Sunday, August 18, 2013

First Fillings

In July, we took Alex to the dentist for his regular cleaning and check-up. Because of his severe anxiety issues the past couple of years, we had not taken him for his six-month appointment in about two years, fearing that at best he would not cooperate, and at worst he might have a meltdown. Although Alex has always liked going to the dentist, we did not think he would be able to handle the sensory overload involved in having his teeth cleaned and checked until recently. Once I made the appointment with the dentist who has taken care of him for the past seven years, Alex eagerly anticipated his appointment. Primarily, he looked forward to seeing his beloved dental hygienist who patiently cleans his teeth, praises him enthusiastically, and calls him “Sweetie.”

While this appointment was the same as others in that Alex happily skipped into the office, excited to be there, this time was also different. For the first time in his life, they discovered that Alex had some decay in his back teeth. While we knew that eventually he would have a cavity someday, we hoped that he would continue his lifelong trend of going cavity-free. Also, we dreaded the thought of needing to have cavities filled. His dentist, who has many patients in his practice with special needs, assured us that the best way to handle this procedure was to have Alex’s teeth filled under general anesthesia in a hospital setting. The idea of putting Alex to sleep, especially since he’s never had anesthesia because he’s managed to avoid surgery the way he’s avoided cavities, made me nervous; however, his dentist told me that he had done over 11,000 hospital dentistry procedures. Consequently, we agreed that this would be the best way to fix Alex’s teeth to prevent him from experiencing needless pain and anxiety.

Before Alex could have the dental work done under anesthesia, he had to be cleared medically with a check-up from a doctor on the hospital staff. Even though Alex had a complete physical examination by his family doctor in June, he is not on the staff of the hospital where the dentist has privileges, so we went to a doctor recommended by the dentist’s office. While the doctor was kind to Alex, he seemed to be more concerned with issues unrelated to the upcoming dental procedures. We understood the need to check Alex’s heart and lungs, but the doctor’s insistence upon checking for hernias and scoliosis seemed unnecessary to us. Moreover, we were surprised that he didn’t order any blood tests. Nonetheless, the examination was completed, and we were anticipating the upcoming dental appointment at the hospital.

In the six weeks between Alex’s first appointment with the dentist and the scheduled appointment at the hospital, I had called the dentist’s office a few times with questions about the procedure. They assured me that the hospital would call us to gather pre-registration information a few days ahead of the appointment for the dental work. Since I had not heard from the hospital at all, I called the dentist’s office again and asked them if I needed to call the hospital myself to make sure they had all the needed information to confirm all the arrangements had been made. I was told that I didn’t need to call the hospital, but I could if I wanted to. To ensure everything would be smooth the next day, I decided to call the hospital and check on the arrangements; this was a good idea.

When I called the hospital, I discovered that Alex was not on the schedule for his dental work the next day; apparently someone from the dentist’s office had not notified them. Although my first instinct was to panic, the calm and understanding nurse assured me that she would call the dentist’s office, straighten out the arrangements, and call me right back. As promised, she did make all the necessary calls, made certain that Alex was on the schedule, and called me right back to let me know that everything was ready to go for the next day and answered several questions for me, as well. Things seemed to be set until the dentist’s office called me and asked me why we hadn’t had pre-procedure blood tests done for Alex. A bit taken aback, I told her that the doctor they had sent us to had not ordered any lab tests, or we would have taken care of that already. She told me what lab test needed to be run before Alex could have anesthesia, so I called the hospital nurse who had made the arrangements and asked her what we should do. After discussing options, we agreed the easiest solution would be to have the lab test run when Alex arrived at the hospital for his procedure. Once again, she made arrangements for us, setting up orders for the lab test to be done upon Alex’s arrival. Thanks to her efficiency, we seemed to be ready to go the next day.

With Alex scheduled to check in at 5:15 A.M. for his 7:00 appointment, we had to awaken in the middle of the night to get ready and to drive to the hospital, which is nearly an hour away from our home. Despite having to get up so early, Alex was good natured and enthusiastic about going to a new place. Ed and I were thankful that he wasn’t nervous or scared, which was a blessing to us, because we were a mix of both emotions. At the hospital, we were impressed with how friendly and pleasant we found everyone to be, and Alex was amazingly cooperative. He handled his blood test and the insertion of an IV without flinching or complaining, and we were proud of him for being so brave. He took everything in stride and just seemed to view the experience as an adventure. The fact that the television in his room had a channel devoted to the stock market, one of his interests, helped keep him occupied while he waited was also a blessing. Fortunately, everything ran on time, and his dental work was completed within twenty minutes with no problems. He handled the anesthesia well and came back from the recovery room a bit drowsy but in good spirits. Of course, we were relieved that the dental work was done and that he was fine. However, we were not certain what exactly had been done because his dentist didn’t talk to us before Alex was released, and the nurses were not sure, either. They suggested that we call the dentist’s office to find out exactly what had been done while Alex was there. To be honest, I couldn’t believe that they had filled cavities in the short time he was there and was upset if they had put him under anesthesia just to clean his teeth. However, I planned to call the office to find out for certain.

Yesterday, I called the dentist’s office and discovered that during the procedure they had cleaned Alex’s teeth thoroughly, taken x-rays, and filled two cavities, one upper and one lower. Since he had done well and all the work had been completed, they don’t need to see him for another six months. Apparently, the dental work had been essentially painless because Alex never complained of any mouth discomfort, and he had no problems eating afterward. His only complaint was a slight sore throat and nose from the breathing tube they had inserted, but he handled that well, too. While we hope that Alex can once again go twenty-one years without having any more cavities, we are thankful that the arrangements were straightened out at the last minute and that God took care of him, making everything go smoothly. Moreover, Alex still thinks going to the dentist is fun. If that’s not miraculous, I don’t know what is.

“Your teeth are as white as sheep that are freshly washed. Your smile is flawless, each tooth matched with its twin.” Song of Songs 6:6


Jerri Franceschi @ South Bridge Dentistry said...

Glad to hear that everything went well on Alex's return to the dentist after long years. With his current condition, I don't think he can bear to experience another pain just because of tooth cavities. Finally, after these dental treatments, you're now relieved that Alex will never have to suffer any toothache.

Pam Byrne said...

Dear Jerri,
Thank you for your nice comment. Fortunately, Alex's cavities were small, and he never seemed to experience any pain from them (He would have complain that his mouth hurt if they had bothered him.), so they must have been caught at an early stage. Taking children who have autism to the dentist is challenging because of their sensory issues, and we are thankful to have found a dental practice that understands Alex and his needs. His hygienist Laura is especially sweet and patient with him, so that Alex is never afraid of going to the dentist. Unfortunately, not all children have that same positive attitude. We're pleased that he came through the recent procedure well and that his teeth are so healthy.
Take care,

Lon Peckham said...

Hi, Pam. I know that you're very proud of your son for doing great on every dental appointment that he had in the past. The credit also goes to Laura, as she really knows how to make your child comfortable. It's good to hear that he has a healthy set of teeth. Regularly visiting the dentist will keep him away from dental problems.

Lon Peckham @ Dr. Bill Kramer

Dr. Arun Narang said...

“Alex still thinks going to the dentist is fun.” - Aside from having a successful operation, this is good news. This is the main goal of every dentist with their patient, to make them feel comfortable and encourage them to attend a regular visit. Thankfully, you found a dentist, who's not only good in communicating with the patients, but who's also well-experienced in his field. It's a relief to have an assurance that Alex is in good hands. How is he, by the way?

Dr. Arun @ Smile By Design

Pam Byrne said...

Dear Lon,
We know what a blessing Laura is; we are thankful that she is wonderful with Alex and have told her repeatedly how much we appreciate her kindness and patience. We are also thankful that Alex has such healthy teeth with only two small cavities after 21 1/2 years shows the value of regular dental care. :) Thanks for your nice note.
Take care,

Pam Byrne said...

Dear Dr. Arun,
I totally agree with you about the importance of the relationship between a dentist and his patients. As a child, my family dentist made me feel comfortable, and we have been fortunate to find a dentist for Alex who has also built that positive attitude. In addition, Alex's dentist has extensive experience with special needs patients, which has benefited us. Alex came through the procedures with flying colors and is eagerly looking forward to his next regular cleaning appointment in February. Thank you for asking about him and for your nice comments.
Take care,