Dental Trauma and "Adjustment Disorder"

NAS83709 said:

Anyone with experience of recovery from dental extractions

Yes.....me.....and I have a MAJOR problem with dentistry.  I am 50+ years old and am generally considered to be a capable, calm and logical being - albeit a "little odd."  I am not prone to meltdowns because I have developed strategies to soothe and contain my turmoil at times of stress.  I am not an aggressive type.

I have been agonising over this response to you.

I can clearly see and understand your dilemma with your son's dental treatment.  I do appreciate that it is a very hard judgement call that you have made.  Accordingly, I do not proffer my thoughts below lightly or flippantly.  You are in an impossible situation, but for what its worth, I think you should consider pivoting your strategy here - and tell him what is going to happen - AND WHY!

I say this based of my own experiences and feelings surrounding dentophobia.  I have had 3 of my wisdom teeth out plus a handful of other extractions and a couple of root canals in my adulthood.  As you might expect, I have planned and prepared for each of these events, including "special measures" to help me cope with it the experiences.

Despite being relatively in control of myself, I have totally 'lost my sheet' on two occasions AFTER dental work.  Despite the lead-up to these events being horror inducing and the event itself being unimaginably awful (despite the variety of drugs employed).......it wasn't until AFTER that my meltdowns occurred - and they were proper "red mist", animated aggressive posturing, and I think I actually created indoor lightening and thunder on one occasion !  I scared everyone to death - including myself.  It took me weeks and weeks to come back to a point of balance and poise.

I think it is the sequence that I would ask you to consider.  There is a BEFORE, DURING and AFTER.  I think there can be little doubt that your current intended approach is best for handling the BEFORE and DURING parts........but I fear it may induce a catastrophically destructive effect in the AFTER phase.

I fully accept that my dentophobia is illogical and causes me unnecessary and mind-bending pain at times and for prolonged periods.  I also fully accept that my nearest-and-dearest cannot possibly appreciate how visceral my fear is and I appreciate that they would consider it a "kindness" to override my indefensible "dignity of choice" arguments if they could - but I won't let them.

If I woke up one morning to find no pain, a full mouth of pristine white teeth - but knew that it had been done without my knowledge, I would be furious and my trust in them would be critically endangered.

If I woke up one morning to find a lot of pain, more missing teeth from my mouth, oodles of swelling and bruising on my face, a couple of weeks of needing to be VERY careful with the weird "jelly" blood clots in my mouth (that feel like sea anemones), I fear that I might be prone to a full psychotic break.  And that is not hyperbole.

I do not think you should change the plans you have made for your son (and congratulations on organising the logistics) but I really do feel that you should tell him; a) what is going to happen b) why it must happen c) what he must expect afterwards.

Naturally, this is just my opinion and I wish you and your son the very best of fortunes, no matter how it unfolds for you all.

Hi, Unfortunately our son (the "patient") is a lot further along the spectrum than "a little odd". He is virtually non-verbal, has no concept of "cause and effect" and only a faint grasp of "future and present". If we did tell him then he would point-blank refuse to co-operate and could not be forced.

He is still dealing with the aftermath of some far less traumatic surgery involving milk teeth 15 years ago and still refuses to enter the local hospital for that very reason : which is what promted this request for advice.

Your post reinforces our view that the fallout from this will be life-changing but whenever we raise this with the Multi-Disciplinary team with questions like "Wnat happened to the last severely autistic patient with a mouth full of bad teeth ?"  we are met with blank stares and comments like "Oh! its bever happened before".

So basically, there is no point in telling him becuase he will never understand the logic and necessity but there is no way that we can subject him to the consequnces.

We are still no closer to understanding what we should actually do.

Cheers

PT and AT

Hi, Unfortunately our son (the "patient") is a lot further along the spectrum than "a little odd". He is virtually non-verbal, has no concept of "cause and effect" and only a faint grasp of "future and present". If we did tell him then he would point-blank refuse to co-operate and could not be forced.

He is still dealing with the aftermath of some far less traumatic surgery involving milk teeth 15 years ago and still refuses to enter the local hospital for that very reason : which is what promted this request for advice.

Your post reinforces our view that the fallout from this will be life-changing but whenever we raise this with the Multi-Disciplinary team with questions like "Wnat happened to the last severely autistic patient with a mouth full of bad teeth ?"  we are met with blank stares and comments like "Oh! its bever happened before".

So basically, there is no point in telling him becuase he will never understand the logic and necessity but there is no way that we can subject him to the consequnces.

We are still no closer to understanding what we should actually do.

Cheers

PT and AT

I wish we were more help I really do. 

Most of all, I wish your team were more clued in. Yes, it has happened before!! Why not print off this post with all the comments and give it to them. We ARE your evidence of what can happen.

The only difference between us and your poor lad is that we can communicate and have some concept of what's going on.

We were traumatised by dental treatment as children. We are traumatised now. 

Believe me, I totally get the dilemma. The treatment is necessary for oral and physical health. But at what cost to his mental health? So much sensory and emotional distress it is unimaginable to anyone who does not experience the sensory world the way we do. He is literally about to go through torture of the type that causes sever PTSD.

I am university educated and fully appreciate why my dentist had to do what she did, but it shattered my whole life and I STILL can't cope with the sensations in my mouth FOUR years on. I rarely melted down until then. Then, suddenly I'm on the brink of it 24/7 for years because I can't cope with the sensory overload coming from my own face. Your poor lad can't even process why? And he'll be ambushed with it. His trust will be irredeemable and he'll live in terror of it happening again. I live with that terror of more medical stuff. It can make you suicidal. 

It's almost like they think they are taking the cat to the vet and it's all going to be over when his mouth heals. It won't be. They need to wrap their heads around this fast and ramp up a shed load of support, big time.

Bless you