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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

  • Oh dear God, poor you. Your poor son. You have my prayers.

    It was such a procedure that finally led to my autism diagnosis. I was expecting one extraction. They took six. I took off with suicidal intention afterward, was spun into a melt down/ shut down cycle complete with self harm, which went on and on. I'd never self harmed before. I was mute for weeks. I could never let my husband kiss me again. It causes eating problems and I've lost too much weight. I am still not coping.

    Four years on the dentist is still trying to put plates in my mouth and I am dry wretching immediately. The desensitization isn't working. I want it to. I want those plates. I want my mouth to feel normal again. But it doesn't and I can't cope.

    MH never believed me, misdiagnosed me. I worked out it was a sensory problem due to autism for myself in the end. Worst is my tooth condition is degenerative, and WILL get worse.

    I wish I could be more cheery, offer more hope, but I can't find an answer for myself yet. Your son is likely to be thrown into the most severe of sensory and psychological shocks, especially if they take him by surprise like that. Is that really wise to ambush him? I'm surprised they are allowing an approach like this. Autistic people cannot handle surprise, especially not surprise by their worst nightmare. The trauma will be beyond tolerance.

    I really don't know what to suggest. I so wish I did,  except to say you and he are not alone with this. I'm so sorry, this won't be what you want to hear. I'm so sorry I don't have a better truth to give. I'm so sorry this must be so scary.

    Please keep us updated. I hope you find an answer. I'd like an answer. Please keep shouting at professionals to help you. Short term medical care afterward won't do. He will be severely traumatised. They may not have ready answers, but don't let them stop trying.

    My heart really does go out to you.

  • in reply to Dawn

    Oh Dawn, this must have been so absolutely horrific for you, I don't know what to write but wanted to still write something even if it cannot express adequately.

    Are implants possible? My husband had two and says they were worth the money. I only had one extraction and the gap is bearable, but I can see how six might not be even once they have healed over.

  • in reply to AuTriker

    No, the sensations are awful and the condition is degenerative. So, it will happen again and they can't do implants.

    We just can't get over the denture issue. For the moment they are optional, but next time they won't be.

Reply Children
  • in reply to AuTriker

    Thanks for the reply...all of the above is a problem.  I am by training a linguist and a trainer, so you can imagine how that upsets me to have my speech effected.  And I may be an older woman now, but I'm still bothered by the appearance and the loss of my sexuality.

    But all that stuff is peanuts compared to the sensory torment of my mouth.  I just want it to feel normal again.  When the dentist puts in the plate it's very strange, I can at one and the same time feel instant relief that the gap is filled, but instant unbearable disgust at the plate that holds the teeth.

    My dentist is a Special Care dentist, who is very compassionate and patient and she does have some training in autism, is trying all she can.  We realise that part of this is in the proprioception, but also texture and look has a lot to do with it.  I can't as a rule handle anything with spit on it.  I heave immediately.  The sight of my son's retainers in the bathroom as a kid used to make me want to chuck up.  The dentures feel so slimy. It's like having a mouth full of slugs.

    I did get them in a time or two, but was sitting on the edge of the bed panting like a dog.  When I did bring myself to close my mouth, the reaction was immediate.  they had to come out.

  • in reply to Dawn

    I'm so sorry to read that, Dawn.

    Have you analysed precisely what the problem with the dentures is? If you have been unable to tolerate them in for more than a few seconds that would be difficult! But I can image a range of problems. If they are making you gag, they might go too far back. A dentist might not be thinking outside the box and just assumes a full set is required. But there are two main aspects to teeth. One is eating and the other is appearance (also they can affect the sounds of speech)

    For eating you do have the option of only eating soft food and giving up chewing. Extreme, but we do consider extremes that NTs might not. So front only dentures might then be an option, which would not protrude anywhere near the parts of the mouth which cause a gag reflex. Sticking them in might be an issue, as a non dentures wearer I know there are things about them I do not know as my Dad wears them and has had some issues with his which we have discussed. Or just the front molars as also a partial denture.

    If you have already considered these things then sorry, but it might be useful for you to discuss less obvious options. Like soft gum dentures, I think that might be a thing? I can ask me Dad if he has any thoughts.