Asperger's Syndrome and dental work . . .

[BamaTanya]

My man-sized ds with Asperger's Syndrome has been especially blessed with strong teeth. He has never had a cavity, so his dental visits have been pretty easy.

 

He is going undergoing orthodontic work right now and . . . so far, so good.

 

However. He's going to need to have 4 teeth extracted.

 

This is a ds who has strong tactile defensiveness against many food textures. The orthodontist, after our consultation, decided to stick with just x-rays instead of try to do impressions.

 

I remember the experience of tooth extractions. 2 of our other dc have had these, too.

 

I'm nervous that ds will panic and not cooperate. Several years ago (when he was much smaller) it took four techs to hold him down to take a few vials of blood . . . .

 

I've talked to the dentist about my fears and he says we could opt to have this done with mild sedation and an oral surgeon.

 

Ack.

 

I don't really want that.

 

Maybe ds will cooperate with the dentist after all.

 

HOWEVER.

 

What if the dentist takes care of these 2 teeth next week but ds cannot face another session with 2 more???

 

A part of me thinks we could go without the extractions. Yes, his teeth will still be quite prominent, but they aren't sticking out at all angles like before ...

 

Another part thinks we should suck it up and do everything just as we would for our other dc.

 

He is high functioning intellectually, but his fears? Aye-yi-yi. If he panics he reacts like a preschooler . . .

 

Any advice? Experience?

[Mergath]

I've had a tooth extracted while awake. Never, ever again. And I don't have any sensory issues at all.

 

I'd say that if he can have it done by an oral surgeon under sedation, do it that way.

[Night Elf]

Well, this is very timely. *sigh* Ds16, also with Aspergers, is having oral surgery on Tuesday. He has braces. His canine baby teeth didn't come out and therefore his permanent teeth are impacted in the roof of his mouth. The surgeon will pull the two baby teeth, expose the permanent teeth, and attach brackets to them. And since he's already having surgery, all of the professionals, dentist, ortho., oral surgeon, think it's best to go ahead and take out his wisdom teeth as well. That makes a total of 6 teeth being removed on one day. We've opted to let him be asleep for this procedure.

 

I'm terrified. I can literally name the foods he'll eat during the first 3 or 4 days: yogurt, applesauce, boxed mashed potatoes, pudding, milkshakes, and possibly pasta though I'm worried the noodles will get hung up on all of his stitches. He's going to be very sick of those foods, which scares me because in the past he has stopped eating foods and hasn't replaced them with anything. His food list is very limited as it is!

 

He was told that he will hurt for 3 days and his face will be swollen for at least 4 days. Some people are able to start eating regular food again on day 4, but some need a little longer. When he got his braces on, he didn't eat regular foods for 2 days and it was a very unpleasant experience. I really can't even imagine what this experience is going to do to him.

[BamaTanya]

 

 

I'm terrified. I can literally name the foods he'll eat during the first 3 or 4 days: yogurt, applesauce, boxed mashed potatoes, pudding, milkshakes, and possibly pasta though I'm worried the noodles will get hung up on all of his stitches. He's going to be very sick of those foods, which scares me because in the past he has stopped eating foods and hasn't replaced them with anything. His food list is very limited as it is!

 

 

 

This frightens me even more. :001_huh: Ds won't eat yogurt or applesauce or mashed potatoes . . . . He's Mr. Crunchy and eats tortilla chips with salsa every day . . .

 

I'll be praying for your ds. And for you. :grouphug::grouphug:

[Night Elf]

This frightens me even more. :001_huh: Ds won't eat yogurt or applesauce or mashed potatoes . . . . He's Mr. Crunchy and eats tortilla chips with salsa every day . . .

 

I'll be praying for your ds. And for you. :grouphug::grouphug:

 

What teeth are going to be extracted? And will there be stitches?

[jeninok]

I've had a tooth extracted while awake. Never, ever again. And I don't have any sensory issues at all.

 

I'd say that if he can have it done by an oral surgeon under sedation, do it that way.

 

It is really not nice at all, at the very least I would want nitrous oxide and lots of lidocaine.

 

 

You don't want to foster future dental anxiety and avoidance.

[mom31257]

Well, this is very timely. *sigh* Ds16, also with Aspergers, is having oral surgery on Tuesday. He has braces. His canine baby teeth didn't come out and therefore his permanent teeth are impacted in the roof of his mouth. The surgeon will pull the two baby teeth, expose the permanent teeth, and attach brackets to them. And since he's already having surgery, all of the professionals, dentist, ortho., oral surgeon, think it's best to go ahead and take out his wisdom teeth as well. That makes a total of 6 teeth being removed on one day. We've opted to let him be asleep for this procedure.

 

I'm terrified. I can literally name the foods he'll eat during the first 3 or 4 days: yogurt, applesauce, boxed mashed potatoes, pudding, milkshakes, and possibly pasta though I'm worried the noodles will get hung up on all of his stitches. He's going to be very sick of those foods, which scares me because in the past he has stopped eating foods and hasn't replaced them with anything. His food list is very limited as it is!

 

He was told that he will hurt for 3 days and his face will be swollen for at least 4 days. Some people are able to start eating regular food again on day 4, but some need a little longer. When he got his braces on, he didn't eat regular foods for 2 days and it was a very unpleasant experience. I really can't even imagine what this experience is going to do to him.

 

I hope all goes well for both of you!

 

If he will drink milkshakes, I make fruit smoothies that have a consistency of milkshakes. I use half a blender of baby spinach with a banana, some frozen berries, and OJ. It's very tasty and would be some good nutrition. Spinach blends up very well, even in a regular blender. You can't see it or tell that it's there.

[BamaTanya]

What teeth are going to be extracted? And will there be stitches?

 

I think it will be the first bicuspids. The initial plan is to do the top ones this week and the bottom ones later . . .

 

And I don't think he'll need stitches.

 

We haven't talked about the impacted wisdom tooth yet. Fortunately, he only has one.

[Night Elf]

I hope all goes well for both of you!

 

If he will drink milkshakes, I make fruit smoothies that have a consistency of milkshakes. I use half a blender of baby spinach with a banana, some frozen berries, and OJ. It's very tasty and would be some good nutrition. Spinach blends up very well, even in a regular blender. You can't see it or tell that it's there.

 

Thank you! I'll make one this weekend and see how it goes. Should I snap off the stems to make sure they really do blend well?

[Night Elf]

I think it will be the first bicuspids. The initial plan is to do the top ones this week and the bottom ones later .

 

Was this suggested by the dentist? Since he mentioned an oral surgeon, did he suggest the possibility of having all of them done at once? I had to look up the bicuspids and they are between the canine and premolar teeth. I don't know what kind of effect that will have on his chewing. It's certainly not easy though! And good grief, the price we're paying the oral surgeon is crazy! We're just considering it part of the cost of braces, but it's absolutely ridiculous.

[mom31257]

Thank you! I'll make one this weekend and see how it goes. Should I snap off the stems to make sure they really do blend well?

 

I don't snap them off, and they blend well, IMO. I guess it might depend on your blender. They really do taste like a dessert instead of something healthy.

[QueenCat]

My aspie could not have done something like this without mild sedation.

[Susan C.]

Dd (with no issues) does have dental anxiety, so I requested that the dentist give us one valium for her. I gave it to her an hour before appointment time, and she giggled all the way to the dentist.

 

NO seeds (or rice) after wisdom teeth extraction!! We put protein powder in ice cream milk shakes, alternating with mashed potatoes with a lot in them (chicken broth, sour cream, cheese). After a day or two, sugar becomes disgusting! I think at day 4 or 5 they were able to eat meatless spaghetti.

[Chris in VA]

Thank you! I'll make one this weekend and see how it goes. Should I snap off the stems to make sure they really do blend well?

 

Freeze the spinach--it'll shatter instead of tear in the blender and you can still use the stems. :001_smile: Have to get it right into the blender from the freezer b/c it can defrost in a matter of seconds in your hands--

[Chris in VA]

I would definitely go the sedation route. He won't feel a thing, he won't have a negative memory of it--really, it's the only way I'd do an extraction, Aspie or otherwise.

Can you do them all at once? I'd at least take care of that wisdom tooth at the same time. You will pay for the sedation each time, so you might as well.

[BamaTanya]

Was this suggested by the dentist? Since he mentioned an oral surgeon, did he suggest the possibility of having all of them done at once? I had to look up the bicuspids and they are between the canine and premolar teeth. I don't know what kind of effect that will have on his chewing. It's certainly not easy though! And good grief, the price we're paying the oral surgeon is crazy! We're just considering it part of the cost of braces, but it's absolutely ridiculous.

 

I think if we went the oral surgeon route, they would take care of all four . . .+ maybe that pesky lone wisdom tooth . . . at once. The 2 and 2 is assuming we'll just have nitrous and local at the dentist's office.

[jelbe5]

Our medical insurance pays for children with disabilities to be sedated with general anesthesia. Would yours do this? If so I would opt for this and have the work done at one time if possible.

[Kathryn]

I would definitely go the sedation route. He won't feel a thing, he won't have a negative memory of it--really, it's the only way I'd do an extraction, Aspie or otherwise.

Can you do them all at once? I'd at least take care of that wisdom tooth at the same time. You will pay for the sedation each time, so you might as well.

 

:iagree:

[LucyStoner]

Another vote for oral surgeon and sedation. I had 7 teeth (4 impacted wisdom teeth, 1 tooth that was fully erupted behind the other teeth and its sister tooth that was unerupted and 1 molar that was very damaged from shoddy childhood dental work) out last year and sedation was worth the price and then some.

[Mommy22alyns]

I just had a tooth extracted with only novocaine, but never again. I'd had one done before and it didn't bother me much, but this one was no fun at all. I'd get him as sedated as possible.

[cin]

I don't snap them off, and they blend well, IMO. I guess it might depend on your blender. They really do taste like a dessert instead of something healthy.

 

Put them in an insulated mug with a lid. My sensory child couldn't stand the COLOR. :rolleyes:

 

 

Also, it all depends on the teeth, as to the number of stitches and recovery time. My daughter had 4 baby teeth pulled by an oral surgeon. It was baby teeth though. She came home and rested for the day and was eating cautiously the next day. The next day she was fine. This was 4 baby teeth that were NOT coming out and we had to get them pulled so we could move ahead with braces. I don't know how old your son is. From his size, I assume he's a bit older than DD was. Hope things go smoothly.

[mom31257]

Put them in an insulated mug with a lid. My sensory child couldn't stand the COLOR. :rolleyes:

 

 

Also, it all depends on the teeth, as to the number of stitches and recovery time. My daughter had 4 baby teeth pulled by an oral surgeon. It was baby teeth though. She came home and rested for the day and was eating cautiously the next day. The next day she was fine. This was 4 baby teeth that were NOT coming out and we had to get them pulled so we could move ahead with braces. I don't know how old your son is. From his size, I assume he's a bit older than DD was. Hope things go smoothly.

 

Ours don't actually turn out green if that's what you are thinking. The berries sort of take over and it turns out slightly purple.

[Amy in NH]

I've had a tooth extracted while awake. Never, ever again. And I don't have any sensory issues at all.

 

I'd say that if he can have it done by an oral surgeon under sedation, do it that way.

 

:iagree::iagree: Meee tooo!

[dancer67]

I would have him sedated.

 

I don't have an aspie child, nor do I have any sensory issues but I had my wisdoms extracted in the hospital under a general. But I had 4 regular molars pulled with just novacaine, and it is a piece of cake. MUCH easier then a filling or root canal. Once the novacaine takes, the process lasts about 2 minutes, if that.

 

:grouphug: to you and good luck. Dental work is no fun for anyone. I just had a root canal on Tuesday and my jaw is still sore.

[laundrycrisis]

I have had two teeth wisdom extracted without sedation. If was not an experience I think our son could get through. He has had one very easy extraction with just nitrous. If he was going to go through a difficult extraction, or multiple teeth, I would go the oral surgeon/more sedation route and have them all done at once.

[Tidbits of Learning]

Is he under 18? We took our dd to a pediatic dentist instead of an oral surgeon. She had gas and was oblivious to it all. We too were referred to an oral surgeon, but were having oral work done on younger sons and I asked if they could do the extractions there with sedation (gas). They said of course. They also did it over 2 visits.

I would suggest finding a pediatric dentist office instead.

[BamaTanya]

I appreciate all the responses and have been sharing the consensus with dh.

 

He said, "I wonder what the dr would say if we just skipped this part of the treatment."

 

Would any of you consider doing that?

 

I really haven't explored the wisdom tooth issue because it hasn't been a concern. Yet.

 

Have any of you decided the extraction just wasn't worth the trouble to your child?

 

I have no idea about cost. I don't think our insurance covers extractions. Maybe a small percentage.

 

It doesn't cover orthodontics at all. I don't know about oral surgeons or sedation. I don't want to make medical decisions based on cost, but I do need to prepare.

 

I know we've been charged extra for nitrous oxide for another dc's work.

 

The appt is this week and I think I am panicking. If we're going another route, I need to call Monday . . .

Edited September 9, 2012 by BamaTanya

[Pegasus]

Wanted to add our experience. DD had to have extractions mid-way through her orthodontia treatment when she was about 12. We haven't sought a diagnosis but she definitely has traits of both sensory integration issues and aspergers.

 

She had 2 baby teeth with no adult teeth behind them and 2 baby teeth with malformed adult teeth behind them (in the gums). We talked to her dentist, the orthodontist, and the oral surgeon, and everyone agreed that the best solution was for all 4 baby teeth and the 2 "bad" adult teeth be removed. The oral surgeon offered to do it one side at a time with DD awake or take care of it all with her fully sedated. I asked and he said that if it was his kid, he would do it fully sedated. So, that is what we did and we have no regrets.

 

We were self-pay for the orthodontia but the health insurance did kick in and help with the full-sedation costs.

 

I would go ahead and do it. You will be much happier with the final orthodontia results.

[NASDAQ]

My brother has Autism and never gets anything done at the dentist without a happy dosage of lorazepam.

 

I would do sedation if you can swing it, and lorazepam if you can't.

[Night Elf]

He said, "I wonder what the dr would say if we just skipped this part of the treatment."

 

Would any of you consider doing that?

 

 

 

I did ask that question, and got similar answers from my dentist, the orthodontist, and the oral surgeon. None of the answers sounded good for long term. With ds16 being a teen, this is the best time to take care of these problems because they will be more difficult as he gets older, especially the wisdom teeth. Those teeth have very few shallow roots right now which makes this a good time to pull them. They haven't erupted yet but the bottom ones are already leaning against the molars so we believe they would have to come out at some point.

 

Last night, ds and I talked the whole thing through. I recently had oral surgery, with the same surgeon, so I was able to explain step by step what will happen when he's in the office. We talked about the possible pain and swelling and brainstormed a list of foods that he can eat that don't require chewing. He'll just be getting lots of treats, in the form of milkshakes and soft serve ice cream, the first few days.

 

If you're unsure of this, call the dentist and tell them you still have questions and you would like to reschedule the procedure and schedule a time for you and your son to come in for a consultation. Let them explain why this is a good idea and what to expect. Are you worried your son will freak out and not want to go through with it? My son is the type of guy who needs to know everything in advance. He would be more nervous if we just showed up and he was taken into the back with no knowledge of what was happening. You know your son best. It's also possible that it will be okay but that you're just scared of the unknown as well. That happens to me a lot. I'll be taking my anxiety meds tonight and tomorrow just to get through this first part, the actual surgery. Egads.