wwyd? Child with phobia of dentists

[ktgrok]

My 11 year old DS, who I have already posted about in regards to behavior issues, and will be taking to therapy, is also phobic about dentists. He hasn't been in 2 years (I know, bad mommy) and needs to go. I scheduled an appt for him for tomorrow. He is freaking out. He didn't want to come home from his Dad's house. He threw himself on the ground while there, in frustration/anger, and hit his head hard on the ground...he's got a big bump/bruise on his forehead now. He didn't mean to hit his head, that part was supposedly and accident. He is begging to wait until after his loose tooth falls out because he doesn't want them to fiddle with the loose tooth. This is a child that has always hated anything to do with his mouth. He hates having a loose tooth, and hates when it falls out and leaves a hole. He generally will eat very little once the tooth gets very loose because it bothers him so much. He had to have 2 teeth pulled at his first dental visit because they hadn't fallen out and the permanents were coming in wrong. Ever since then he has freaked out. laughing gas doesn't seem to help the anxiety and it makes him very very twitchy, which is not helpful when having dental work. My question is...do I make him go tomorrow, or do I cancel and wait until after we do some work with the counselor? He doesn't have any pain or obvious issues with his teeth, they just need a cleaning. I hate putting it off longer, but at the same time I guess another month or so doesn't make a difference. And maybe the counselor could help him deal with this. What do you think?

 

ETA: he does have sensory issues, as evidenced by the fact that he can barely even eat when he has a loose tooth, but has no pain at all from the goose egg on his head.

Edited September 20, 2010 by ktgrok

[Gwenhwyfar]

My question is...do I make him go tomorrow, or do I cancel and wait until after we do some work with the counselor? He doesn't have any pain or obvious issues with his teeth, they just need a cleaning. I hate putting it off longer, but at the same time I guess another month or so doesn't make a difference. And maybe the counselor could help him deal with this. What do you think?

 

 

 

given that he's not experiencing any problems right now and you have plans to address his fear with a counselor, i'd let it go for now.

[Remudamom]

Wait.

 

My niece, whose only behavior problem stems from over indulgent parents is dentist phobic too. She has a tooth that is sticking out and needs to be pulled, looks funny. Her mom took her in, she refused to open her mouth. Then her dad tried, she refused to open her mouth. They finally told her she can just look funny, they aren't going through that again. Now she's begging to go in.

 

Maybe in your son's case some counseling/therapy might make it easier. I wonder if there's a pill you can give him before going in to help him relax before you get there?

[ZooRho]

I almost wonder if it would be worth it to take him in and just let him have the dentist take a quick look to see if there are any major issues. Asking the dentist to not do anything painful but allowing ds to get relaxed and use to things.

 

 

I'm sorry he had such a bad first experience. I hope the pulled teeth were a HUGE emergency. We too had a son that had teeth coming in wrong behind the baby teeth but the Baby teeth eventually fell out on their own and he now has perfectly beautiful teeth without any need for braces.

[Jean in Newcastle]

My dd was very scared of dentists. We told the dentist that and he called in a prescription for a tranquilizer that we gave to dd before the dental visit. The tranquilizer (I'm sorry, but I can't remember the name) made her mellow but still able to walk and talk. It just took the edge off of her anxiety.

[Elizabeth in WA]

Well, my 14 year old aspie hasn't been in over two years either. When he last was, we spent well over $3000 after insurance having everything that needed doing and all possible preventive work done under sedation. Maybe some day he will be able to have work done without sedation, but that day isn't now. If the child has really serious sensory issues, and especially if having strangers in his personal space is also a big problem, dental work might be beyond what he can handle. My ds14 can handle himself increasingly well in the world without having the people he is dealing with informed in advance, or suspecting afterward, that he is special needs. But, having someone literally in his face to the extent required by dental work, might not be something he can ever do. Fortunately, dental work can always be done under sedation if necessary. Unfortunately, my insurance will not pay for the sedation.

 

So ... what I would ask is, realistically, is the child going to cooperate enough to open his mouth and let the dentist look around? Because if not, whether because he can't or because he won't, meaningful dental work won't happen. And attempting to force the matter might only reinforce the dentist phobia. If he hasn't figured it out yet, he will eventually. If you refuse to unclench your teeth for any reason, noone can make you without risking serious injury to your teeth. the human jaw can generate a tremendous amount of force. If the fear is too much, cooperation won't happen no matter what reason, punishment, or reward is held out. Only you know the child well enough to judge if its a forceable issue. If it;s not, I wouldn't generate a lot of bad will and adversarial feeling over it.

 

I'd love for ds14 to get braces. But that isn't going to happen unless he wants it badly enough and even then could require sedation for the major work of initial installation of the braces - which won't help if he can;t even tolerate the brief time required to adjust them. I comfort myself with the knowledge that he can still get orthodontic work as an adult should it later matter enough to him.

 

:grouphug:

 

Elizabeth

[nd293]

I would definitely ensure that you choose a specialist children's dentist (the one we go to also deals with special needs adults). They have had plenty of experience with nervous patients who don't obey instructions! My ds's first fillings were actually done with him sitting on my lap on a normal chair, lying back with his head on the dentist's lap. By the next appointment he was begging to sit in the "big chair" and wear the cool sunglasses that went with it :-) I would also specify that the first appointment should not involve any actual dental work.

[ktgrok]

Thanks everyone. I didn't want to just let him out of this, but you are right, it will make it worse to force it. I will give him the chance to go, and earn the new skateboard backpack he wants as a reward (he will get it sooner or later anyway, but I'd stretch the budget and get it right now if he went), but will probably end up canceling and maybe just doing a tour at some point, and letting the counselor work with him. I talked to DS about sedation, that idea freaked him out even more. Losing more control did not sound good to him.

[Tiramisu]

My dc aren't quite as phobic but it's helped that two dentists understand my dc's sensitivities and the first visit we had with both of them didn't include more then a peek in their mouth and, "Everything looks great! You can go home now." After major work on my then 2 yo with sedation that seemed like it would never work, the next visit back was the littlest peek again and nothing but praise. It worked for her and she would shout for joy everytime we drove by the office. However, another dc who has sensory issues, would cry and cry, silently though, through dental work. The gas seemed to make it worse for her. When we switched because our pediatric dentist retired, the new dentist was so easy going with just that peek and tons of praise that it seemed to overcome her fear to a degree. She said afterward, "I like that dentist." I don't know how this work with everyone's insurance, especially if there was serious work that had to be done ASAP. In that case, I think I'd go with a tranquilzer but I'd want to try it out at home first because I'd want to know how it would affect that particular dc, having experienced what we did with the one dc with whom the sedation wouldn't sedate. In any case, I'd talk to the dentist first.

 

BTW, I've heard there's a pediatric dentist near us who specializes in kids with Aspergers and sensory issues. Wouldn't it be great if you could find someone like that who would really understand?