Monday was our semi-annual trip to the dentist. I doubt I need to go into much detail as if there’s one universal dread we share as parents – and a mortal fear that most of our children experience a thousand-fold worse – it’s the dentist. No offense to the dentists in the world, but with every system in your body on sensory overload most of the time, having a bunch of people crawl around in your mouth with loud and/or pointy instruments under bright Klieg lights isn’t really a recipe for that peaceful, easy feeling.
The truth is, it sucks, and all we pray for is that no one is injured as a result of going and that our son isn’t permanently damaged emotionally. We get through it because we have to. I know many parents avoid it altogether. Seeing our children experience what looks like – and likely is – frantic terror is something we’d do about as willingly as having a few fingers chopped off. I guess we just decided that some kinds of bodily care have to be done, and we have to accept what comes as part of that as best we can, which usually isn’t very well.
Monday’s visit was about typical. Lots of wrestling and J-Man screaming and all the dread and parental guilt that goes along with it. It helps that we fired the dental practice that treated us like second class citizens over a year ago. We love our current dentists. They’re constantly saying affirming things to the J-Man, they are completely calm about everything, and they get it done fast. Worth every penny.
But Monday we had to start coming to terms with an issue we’ve never been able to make peace with – to use restraints or not.
To this point, we’ve never used mechanical restraints on him for anything, medical or otherwise. It’s all been a variety of holds that aim for close body contact (deep pressure and hopefully reassurance) without doing anything that looks like it belongs in a pro wrestling ring. We’ve strained a dozen or so of our parental body parts along the way, but the thought of him bound up in something while strangers worked on him in his already terrified state was too horrible to consider.
However, it now takes three of us using all of our strength and skill to hold him at the dentist. I’d suffer a thousand injuries for him over and over again to make it easier on him. But he’s getting so strong that I’m almost to the point where I can’t hold him without hurting both of us, particularly him.
This leaves us with a possible outcome that we dread – using the papoose board. (Link to a product page – click the Images tab for more pictures) The idea of wrapping him in one of these restraints makes my blood feel cold. Even more mortifying for me are ones I’ve seen at hospitals that have the arms extended outward such that the child looks like a swaddled crucifix. Even though they don’t use those at the dentist, the image stays with me.
I can come up with one possible justification for a papoose board for some autistic children that makes some rational sense. For kids like the J-Man who crave deep pressure in their bodies and are calmed by it, there is a certain logic to using it. It wraps them tight, gives them full body pressure, and simulates to some degree the kinds of deep pressure work he seeks out whether as part of occupational therapy, sensory copying techniques, or whatever. I have read the experiences of a couple of other parents whose children were indeed calmed by the papoose board for this very reason. If the J-Man wasn’t a child who responded to deep pressure many times a day in daily life, I can’t imagine trying a papoose board.
The main question is whether we’re more likely to hurt him with three, four, or more of us trying to hold him vs. using a papoose board. Up until now, I’ve felt like the answer to this question has been simple – just hold him and do the best we can. He’s getting stronger and stronger by the day it seems, though. There will come a point where we can’t hold him. I’m trying to make peace with the idea of trying it once, and if it looks like he’s worse with it than without it, we’ll fall back and think of something else.
I know he’s scared out of his mind. Our hearts break into pieces for him. I’d give anything if there were some way we could talk him through it and reassure him. Feeling powerless is a common emotion for all of us, and this is one of those instances where that feeling is unavoidable.
That day six months from now is going to be full of dread. In the meantime, we’d love to hear your perspective.
Posts that hopefully are similar:
- Boy vs. Dentist – The Next Chapter
- Our Last Trip to the Dentist – or That Thing I Haven’t Wanted to Talk About
- Our Trip to the Dentist
- Survived the dentist!
- Dreading the dentist…
- You Kinda Get Used to Weeks Like This
- Time For Our Semi-Annual D-Day
{ 8 comments… read them below or add one }
We’ve successfully avoided the dentist for quite some time now bc we left the only “pediatric/speecial needs” practice for also treating us like second-class citizens. The last time we went, we had to give Nik valium. Yep, good times to discover that (a) it didn’t do a damn thing to calm him and (b) he has a paradoxical response to it. (Think preschooler on angel dust. UG.LY!)
So, I don’t have any great suggestions except this…don’t use the papoose board. Not without trying it a time or two just to see how he responds. Will the dentist set up some appointments where s/he doesn’t do anything except let J try the board, touch the instruments, see how things are done on someone else (you or Mary??), etc.
My son loves deep pressure but the papoose boards (we’ve had to use them in the hospital a time or two) FREAK HIM OUT. What about a weighted vest or blanket?
I hope you come up with something that works for all of you and which doesn’t feel traumatic to any of you!
We haven’t taken Moe to the dentist yet. He just turned 3, so it is time. Can you try going just once a year instead of every 6 months?
@niksmom has the same thoughts I did: try it at home first to see how he reacts, and maybe try a few “desensitizing” trips to the dentist where he gets to go and not be touched. Maybe he even gets his favorite candy/toy/whatever. Sedation is scary to me, but definitely something I’d try if necessary.
Good luck. I can’t think of anything worse than watching my kid suffer while restrained, but if it does calm him, go for it.
Let us know how it goes. Our dentist is the gentlest, kindest, most engaging man I’ve ever met. He reminds me of Mr. Rogers. Goldilocks absolutely loves him. When he knows he has an appointment, he says, “I get to visit Dr. N., my dentist? Hooray!” and runs to the car.
But it wasn’t always this way. At first, Dr. N. was not sure he could handle a patient with autism. He referred him to a “pediatric/special needs” dentist who he said would give him a sedative. He teaches at the state university dental school, but he didn’t feel comfortable prescribing a sedative, because he felt that was outside his area of expertise.
The “pediatric/special needs” dentist was horrible. She refused to give the sedative she had promised, and instead, put her knee on his chest and told Mama to hold his legs, all the while scolding him for being “naughty”. He was so terrified, she couldn’t even do a basic exam. Mama Bear promised Goldilocks he would never have to go see that mean lady again.
When we reported this to Dr. N., he was shocked, and said he would never refer anyone to her again. He also agreed to give Goldilocks a chance. He scheduled him for a slow time of day with his gentlest, most patient hygienist. At the end, he came in, introduced himself, shook hands, and sent GL home with a big bag of trinkets. With each visit, he did a little more of his usual exam, eventually working up to a cleaning, complete exam, and x-rays.
But on his last visit, Dr. N. found a cavity. Next visit will be GL’s first filling. Dr. N. is willing to try it, but is still not ready to prescribe a sedative. GL has his daily meds, plus an extra Trazadone tablet to be given PRN, and we’re going to try it with that.
When GL had stitches, it took four men to hold him down, and he was two years old! Now he’s thirteen. Once, after surgery, he had a bad reaction to morphine. The doctor said not to give him any more morphine, but wouldn’t start a new pain med until the last dose of morphine was out of his system–and they had just given it. He got so upset, he stood on the femur that had just been sawn through that morning. Desperate, the nurses put a bolus of valium in his IV. Have you ever watched an animal be put to sleep? We had a cat once that was dying and in misery. Mom wanted to be certain he was out of his misery, but couldn’t bear to watch. She asked me to take him in, and watch to be certain he was dead. GL’s response to the valium looked exactly like that. It was frightening, disturbing even. But when he awoke, he was calm, and they were able to give him a different pain med.
All this to say, medication makes me uneasy, but compared to GL’s meltdowns, http://findmyaddress.blogspot.com/2010/08/meltdown.html
or seeing the “pediatric/special needs” dentist again, (which would bring on a meltdown, if not in her office, once we got home) temporarily drugged out of his mind doesn’t sound so bad. But I’d rather have the Versed they gave him before surgery. About an ounce of liquid in a dose cup, and it apparently didn’t taste too bad, but once it started working, although he was quite awake and alert, when they asked if they could take his Game Boy away, he didn’t care.
Is chemical sedation out of the question? I think I’d prefer to be loopy & have no memory of a traumatic event over being physically restrained and terrified. The second option sounds like a recipe for nightmares. I read somewhere, a long time ago, that pediatric anesthesiologists were finally getting on board with sedation before surgery. Previously the rule of thumb was that a crying child would suck down the anesthesia faster & go to sleep faster. Yeah … like that’s a compassionate plan.
Hell, as a teenager I had “conscious sedation” during surgery & said that the next time, they need to knock me out completely. To hell with the risk, no one WANTS to be awake and hear the real-life script of every medical drama re-enacted over your immobile body. And that’s coming from someone who was fascinated with medicine, knew what was happening, and wanted the surgery. It was still terrifying to feel the impact of having bones broken.
Semi-conscious sounds like a good plan for dental work for J-Man. No bruises for him, no sprains/strains for you, and no reason to fear the dentist. Good luck, I know it isn’t as easy of a decision as I wish it was. Sigh – one of the benefits of having pets is that I have more say over the care they get than most parents have for their own kids. I’ve demanded (and received) a cardiac ultrasound, transdermal pain patch, and more for our dogs. Vets seem to have a better understanding that sometimes, the customer really does know what the hell they are talking about. The rest of the medical establishment needs to catch up, IMHO.
We experienced the papoose board in the ER when was Reese was 18 months old and needed stitches.. he busted out of it.. twice before they finally decided to sedate him. Even with the sedation it took myself two docs and a nurse to hold him down as he spit and clawed at everything around him. I am terrified at the very thought of a dental visit. Reese loves deep pressure but he hated that board… I think I might try weighted blankets? I have just recently read about them and think that might be an alternative? As far as the sedation, if he’s anything like my child they had better know before hand how much it would take to be effective. At one point the doc in the ER looked at the nurse and shook as head and said… “I can’t believe we almost tried to do this w/o sedation” Even drugged it took 4 of us to pin him down and, he didn’t fall asleep until well after midnight. I swear to God, I’d be rich if I could bottle his energy and sell it. Good luck, let us know what you decide to do.
As A thought for Children who like deep pressure there are also Bear Hug vests – They are made from neoprerene and wrap around and fasten with velcro it feels like having a big hug and can be very calming for some children
http://www.southpawenterprises.com/%2FBear-Hugs-P837.aspx
GL had a deep pressure vest. It helped him when he needed to stay calm and focused, but only if he wanted to be calm and focused. He didn’t like wearing it at all, and could only tolerate it for a maximum of 30 minutes a day. We bought another one when he outgrew it, but by the time he outgrew the second one, he had come to dislike it so much, we didn’t replace it.
Today was filling day. Before he left the house, I gave GL his bedtime meds, plus everything else we’ve been told we could safely give him. Ever notice how it doesn’t feel as safe when it’s your kid? But I didn’t know what else I could do. Mama Bear took him to the dentist. I had to promise to take him to the library for DVDs afterward before he would get in the car. I stayed home with BB, who has been having issues of his own.
MB said that GL didn’t yell or fight, but Dr. N seemed nervous about the whole thing. GL spent the whole time worrying aloud, which made Dr. N more nervous. GL tolerated the needle fairly well. MB gave everything less-threatening-sounding names, which helped a lot. So the needle was only a “pinch” that would make his tooth “tingle” not “sleep”, and the drill was only a “scraper”. I know it sounds like lying to the kid, but to him, names are everything, and the wrong name can send him into a panic far worse than the procedure itself can.
Near the end of the drilling, GL hopped out of the chair and said, “I’m done!” Only those who know him very well can appreciate the finality that phrase carries. That’s when Dr. N looked Really Panicked. You just can’t leave a tooth like that. Since they were past the point of no return, MB resorted to bribery, something we desperately try to avoid, because no matter what you offer, GL always tries to negotiate for more. She offered to take him to the store to buy a DVD. He got back in the chair, and let Dr. N finish drilling and filling as quickly as he could, hoping GL wouldn’t change his mind again. Dr. N was embarrassed, saying this wasn’t his best work, but it should hold.
MB found a boxed set of all three Stuart Little movies for $10. I hope he doesn’t expect three DVDs next time he needs a filling, but it was enough to keep him busy until bedtime. Still, he kept coming to me with sad, tired eyes, asking to go to the library for more DVDs. I told him I’d take him when he finished watching these, knowing that won’t be until tomorrow, when we were planning to go anyway.