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DENTISTS and autistic children - idealism versus reality

tuta

Hello everyone,

My son is six. He has a habit of crunching things and grinding his teeth at night. Consequently he has chipped the crowns from one of his baby premolars in his lower jaw.  By the time I noticed it, and we had taken him to his dentist who referred him to the Dental Hospital the decay had progressed to just above his nerve and this is compounded by the fact that there are no adult tooth ready to come through under this and its partner on the other side of his lower jaw. From the 'outside' it doesn't look too bad but obviously there is a lot more going on inside. He has a reasonable, arms length relationship with the specialist community dentist, but he has never really done that much to him other than ask him if he can look in his mouth and popped a bit of paste on the fissures of his molars.  

Now the Dental Hospital dentist is saying that he needs the tooth extracting under general anaesthetic or be put through the equivalent of a root canal treatment for baby teeth.  The general anaesthetic is really scarey for me and my husband thinks that they are suggesting this because it is easy for them. After talking to the dentist at the Dental Hospital I was told that filling is multiple visits, with injections, and sitting for goodness knows how long.  They also said that it might not work and that the crown would be softer than in an adult so it would have to be checked and changed regularly and that to top it all it would fall out eventually and leave him with a big gap.  Even sedation wouldn't make him compliable or able to cope with the proceedures. The dentist said that removal would be a one off solution and that maybe his other adult teeth would migrate to some degree and close the gap.

I am really confused, I am scared of the anaesthetic and how he would cope with the medical proceedures, but the idea of him having injections in his mouth and drilling makes me want to cry for him.  My husband thinks they are fobbing us off and as he has had a root canal he knows it is not that bad, but all I can think of is how scared and upset my son will be.  I don't know if I have too low expectations for his ability to cope, or if I am copping out because the hospital is the quick and easy option for all of us. I am going to see his own dentist (specialist community dentist) and my husband is taking him to his dentist for a second opinion.

Has anyone here had any experience of this or advise?  I want to do what is right but I am having trouble separating idealism (saving the tooth under any circumstances) and the possible reality of what treatment he can deal with. Thank you.  

  • Hi there,

    I'm not a dentist, but I am related to one and have been a dental nurse in the past. I am not qualified to give medical advice just to clarify, I can give you my opinion though and hope that it might help a bit. I can see why you'd be distressed for your son, it's not exactly a comfortable atmosphere even when it's pain free. It's clinical and unfamiliar so his anxiety will already be raised. But remember his baby teeth are supposed to fall out and go away so the big ones come through. I don't mean to sound patronising or state the obvious, I just can;t think of a better way to say it. I know him losing the tooth isn't ideal, but his new replacement big tooth will come through pretty shortly after his baby one falls out. And extractions (particularly for baby teeth) are really not long at all. Most of the fuss will be regarding the injection. If that would still distress him then ask your dentist about conscious sedation. This is also know as twighlight sedation. It can be done by any dentist safey but ideally by a sedationist. You want to ask then how many they have done before etc and success rate. Also that could be an option if you did wish to pursue the root canal treatment option. Twighlight sedation is very safe and he wont be asleep, just a little groggy.. kind of like he's had a couple of glasses of wine! Also he will have very little memory a week on. He may remember it after the procedure, but the action of the drug will reduce what he remembers significantly within a few days to probably nothing at all. It's a big positive because it'll be like the problem magically solved itself over night for him! Also, it's not a hospital procedure, you'll go home straight away and can look after him at hme while he sleeps it off. I don;t mean to sound like an advertisement but it's a great option and will reduce stress levels. My ultimate adive though would be get that tooth out, it's quick and easy and there'll be a new one there in no time!

    Hope this helps!

  • Hi again - my son had gas + air then a sedative administered thru a cannula in the back of his hand. It was a big job to do the filling.  He was in their about 40 mins from entering until leaving the treatment room. They used a special kind of filler because the tooth was pretty bad inside.  The filler expands/bonds with the natural tooth over a day or 2.  If you've ever had a diagnostic procedure at a hospital, then they administer a sedative thru a cannula and generally speaking you don't remember a thing.  Hope this helps.  Give your specialist community dental practice a call or talk to the hospital again.

  • Hi Crystal12 thanks for replying, just to clarify did your son have a general anaesthetic with anaesthetic gas to render him unconscious first? Or did he have gas and air and was basically 'out of it' for the full proceedure time but not unconscious? 

  • Hi -I think you're right to worry about how much he can cope with.  You don't want him developing a phobia of going to the dentist.  My son, now an adult, had to have a major filling.  We used the specialist community dental service who were brilliant.  I explained as much as I could to him before he went such as he would get a clear mask over his nose + the air he breathed in would make him feel happy.  I didn't mention the cannula which had to go into his hand as he reacts badly to needles.  Everything went well.  They let me stay in the same treatment room until they'd put the cannula in, which he did notice, but wasn't bothered about.  I then waited in the waiting room.  A consultant dentist did the procedure.  It was a very big filling because the tooth had been affected from the inside.  We had to wait about 20 mins until he came round.  They took the cannula out and a little while later he was back to his usual self.  So, yes, check everything out.  I hope me telling you how things went for us has been a bit helpful. Good luck