Lil’ Bit by Lil’ Bit: The Return to the Dentist (#385)

A beautiful portrait of Charlie, top two front teeth missing, sits on my in-laws’ coffee table. It is a school picture, taken in September 2004 when Charlie seemed to be on a path to partial mainstreaming in our old town. It was in the months after taking that picture that Charlie’s teeth came in—one crookedly—and that he began to struggle so much at school that Jim and I sought a different placement for him, that first resulted in him attending a private autism school in December 2005 after we had taken him out of school for a month, and that ultimately resulted in our moving in with my in-laws.
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We have not taken Charlie to the dentist for over a year after a traumatic visit in February 2005 in which Charlie had to be held in the chair by four people, got his mouth nicked, and said “pee ah pee ah” after every sentence for a month (he had gotten a sore under his tongue). The hopelessness that Jim and I felt after that experience was a feeling we felt again and again in 2005 as Charlie continued to struggle even more at school, to head-bang more and more, and to just seem stuck. It was a year ago that we started Charlie again in an ABA/Lovaas home program similar to what he had done so successfully as a toddler, and it was about a half a year ago that Charlie started again to like, to love school, to learn how to read, to be nervous if the schoolbus did not appear, to be peaceful-easy.

So it has been time to return to the dentist, and that was how our day began.

After strategizing for the past few months—finding a dental practice with “experience wth special needs kids”; buying dental tool kits from Walgreens (one for school, one for home); visiting the dentist’s office and talking to the staff with our ABA consultant; taking photos for a “dentist book”; going over the book with Charlie before taking him to visit the office; brushing Charlie’s teeth with an electric and a manual toothbrush and finally getting the orangey gunk off the top (under the lip) of his large and definitely crooked right-front tooth; after preparing a backpack with the “dentist book,” token board and tokens, several squishy balls, some frozen French fries——–

After wondering, are we going to have to put him in a papoose? Are we going to have to take Charlie into a hospital and have him “knocked out” under an anesthesiologist? If Charlie has a major problem with his teeth, won’t that have a major effect on his health, eating habits (and Charlie likes to eat), everything?—-

(Yes, I have been engaging in some autism mother catastrophic thinking)—-

After all that, Charlie had a great visit to the dentist this morning at 8.15am.

(Sometimes, you can plan too much.)


It was “great” in the sense that Charlie went into and left the dentist’s office with a positive view of the whole experience. On the way there, he started to say “den-tist, den-tist” earnestly yet calmly. Soon as he sat in the chair, I slipped him a spikey squishy football into his hands, and this helped (partially) to prevent Charlie from pulling at the hygienist’s or dentist’ hands. The hygienist and Jim gently prodded Charlie to stand in a machine for an x-ray; Charlie had to bite down on the x-ray film but only did so for a second, and he needed to hold the bite long enough so that the hygienist could turn on the machine. Charlie was doing it but put his hand into a crevice, shrieked when it got squeezed, and stayed calm. He went back to the dental chair where the dentist turned off the lamp that was glaring into Charlie’s eyes and first counted Charlie’s fingers and then his teeth.

(Jim and I did our best to stand to the side and smile rather than looking nervous.)

“He’s doing great,” the dentist said. “He’s staying in the chair and some kids won’t do that at all.”

The dentist put a nose mask over Charlie’s face and, when Charlie was okay with it, he hooked up the mask and Charlie started to lean back and grin a little goofily, thanks to the flow of nitrous oxide. He attempted to start cleaning Charlie’s teeth but, at the first kick and pull, he told us he thought it best to wait until the next appointment. Charlie’s teeth looked good—-apparently my attempts to get the brush in and Charlie’s patient endurance as I do this have been sufficient. I made several mental notes about working first on Charlie keeping his mouth open for a few and then several seconds, about gently getting Charlie used to having those stange metal implements near and in his mouth.

Charlie got out of the chair and off to school, a little groggy. He had trouble once with a transition mid-morning and his teacher and I agreed, he had certainly had to go through several (some new and unusual) transitions in a short period of time.

And the day held more: Charlie took the bus home and then I drove him back after ten minutes for a make-up session with the school speech therapist. We went to the pool and had to leave before Charlie swam due to someone doing something in the shallow end that will require total disinfection of the pool. (It wasn’t us!……Yes, I have worried in the past that it could have been us.) En route to get Grandma (who, after being in bed or a wheelchair since January, took six steps yesterday and today) some socks, we got stuck in traffic due to a car-truck collision. After a lively visit with Grandma who expressed her pleasure at having the three of us living in her house, reminded me to make sure the live-in nurse has enough to eat, and accepted a “muh” kiss from Charlie, he and I had to wait ten minutes to leave the rehab hospital when another wheelchair-bound resident wanted to go outside, but could not without a nurse (resulting in the front door being locked).

“Say p’ease!” laughed Charlie in the car on the way home. “Lil’ bit.”

Bit by bit, Charlie—we—my mother-in-law on her swollen feet and weak legs—have been finding our way.

Success is counted sweetest
By those who ne’er succeed.
To comprehend a nectar
Requires sorest need.

Writes Emily Dickinson.

We may not succeed entirely, but how we do try. Lil’ bit.

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Comments
7 Responses to “Lil’ Bit by Lil’ Bit: The Return to the Dentist (#385)”
  1. Congrats Charlie! I understand Charlie’s fear of the dentist. I have an extreme phobia of the dentist. Novacaine does not work on me and I have had to be put asleep several times. I use to think my fear of the dentist came from my childhood because one dentist repeatedly hit me when I wouldn’t cooperate and complained that it hurt.

    I “prayed” that Alexander wouldn’t inherit my poor enamel, but alas he did. In January we took him to Duke University to have 4 crowns put on as well as some type of stuff that coats the teeth and prevents cavities. He was placed under GA as I sang Twinkle Twinkle Little Star to him. It also helped that a month before I made two small exit signs for him and gave them to him while we were waiting for the operation room to be readied. It was a good experience despite our fear of GA and its effects on his developing brain.

  2. Christine says:

    I worked through college as a dental technician and let me tell you: going to the dentist causes anxiety for a LOT of people — autism or no! Sounds like Charlie did a great job!!

    I also wanted to tell you how impressed I am by how much Charlie’s language skills seem to have progressed over the last year since I started reading here. Way to go, Charlie!

  3. There is a dental practice called The Sensitive Patient around here…… Jim has some “dental anxiety” of his own; I was lucky to have a very nice, soft-spoken, dentist and then my favorite uncle as a kid.

    Nonetheless, I have to say, dental offices esp. for kids are not the barebones places I remember. The office was bright and cheerful, with open spaces, video games, a movie theater (for watching an informational “Dudley the Dinosaur” video), balloons, prizes, very nice staff, you name it. And, of course, TV monitors above every chair.

    Now it’s back to brushing and flossing….

  4. Daisy says:

    Over preparing? Probably not. I’m sure your preparations made a great deal of difference in Charlie’s comfort level. Associational memory of a bad experience is hard to erase; you did very, very well, and so did Charlie.

  5. Typepad.com had an interruption in service yesterday and two comments to this post disappeared—the comments did make it into my email inbox, and here they are.
    ————————

    Alexander’s Daddy of http://morethanalabel.blogspot.com/ wrote:

    Congrats Charlie! I understand Charlie’s fear of the dentist. I have an extreme phobia of the dentist. Novacaine does not work on me and I have had to be put asleep several times. I use to think my fear of the dentist came from my childhood because one dentist repeatedly hit me when I wouldn’t cooperate and complained that it hurt.

    I “prayed” that Alexander wouldn’t inherit my poor enamel, but alas he did. In January we took him to Duke University to have 4 crowns put on as well as some type of stuff that coats the teeth and prevents cavities. He was placed under GA as I sang Twinkle Twinkle Little Star to him. It also helped that a month before I made two small exit signs for him and gave them to him while we were waiting for the operation room to be readied. It was a good experience despite our fear of GA and its effects on his developing brain.
    ———————

    Christine of http://daysixtyseven.blogspot.com/ wrote:

    I worked through college as a dental technician and let me tell you: going to the dentist causes anxiety for a LOT of people — autism or no! Sounds like Charlie did a great job!!

    I also wanted to tell you how impressed I am by how much Charlie’s language skills seem to have progressed over the last year since I started reading here. Way to go, Charlie!

    Thank you, friends!

  6. kyra says:

    i’m so glad the dentist visit went so well! congratulations to you, jim, and, of course, charlie! fluffy needs to return to the dentist to find out why his gums are hurting and i don’t look forward to it. time to break out the dentist play kit!

  7. Julia says:

    Glad to hear it went so well!

    I took my 3 in for getting their teeth checked in 2 appointments (the twins doubled up), and Sam did not want his teeth cleaned, but he handled having them counted and examined without too much trauma. (The only one who got teeth polished was my daughter, and we were all very proud of her for how well she handled it.)

    And I love this dentist – I saw her for the first time a month before I took the kids in, and she noticed that my palate had a little bit of a weird shape and remarked that it probably made holding in the bitewings for dental X-rays uncomfortable; this was the first understanding I’d had about that problem, and there’s a good explanation for it, it turns out! (I won’t be going 3 years between dental visits now, I think!)

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