Dental Fear or Dental Care

My children’s dentist is a free dental clinic attached to a school that is about half an hour’s drive from home. It’s not close, it’s not convenient, and I could get free dental care for the kids directly through their school. Yet I keep going back to this one place, even though my children never actually went to the school that the clinic is attached to. There’s nothing special about the building, there’s nothing special about the official range of services they offer. They aren’t a special needs clinic and they don’t offer to sedate my children in order to perform dentistry on them. But they do have something exceptional: a specific dentist. This dentist has no specific training for dealing with autistic children, what she does though is a perfect example of how inclusion can work, and how making inclusion work is in the best interests of everyone (not just the children).

Mouth checkup

I remember an early visit to this clinic, when I saw a different dentist than the one we now see. It was the closest dental clinic to my home at the time. That dentist quickly lost patience with my eldest son, and told me that if he wouldn’t comply with her instructions, she’d have to make a referral to a place where he’d have to be sedated in order for them to carry out dental care. I was shocked and upset, I said I’d have to think about the option, and left feeling quite upset – both that she believed he required such an extreme approach, and that she hadn’t persisted with a gentler approach.

In those early years, I quickly learned that my eldest son had a strong fear of dental work, and that he was going to need me by his side for every dental appointment. So once he began school, I signed a form clearly saying he was not to attend the roving school dental nurse clinics, where he’d have no relationship with the dentist and I couldn’t be by his side. The school ignored the paperwork, and sent him along to the dental clinic anyway, even as he protested that he “didn’t have to go” (because I’d told him he didn’t have to go to the school dental nurse). He was told “yes you do” and was forced to. His fear of dentists after that only got worse. (And yes, there was an enquiry – that went beyond the school and into the health sector – and an apology, for the incident.)

I thought this was just going to be the way of things – stressful, largely redundant dental appointments, eventually ending up with sedation to carry out the simplest of dental care.

Then I had yet another scheduled appointment at the initial clinic we’d visited- I was dreading the appointment, thinking she’d tell me me had no choice but to go with sedation. But it was a different dentist at the clinic this time. She was clam, she was reassuring, she was gentle and encouraging. She didn’t say he’d require sedation, but she did say we better come back again soon so she could keep a close eye on his dental health since she wasn’t able to get him to accept the process for taking x-rays and he had a limited time during which he’d allow her to work within his mouth. She also said it would be good for him to come back again soon so he could become more accustomed with the experience and grow to fear it less. I liked this woman, and I have chosen to only ever attend dental appointments when she is available ever since. And she only got better. So much better.

Each time we see her she seems to come up with yet another way to help both my children become more compliant and less fearful of the dental experience. This is the current list of things she does, that has built up to this point over the years, of her own accord:

She makes sure no other children are scheduled at the same time in adjacent rooms so there is no crying or screaming or distress from other rooms to add to my children’s anxiety; she always advises them of what she is about to do and shows them what equipment she will be using, to reduce anxiety and unexpected events; she involves the children in each process, answering all their questions and teaching them about why she does what she does; she schedules six-monthly appointments so there is less danger involved in her not being able to gather full information from them through x-rays between otherwise yearly appointments (their teeth are in great condition with all this care, as you can imagine! One temporary filling for each child, but that’s not too bad); she uses praise and rewards to keep them engaged and compliant as much as possible; she even specially reserves a parking spot for us so the children have less distance to travel. She always schedules my boys’ appointments together, and uses what she does to one boy, to help the other – to encourage the other to give it a go too, and to show them they need not be afraid.

She is aware of their sensory issues – she’d learned, for instance, that both my boys panic when the x-ray tab is put in their mouths because they both get the sensation they’re going to choke on it or accidentally swallow it. So she changed the positioning for the x-ray, and even managed to get my youngest to finally have an x-ray last time by sitting him forward to avoid the fear of choking. Little things; big progress.

She is not specially trained to deal with autistic children or children with special needs, but she hasn’t had to be, because she is so patient, so compassionate, and so thoughtful. She has built a relationship with both my children – and with me. I wish she was my dentist!

Her success with my children, hasn’t just benefited them through her ability to increasingly perform longer checks and more intensive care of their teeth; it hasn’t just soothed and comforted me, as their parent. It has also saved the public purse a heck of a lot too – otherwise having to send my children along for sedation at a hospital facility, which would have involved a lot more resources and people (and expensive ones at that) than them just seeing her briefly every six months. She has also saved the public purse from having to pay out for more drastic damage to my children’s teeth – because she sees them so regularly and is able to do more with them each time, there is less cost involved than had she not been able to get them to comply and their dental issues had got a lot worse than they are.

I wish there was a way to have her acknowledged publicly for what she does. I want people to see how it can be, to know it is possible to work with kids like mine without having to necessarily sedate them. To build meaningful relationships that benefit everyone. I want people to know how awesome she is, and to learn from her. At least I can blog about it!

The last time we visited her, which was only a few weeks ago, I was walking back to the car with both my boys, and my eldest turned to me and said: “Mum, I don’t think I’m so afraid of the dentists anymore.” I gave him a big hug and told him how proud I was of him. I wanted to rush back and give the dentist a big hug too! I hope she knows what a difference she’s made in our lives; I always do tell her how much I appreciate her care of my boys, and she turns the praise back on me and tells me what a great job I’m doing with my boys!

I’d travel a lot more than half an hour to keep someone this special in my kids’ lives.

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6 Responses to Dental Fear or Dental Care

  1. I wish I’d found someone like that here in Christchurch, my eldest is fine with the dentist, but youngest won’t tolerate work being done. They can look, but no drilling etc. Last time work had to be done he had to go to hospital to be knocked out which resulted in him fearing hospitals for some years.

    • Poor kid. I realise that, for some children, sedation is going to be the only option, but the whole process can be very distressing and should be a last resort within the system, whereas I know (anecdotally) that some dentists go for the sedation option too quickly when there would have been some kinder, gentler, more open-minded options available to them. I hope you manage to find a compassionate dentist for your child, who can help reduce the need for sedation in the future. Thanks for sharing your experience.

  2. wife of jack says:

    The x-ray tab for the large standing machine has been a problem for my son as well. To much going on in his mouth and then he has to stand still as well! He loves going to the dentist and is quite compliant with all the other treatments. The little x-ray machine at the chair is easier. Pehaps because he is lying down and already relaxed? We are fortunate that our local school dental hub is near us and they understand that I would rather go with him than send him to the caravan without me. He does go to the caravan for a checkup but any treatment is best with me around to hold his hand.

  3. Your dentist sounds like an absolute gem. Our dentist is also a compassionate and gentle man. We have to pay for health care here, however, he never charged me in the early days AND he was very happy for us to slowly extend the amount of time during each visit. Hats off to your dentist and ours.

  4. There are wonderful caring people out there who give of themselves every time the interact with another human. A hand written thank you is priceless.

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