The Dentist, From One Generation to the Next

I took Scott to the dentist for the first time when he was two and a half.  It was a complimentary visit (free of charge) intended to introduce him to the experience and, basically, woo him.  I took him when my sister was going with her two boys, to even make it seem more fun.  There are video games there and prizes and balloons.  This is a well respected, popular children's dentist in our town.  He travels to the area schools and preschools to teach dental health.   He even races in triathlons, like Matt, so they know each other personally.

I didn't know what to expect exactly, because I hadn't been to a children's dentist for a long time.  But Scott was leery of all doctor type places and getting his haircut and, well, anything involving invading his personal space (at this time I thought all toddlers were this way).  He screamed and cried in terror while I sat with him and they counted his teeth.

At 6 month intervals we went back, but he never seemed to get used to it.  They told me he'd adjust and I believed them.  I stayed positive.  Two years later, when he was four and a half and we had finally learned about the SPD, I started to understand what it must feel like for him to go to the dentist.

I knew that I didn't like the dentist.  Never had.  But I guess I just figured that's how all people felt.  I mean I'd almost rather go to the gynecologist than get my teeth cleaned.  Almost.  I have a pretty strong gag reflex and now understand how my own sensory issues make this experience even worse.

When I was around 10 years old, I had to get two teeth pulled to make room in my mouth for the grown-up teeth that were crowded.  My parents took all of us (my older siblings and me) to the same regular dentist who treated both kids and adults.  I was scared to get my teeth pulled but was told repeatedly that it wouldn't hurt.  While there, the dentist kept checking with me, "does this hurt?"

As I remember it, at one point, I answered, "yes, it does hurt."  They told me it couldn't possibly hurt because they had given me a lot of Novocaine.  But in my mind, or for real, I thought I could feel something that to me qualified as "hurting".  They kept trying to convince me otherwise.

I was not a difficult child in general and my parents were pretty strict so I followed the rules.  But certain things, especially when I felt scared or not listened to, pushed me over the edge.  I clamped my mouth shut and refused to let them pull my tooth.

The dentist finally gave up and sent me home.  To say my parents were furious would be a huge understatement.  I was in enormous trouble.  The yelled at me and told me they couldn't believe they had to take me to a "high priced" children's dentist for babies.  They didn't have to do this with either of my older siblings.  I was labeled a brat.  As an aside, they still like to bring this up when trying to prove how over-sensitive, particular and stubborn I could (and can) be.

Since that time, I have had lots of dental work done.  Cavities filled, braces, root canal, caps and veneers, on and on.  I've never liked it, but I have learned to tolerate it.  And as an adult you are taken seriously if you say something bothers you so I feel in control, at least more than I did as a child.

In fact the gal that has been cleaning my teeth for the last ten years has joked that a good dentist learns to treat the children like adults and the adults like children.  So true.

As I understood how Scott's SPD affected him, I also became aware of how being told that what you feel isn't correct can lead to low self-esteem.  The following is an excerpt from an e-mail I sent Scott's OT a year ago after his five and a half year old dentist visit.  Jane came along for that same complimentary visit because she was two and a half:

Just another note:  We went to the dentist last week and I was really dreading the whole thing.  In the past this has been a real disaster for Scott.  Scott went back alone for the first time and then when I went to check on him he was uncomfortable, but not upset.  Jane, on the other hand was perfectly happy.  She liked the chair and all the gadgets and even when the water went down her throat she just coughed a little and was fine.  She was pleased to get the stickers and balloon.  What struck me was how much positive reinforcement Jane received, as in "wow, what a good job your doing, your such a big girl, oh you like stickers, so do I, blah, blah".  Not to take anything away from Jane's good behavior, but really it wasn't that she was actively trying to be good, it's just that the whole thing doesn't bother her (she just got a flu shot and didn't even cry).  However, Scott was told "it doesn't hurt, why are you upset?  Look how much fun your sister is having?  Oh you don't like the ride in the chair, why not?  Well you get a sticker at the end, isn't that good?"  It was so obvious to me how unfair it was that Scott was being treated like his feelings were "wrong" because it is an experience he doesn't like.  From the people sticking things in his mouth, to the weird tastes, to the loud noises, bright lights, awkward chair, paper towel around his neck, etc.   I guess what I really noticed was how people just think that he needed to be convinced that it was OK, instead of respecting his feelings and not making him feel like he's wrong or bad to have them (as in, "I know you don't like this, but I will try to get it done fast, is there anything we can do to make it easier?").  As soon as we left, I gave him the biggest hug and said "I know that was really hard for you, I don't like a lot of things about the dentist either, but you knew it was something you had to do and I'll bet you're relieved it's over".  I was so proud of him for getting through it.  All I had to do was look at Jane and say "wow, a sticker, lucky you!"

This is similar to how people ask you, after you've had a baby, whether the baby is "good".  As if the baby can willfully decide to be cooperative or not.  I am going to cry and stay up all night and drive my parents crazy.  Of course this isn't true, but there is an assumption, even from birth, that children are either good (easygoing, flexible, fun, happy) or bad (particular, difficult, grumpy).

I took Scott to get his cavity filled on Tuesday morning.  He had resigned himself to going and was not complaining.  Until it was time for him to go back.  He tried to get out of it and started to cry while I insisted he go.  I was happy to see the the woman who would be assisting the dentist was the one hygienist that I had discussed Scott's sensory issues with before.  Her daughter has some similar problems and I figured she would be understanding.  "Remember, he's sensitive, please tell him everything," were my parting words.

I understand and respect why they didn't want me to go into the procedure room.  When I worked at my parent's day care we would suggest that parents not spend too much time with their children while dropping off.  I saw first hand that children with parents who said goodbye and acted like their child would be fine, safe and happy, and then left without much fanfare, were quicker to adjust to the school day.  If a parent lingered, the child would continue to fuss and inevitably get more upset.

While I waited, I tried to distract myself with magazines but couldn't help overhearing a family talking next to me.  There was a mother, a grandmother, and two school-age children.  The one girl said, "I don't like the dentist," then the other girl said, "me neither, it smells and they stick things in your mouth."  "Get used to it.  No one likes the dentist," the grandmother grumbled.  Why are people so unsympathetic to kids, I wondered.

I felt like I had been waiting for awhile and went to the receptionist counter to ask how it was going.  "It's fine, they'll let you know."  I was dismissed.

Ten minutes later the hygienist came out.  She said he was done and picking out his prizes.  Then she sat down and said, "He's a really anxious child.  It took us awhile to calm him down and get him to cooperate.  If I had known, I would have suggested that we give him the laughing gas, you know, to take the edge off.  But I didn't realize until it was too late.  But he's okay now, we didn't even have to numb him."

Wait a minute.  She was telling me he's anxious?  And that she didn't realize he was?  I tried to talk with them beforehand about my concerns but was brushed off.  They saw me as a mom who was worried that they would hurt my kid.  That wasn't my issue.  I knew they wouldn't harm him or intentionally cause him pain.  But I also knew that the experience was going to be difficult for him.  I tried to get them to see that and they didn't listen.  I was stunned.

Then I saw Scott and could tell that he had been crying.  I tried to stay level headed and gave him a hug.  He said it didn't hurt but that his mouth felt weird.  The dentist came out and said that he could tell Scott wanted to avoid the whole thing but then finally decided he had no choice and went along.  After that, it was all fine.  He told Scott he was brave and told him to say hi to his dad.

When we got in the car, I asked Scott again if he was alright and he assured me that it did not hurt.  We talked about how relieved he was that it was over and how he was glad he didn't have to return for six months (unless he knocks his teeth out or something).  I fought back tears as I dropped him off at school and told him I was proud of him and we would discuss what he wanted as a present later.

Back in my car, I cried for him.  I felt like I had failed him for not making the dentist personnel understand beforehand.  Should I have pressed more?  Should I have taken him to a different dentist, one that works with kids with special needs?  Or should I just move on knowing that in the end it all worked out?  He survived and can be proud of himself that he did it.

When I had talked with the hygienist before, she had suggested I not tell him much, "it is better if you don't get your child worried by talking about needles and such."  Well, I'm not that stupid.  But there is a difference between creating an anxiety and managing one that already exists.  I have a friend who told me her eight year old hates to fly.  I asked why and she said she had no idea.  Then she confided that she is terrified of flying.  It seems obvious that she instilled her fear into her child.  Children are perceptive that way, sensing when a parent is concerned even if they don't admit it. 

I wanted to prepare him for what was going to happen but I couldn't.  Because I didn't know everything.  And this, it seems, is the lesson for this experience.  I can't always help him.   Fix it up.  Make it easier.

Later that day he told me bits and pieces of what happened.  They had to hold him down.  He was supposed to spit and swallowed by mistake at one point.  They asked him what he dressed up as for Halloween and guessed correctly, Batman.  "But they didn't really care, mom, they were just trying to distract me."  I remembered what my hygienist had said about treating the children like adults and thought, they probably should have explained, in detail, about what teeth are made out of and how they grow and given him a biology lessen.  That would have fascinated and distracted him.

He surprised my by saying that it was about 3/4 not as bad as he thought.  And that he wanted a video game, or maybe a book on animals or Star Wars legos.  I told him we'd find something this weekend.

Then he proceeded to fall apart about something unrelated.  He was tired and overwhelmed. 

So was I.  But we both survived.

Comments

[Lori at Spinning Yellow]

March Day - Welcome! Thank you for reading and commenting. I am sorry to hear about your bad dentist experience as well. So much for experts, right?

[March Day]

Lori - I have seen your comments on some blogs that I read and decided to check out yours. I'm glad I did and look forward to reading more about your experiences.

Before TJ was diagnosed with autism, we took him to a pediatric dentist. I will forever regret letting them hold him down during the exam, and taking him back there again, for more of the same. But, we just didn't know and understand what was going on at the time. And they are supposed to be the experts, right?

We now see a family dentist who is extremely patient and never pushes. He has made significant gains in trusting our hygenist.

It sounds like Scott was very brave, and you know, it is just hard to gage these things and to know when to let them go out on their own and when to push and make it a easier for them.

[Cyndi]

Yea Scott! Wow, Zoe (who doesn't have a card to play) would have handled that one hundred times worse. The thought terrifies me. She still won't let them do the floride. And I don't mind the dentist all that much...
Sometimes I think people are so busy thinking about getting through the next task that they don't listen or care. I suspect whatever you had said they wouldn't have really absorbed it. Frustrating at best.

[Niksmom]

Wow, Lori. Sounds like Scott did awesom in spite of the obstacle put in his way by the insensitive dental practice! I have to say, I tend to agree with Kristen on this one. I know there are times I hate to use the "disabilities" card for Nik but when people just don't get it any other way...well, you do what you have to do. Trust your instincts; from all I've read so far, they're usually dead on! xx

[tulipmom]

I give you credit for going along with their policy of having him go in alone. I don't think I could have done that even though I'm guessing my insisting on accompanying him would only have heightened the anxiety level (and pissed everyone off).

Good for Scott for being so brave but I agree with Kristin that it might make sense to find a new dental practice.

[Lori at Spinning Yellow]

Kristen - I hesitate to use the "autistic card" b/c, technically, Scott does not have autism (although I know some people include SPD under the ASD umbrella). My husband agrees with you, though, b/c he says, you do what you need to in order for people to understand.

Sometimes I find myself stuck in the middle - I know how much progress he's made so I don't "see" the issues, but then again, I am often the only one who does "see" the differences.

I agree that I (along with most parents) am constantly trying to figure out where to step in and when to let him go on his own. In this case, I think I erred on the side of not wanting to create more of a problem when I should have went with my gut and insisted on more appropriate care.

Thanks for your perspective!

[slouching mom]

Ugh. I'm sorry it had to play out that way. People don't really listen. Poor Scott.

[delilah]

"But there is a difference between creating an anxiety and managing one that already exists"

Spot on, Lori.

Scott is a brave little boy!

[kristen]

Wow, Lori, there is so much here, and of course you feel horrible for Scott. I don't know what the answer is, but again, I think sometimes IT IS simply a willingness to understand.

We go to a local "family" dentist, very lowkey, very small, quiet practice. He has been extremely careful and kind with my son simply because he believes that kids who are comfortable with the dentist grow into adults who are comfortable with the dentist. He's committed to making it a good experience simply for that reason, not because GP has issues. And guess what? It works. I don't think our dentist "gets" GP's issues, but he's just an exceedingly kind and thoughtful man. My son loves him.

That said, maybe you should take it to the next level and rather than say "my son is sensitive" say "my son has autism"--put it in words that will drive the point home.

Scott did great. He got through it. By himself!! That's huge. And maybe next time the memory of that success will sustain him.

It all ties into the discussion we moms continue to have about when we are supposed to ease their way and when we are supposed to let them stand alone. I know it was hard on both of you, but celebrate his success. And maybe find a more sympathetic dentist?