedation to obtain routine dental work, blood work and immunizations? Any ideas on how to pull off what may amount to a pain-in-the-neck effort to coordinate all these doctors and services?

 

[LittleDudesMom]

Hey small,

We did have to sedate (not asleep) difficult child when he was quite young (perhaps 2nd grade) but have not had to since. He was given a liquid that made him extremely agreeable to anything they wanted to do. I even asked the dentist if she could prescribe that for him on a regular basis (tongue in cheek of course).

He does fine at his cleanings and does ok when needing a filling. We opted for no braces (fortunately his mouth is not that bad) because, having been through it with easy child, I knew there was no way difficult child would sit for all those appointments and discomfort.

Did difficult child have a negative experience at the dentist or doctor?

Sharon

 

[tryingteacher]

I am almost 30 years old and I have to be sedated....put to sleep at the dentist. I have PTSD and "the dentist" is one of my triggers. I have been fired from several dentist and it was really really hard on my mom when I was a kid. As an adult it is still hard on my mom. Being kncoked out is way way easier they experiencing such anxiety. I start with xanax or valium a couple days before and they strap my arm down and hook me up to the nitrous before they put the IV in and I do ok. It is less traumatic for me and for the dentist. I so wish they would have started this when i was a kid. It would have made trips to teh dentist so much better. Good luck.

 

[Wiped Out]

SW,
Sorry you are having to deal with this-difficult child at one point used to be afraid to get blood drawn but we never did have to go the sedation route. Now he loves blood draws, dentist appts, etc.-a little odd I know. Best of luck in coordinating everyone. Hugs.

 

[Marguerite]

Some kids need more TLC than usual. Some dentists (and other health practitioners) are not up to handling a difficult child. Don't blame difficult child, don't blame the dentist. You need someone who knows how to be understanding. And difficult child probably needs chemical assistance.

difficult child 3 has had blood drawn but each time has been increasingly traumatic. It has got to the point where we will insist on EMLA cream being used from here on. The last time - the pathology technician was rubbishing the idea, saying, "We can get this done so quickly, he's a big boy now," in front of him and not letting me talk to her in his absence, so I wasn't able to fully explain why we needed the TLC. it was difficult child 3 who was asking for "local anaesthetic". He TRIED to be cooperative, he's a good kid, but the stress tipped him into full-on anxiety mode, with vomiting and fainting. Naturally, this made his veins shut down so she could get very little out of him. Finally she had him lying down and we taking him through deep breathing to relax him. On every breath out, she got another few drops of blood from the cannula.

Never will we be fobbed off again. I've since been told that we CAN insist and any technician refusing will have to deal not only with me and difficult child 3, but with the doctor requesting the tests.

Marg

 

[timer lady]

We've used various interventions for kt - up to & including sedation for dental work, shots, blood draws, etc. This is just part of kt's PTSD. Thankfully we have professionals who know how to handle it.

 

[jannie]

My easy child was quite young but had/has issues with the dentist. They even decided they were going to "fix" this issue, by having several adults come into the office with a "restraint board"--thinking the threat of the board would be enough...obviously not understanding anxiety.... looks like a back board, but has fabric to wrap the child's arms and legs in....for some reason easy child thought it reminded him of a chrysalis :wink: so it didn't totally freak him out...needless to say we found a new dentist.

I would consider the sedation route..a good cleaning can take 30 minutes...I'd contact some new dentists and discuss this with him. Has he ever tried nitrous oxide (laughing gas)--

Sorry this is happening. I understand the stress--and easy child also needs fasting bloodwork as well...we were on our way to get the blood draw and he runs to the refrigerator and quickly stuffs food in his face... :nonono:so he could avoid the blood test...it's still not done.

 

[1 Day At a Time]

We are very familiar with dental drama with our difficult child. I decided to search high and low for the "right" dentist when I realized that this was never going to get any easier. I found her a few years back and she is just what the doctor ordered. I suspect she was a difficult child herself. I say this because of the way she understands difficult child and his sensory issues so well and the fact that she had a complete and total meltdown herself once when my husband was fifteen minutes late getting difficult child to his appointment. She called me at work and complained about my husband for 20 minutes - but that's ok - she works miracles with difficult child. She is willing to use laughing gas as needed - and she has been able to pull 4 teeth when he got his braces and do a root canal and crown (we are desperately hoping that will be the only one). Unfortunately the medications that difficult child must take have a horrible impact on his teeth, and there is just no way around it, he has to have those medications due to his neuropathic pain issues. I highly recommend finding the right pediatrician dentist. We tried out lots of others before we found the right one. I hope ours never retires!

 

[dreamer]

I was awful at dentist, having needed teeth pulled as a preschooler and after the first one, I thought the novacaine shot hurt most, so demanded they do my next one without novacaine, OUCH- it was a few years before I went back. Mom would take me, I would bolt.

My oldest child had the misfortune to have her first dental visit be with a dentist who demanded parents not stay in the room- what did I know- she was my first child- I left the room- and returned to find my daughters entire face bruised with tiny bruises from dentist holding her by her face. She was severely traumatized. SHe gets in dentist chair and her jaw clamps shut tight, and she breaks out in hives. Her heat races dangerously. We have tried buspar, ativan, chloral hydrate, clonidine, klonopin.........with no luck. This is my child who even inpatient at the hospital, they could not get a blood draw. She never did get her last set of child vaccines for HS becuz the docs office and hospital could not manage to do them. Sedation seems to not take hold on her until after we leave and go home.........her anxiety seems to hold off the effects or something. Sadly our phops did not help- they refused to restrain her for an attempted blood draw, and refused to sedate her and they did get the needle in, and she broke loose and got severely injured in the process.

My little guy, my son, turns out, he was having some dental work done and after the novacaine he began to SCREAM. VERY unlike him, he did not scream for IVs for 2 different surgeries, did not scream during blood draws even when they messed those up really badly and hurt him pretty bad, requireing further treatment for the injury (he did not move, the nurse was just THAT bad) After he began to scream, he became quite physical, again NOT like my son AT ALL...............and after 2 VERY serious and 9 hour long eye surgeries, whew!
Turns out he is allergic to some of the things they use in dentistry. It is rare, but, I guess the novacaine makes him feel as if he is on fire. Literally......The first time, the dentist berated my son...the 2nd time the new dentist chastised ME for "permitting my son to behave this way" the 3rd dentist said "this is ridiculous" and the 4th dentist said oh my, you need to take your son to an allergist. The allergist did a challenge test and found out my son is one of the very very few who are allergic. ANd my sons reactions are not all so "over the top" after all.

Sadly my DHs genes are for very bad teeth........and all the problems associated with behaviors and dentists etc mean my kids have sad sorry mouths full of bad teeth. Add in that when we were on Medicaide for years, - well, one year our school had dental screenings a few days after our Medicaide dentist supposedly did cleaning XRays and work, well, the dental screeeners at the school called CPS to report we had not been taking care of our childrens teeeth.........so- what did the Medicaide dentist DO ? Turns out nothing at all----- (fraud) 2 years later it happened again, even tho we had a different dentist.
And now? Now we have no dental coverage at all....husband and I are both on soc sec disability but we do not qualify for Medicaide for the kids. My kids get health coverage thru VA, but they do not provide dental. AND living on soc sec does not leave the thousands it is now going to cost for my kids teeth. :-(

SUch a sad mess.

 

[TerryJ2]

Go for sedation but be extremely careful... kids don't react the same way adults do.

As an aside, my older sisters are identical twins. They were PCs, but still, they didn't want to go to the dentist. When they were very little, maybe 7 or so, they changed places and the other one sat in the chair. Then she refused to open her mouth. No one could figure out who was in the chair and who was in the waiting room. Both of them got out of the appointment! LOL! It was very clever. My mom was very frustrated. But it still makes a great story, 45 yrs later! :grin:

 

[smallworld]

Thanks for sharing your experiences. It's reassuring to know that we're not alone.

I don't blame difficult child 1, and I don't blame the dentist for what's going on. The dentist is gentle and caring. My girls love her and go for cleanings willingly. difficult child 1 has been seeing her since the age of 3. Since his mood disorder worsened 1.5 years ago, he has gotten more anxious about doctor visits in general, although he has always had major anxiety about anyone poking and prodding him. From the age of 3 months to 15 months, he had non-stop ear infections, which were very painful. Then from age 2 to 4 years old, he had chronic tonsillitis, which led to a tonsillectomy and a painful 10-day recovery. I think he associates pain with anyone who comes near him with a medical instrument.

I've had an email conversation with our pediatrician, difficult child 1's psychiatrist and neurologist. They know of a clinic at the University of Maryland Hospital that performs all kinds of medical procedures under sedation. We're in the process of exploring whether we can get the dental cleaning, blood work and immunizations done under one sedation because obviously, the fewer sedations, the less risk involved.

Thanks again everyone.

 

[inneedofhelp]

When ours was very young I would say almost 3 he had very bad teeth. With no avail he would not let the regular dentist use nitrous on him. Said that it stinks and refused to put on the mask. We had to take him to a pedio dentist in and they knocked him out cold. It was by far the best thing for him as he came out with 10 stainless steel crowns and no trauma from the experience what so ever. Now as a dental assistant I myself have worked in his mouth and does have a little cavity going to see how it goes this time around. I would highley recommend going that route if you decide that. Much harder on the parents then the child. In my experience. Good luck with everything

 

[Marguerite]

What about the zoo? They do dentistry on lions, bears, chimps and orangutans under general anaesthetic there. So if they can do it for animals, especially animals which they cherish and pander to, there should be someone somewhere who can do it for your son.

What about dementia patients? Not al are old and toothless - and trying to do dental work on a panicky dementia patient has got to be a BIG problem. Seriously, why not contact a dementia support group, ask THEM how it's managed. Huntingdon's Association? A lot of people with active Huntingdon's are still young and need regular medical care, especially with dental work. The last thing a person with dementia needs, is a dental abscess. To put them through the ordeal of dental work is too traumatic, does too much damage to their ability to cope emotionally. Maybe they know of a technique or a practitioner who can help your son.

OK, your son doesn't have dementia, but similarly he can't cope with the trauma of various procedures without anaesthesia or at the least, heavy sedation. Medazalam, anyone?

Marg

 

[TerryJ2]

Ew! What horror stories!
Good thing it's a free market and we can shop around.

 

[sweepymom]

I have not had to resort to sedation for anything but I have had to go and buy 8 the baby toothpaste to make dental hygiene easier for me to enforce.

 

[Sunlight]

I have to say I understand these stories. there are good and bad dentists. I have worked since 1971 (after dental tech school) as a hygienist, an assistant and now as practice manager.

by the way I walked out on one guy I worked for three yrs...after he slapped a young boy across the face and threw his hand mirror across the room. I went to the waiting room, told the mom and the mother said "well Mikey should have behaved"
I walked out and never returned.

the guy I have worked for the past 26 yrs would never ever hurt a child. we do preschool tours of our office and love to let 200 3 and 4 yr olds come (in small groups of 10 or 12) and play with out chairs and squirt guns, we show them their teeth on TV, we have tooth puppet shows.

when they are 3 we try them for the first visit...a ride in the chair, the polish on their teeth in yummy flavors. if they have tons of work to be done, we may try first "sleepy juice" that the doctor RX for the patient. they come in groggy. if they are really defiant they are sent to a pedodontist who employs an anesthesiologist. they are put out and all work is done at one visit.

older people tell me every day of the traumas they had as kids. a lot of people were not given novocaine and it hurt. we have a drill-less air abrasion machine used on kids to fix fills and not have to have a shot. it blows pumice on the tooth and cleans out the decay. the kids wear sunglasses and we have cartoons on TV when we do it.

it doesnt have to hurt and if it does....go elsewhere.

 

[Marguerite]

I had a butcher of a dentist as a kid. Even these days, I'm a nervous wreck in a dentist's chair. But I'm easy child, not difficult child. For a difficult child it can be a lot worse.

difficult child 1 had to have all four wisdom teeth out as they were impacted in a crowded mouth. For reasons which escape me, he chose to remove all four wisdom teeth in one appointment, under local anaesthetic. difficult child 1 was stoic during the procedure, but as the novocaine was wearing off and for the next few days, he was a basket case. Hysterical, screaming, banging his head against the wall, crying, and generally very difficult. He basically was not coping emotionally or physically. Painkillers wouldn't touch the pain, so he wouldn't take them. I hope I never have to endure a reaction like that. difficult child 3 will need remedial dental work, but nobody is taking out al four of his wisdom teeth in one go.

BF2 (also a difficult child) had to have a tooth pulled a few months ago - he's another dentist phobic, he was almost panicking in the chair. Although he's not my kid, I had to hold his hand and stroke his head to keep him calm - and he's not demonstrative with me usually. And that was with gas!

Marg

 

[Kjs]

difficult child had an MRA scheduled with contrast. After about an hour of waiting in the waiting room they called myself and husband back. He wouldn't get on the table. (he has had MRI's in the past, no contrast)We talked, argued, demanded, yelled..he would say ok..walk in the room, and come right out. Can't do it. He was so worked up he couldn't breathe, chest pain, red face, crying. They brought him back a valuim. He wouldn't take it. I was so upset by this time, several hours and had to leave for work. I sat on his lap and shoved it in his mouth, just to have him spit it out and then couldn't find it. Nurse said it wouldn't do much good because he was so worked up, so much anxiety it wouldn't work. Nurse said he needs to calm down to let it work and that didn't look like it would happen. I left for work, thinking he wouldn't do it. He did. No sedation. husband said they just had to settle him down. He was afraid of "dirty needles".
Dentist is ok, but never had a cavity. Hair cut..my neighbor is a beautician and has been the only one who ever cut his hair. Except ONCE. Brought him to cost cutters, and they cut the top of his ear. So..now we wait until neighbor has the time for hair cuts.

 

[Marguerite]

Kjs, your description of difficult child needing reassurance - it's classic. If only they had worked out what the problem was sooner, all he needed was to have someone SHOW him how the sterile needles are packed and talk to him about it, it would have saved a lot of time.

There are adults who react the same way, they are NOT treated the same way our kids are. But when we Do treat our anxious kids like any other anxious person, we generally get as good a response as anybody could get.

When difficult child 3 had to have those bloods taken, he was cooperative despite his anxiety. But because the technician forced the issue and rushed it, she got no blood out of him because he went into shock and his blood vessels closed down. It would have saved her a lot of time and effort to treat him with respect.

I do think a lot of our kids' anxiety doesn't get treated with the respect it needs. Just because they are kids doesn't mean they should be ridden over roughshod. Nor does it mean that their feelings aren't real, or don't matter.

I like the way you have an arrangement with neighbour to cut his hair. You're doing the right thing, supporting him and letting him have these small positive experiences that get you what you want also - his hair cut!

We've now found a hairdresser that difficult child 3 can cope with. They are very good with him, they reassure him well and show him exactly what they're doing. Before that, I had some disasters with his hair - trying to trim a moving target! The time I had to buzz cut his hair was the worst. It looked awful too, but he cooperated because he had a head full of grass ticks and shaving his head was the only way I could find them all. He'd been patient while I picked the other 150 off his body... and then he came home from school a few days later with another hundred. The incentive then was powerful enough for him to put up with me grooming him. Usually, it's not and we have to find creative ways. I've even tried aromatherapy massage to calm him down. It works, but only a little.

Marg

 

[smallworld]

Kjs, my daughter (difficult child 2) has had MRIs twice. Both times she had general anesthesia because of her anxiety. This is very commonly done at the Children's Hospital in our city.