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Dental Trauma and "Adjustment Disorder"

NAS83709

Anyone with experience of recovery from dental extractions and general anaesthetic in adults??

We have a 31yr old severely autistic son who has refused dental treatment for years despite 50 hours+ of "desensitisation" from our local psychologist team and multiple attempts to cajole/persuade him to enter the hospital supported by our "multi-disciplinary team" over the past 7 years.

We finally (after presenting him as an emergency 12 months ago) have a date booked for "the procedure".

"The procedure" involves pre-med in the home environment supervised by an anaesthetist, car trip to hospital, at least 6 tooth extractions including 4 wisdom teeth, a trip to the recovery ward and a blue-light ambulance trip home followed by some form of short-term monitoring/nursing care.

All of this has to be done without giving "the patient" any advance warning and so is being "bought off" by the Court of Protection.

We are , of course, expecting severe recovery problems, his reaction is likely to be extreme but he desperately needs the treatment.

Does anyone out there have experience of handling a case like this? What strategies should we use? What help should we expect from NHS and Social services? etc ?

Thanks for any helpful suggestions.

PT and AT

Parents

  • That sounds like it will be a horrific trauma for him and he might never trust you again!

    Recovering from extractions is not a simple matter as the holes are quite vulnerable for some time, days, even weeks. If the blood clot comes off it can cause dry socket I think it's called, which is very bad. All 4 wisdom teeth means he will not be able to chew on either side during this time so will need soft or liquidised food. He might have sensory issues with this. Also it can take a while to get used to the new layout inside the mouth and when he is allowed to chew again it takes time to get used to the difference here as well and he might bite his tongue more for a while.

    Are you quite certain this procedure is essential? If it is, then is he not able to understand that having the teeth removed will improve things for him in the long run? 

    50 hours of "desensitisation" sounds quite traumatic in itself, I am surprised it was not realised sooner that it was not working, and might even have made things worse. Sensory issues cannot be cured by exposure, in fact are made worse by it.

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  • That sounds like it will be a horrific trauma for him and he might never trust you again!

    Recovering from extractions is not a simple matter as the holes are quite vulnerable for some time, days, even weeks. If the blood clot comes off it can cause dry socket I think it's called, which is very bad. All 4 wisdom teeth means he will not be able to chew on either side during this time so will need soft or liquidised food. He might have sensory issues with this. Also it can take a while to get used to the new layout inside the mouth and when he is allowed to chew again it takes time to get used to the difference here as well and he might bite his tongue more for a while.

    Are you quite certain this procedure is essential? If it is, then is he not able to understand that having the teeth removed will improve things for him in the long run? 

    50 hours of "desensitisation" sounds quite traumatic in itself, I am surprised it was not realised sooner that it was not working, and might even have made things worse. Sensory issues cannot be cured by exposure, in fact are made worse by it.

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