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Monday, February 4, 2013

Ignore your teeth, they'll go away

Here's another confession. I have terrible teeth. Terrible. It wasn't like that until about 8 years ago. I would visit the dentist about once a year for a cleaning and few fillings and that was it. Until one fine day when a deep cavity turned out to need a root canal. I hadn't seen a dentist in 3 years because I didn't have dental coverage. By the time I finally had dental coverage and saw a dentist to address said root canal, I needed no less than six root canals. Fortunately, three of those could be saved, and I ended up with "only" three root canals and four fillings. Those three root canals + the posts and crowns + the other four fillings ended up being a months-long affair; I was at the dentist once a week for five or six months, finishing the very last crown mere weeks before Chaim was born.

Then, things were kind of quiet on the dental front until right before Dovi was born, when I had a toothache and discovered several more cavities. Since Dovi was born, I've been living at the dentist off-and-on, especially in the past two years. At this point, I have many broken teeth, several more crowns, and I'm still waiting on coverage for a root canal on another tooth. Tooth #28 to be exact.

Crocs, Inc.
It stands to reason that I hate going to the dentist. Hate it. I always seem to feel the drill, and I have a strong gag reflex. Luckily, my newest dentist, Dr. Baratz, has an extremely gentle touch and is very careful to hop me up on elephantine drugs and ask me every sixty seconds if I'm doing okay. Still, my stomach does flip flops every time I even suspect that I need to see the dentist. I deserve all those needles and drills though; I simply don't brush my teeth. And Chaim never remembers to brush his. I also forget to brush Dovi's teeth, especially since it's a fight to get him to open his mouth and I also don't want to get bitten.

My aversion to dentists has spilled over to my kids, too. I absolutely avoid taking the kids to the dentist if I don't have to. Chaim had his first toothache when he was 3 1/2. I took him to Dr. Jonathan Waltner. The child-friendly office and overhead Uncle Moishy did nothing to stop him from screaming, thrashing about, and totally not cooperating. He had five cavities. My husband went to the subsequent appointments as I simply didn't have the physical strength to hold Chaim down during the fillings. After that he swore off sweets; he refused to eat a single candy for several years, his fears of the dentist ran so deep. Since then, bli ayin hora, he hasn't had any more teeth trouble, except for needing one extraction when a baby tooth that simply wasn't falling out got infected. (That reminds me, it's a Binah article waiting to be written.)

When Dovi turned three, I had never taken him to the dentist yet either (besides for a quick visit when he was 11 months old; read later why). With Dovi's sensory issues and hyperactivity, it wasn't something I wanted to do if I absolutely didn't have to. But towards the end of the summer, Dovi simply stopped eating, and his hands were in his mouth a lot. It was clear to me that the kid had some serious toothaches going on. But where do you go with a kid who does not understand anything, and who will not lie still in a dental chair? Taking him to any kind of medical office was a nightmare; during sick and well visits at the pediatrician a nurse and I had to physically hold him down so the doctor could examine him. What kind of dentist could handle Dovi?

I knew I had to look into sedation dentistry, but I was pressed for time. When we came home from the Catskills we fell right into the whole settling in / preparing for Rosh Hashana / new school year frenzy, with no time to breathe. I told myself I would look into it right after the holidays were over and I could catch my breath. I was getting notes home from school telling me that Dovi seemed to be in discomfort and was mouthing a lot of things. I desperately wanted to take care of it - but I didn't have a dentist to go to.

Things came to a head during the intermediary days of Succos, when Dovi was up for two nights crying, in obvious pain. There was no choice now; I couldn't wait until I had the time to research a pediatric sedation dentist. I made an appointment to a local clinic, Maskell & Rubinstein, that dealt with a lot of difficult kids; they wrapped the kids up in a papoose on a board so that they couldn't jump off the bed.

The first appointment wasn't too bad, as Dovi didn't yet know what he was in for. Of course, his teeth couldn't be xrayed, as he wouldn't sit still; intead a dentist looked into his mouth and told me he had four teeth with big cavities. One even needed a 'baby root canal'. I had to go to the other side of the building and a wonderful dentist named Dr. Gabriel. She filled two of them on the spot - the two worst ones - and gave me a second appointment to come back. It was a little stressful, but doable. Since his teeth were so tiny, it took almost no time to fix them. Dovi tried pushing the instruments out with his tongue, and he bolted from the chair the second he was done - but it was survivable.

However, the return trip wasn't so easy. It turned out that one of his teeth were infected, and Dr. Gabriel simply extracted it on the spot. (This wasn't, by the way, the first tooth Dovi is missing; when he was 11 months old, he once cried behind a closed door and when I went to open it, I didnt' know that he was biting on the bottom of the door, and his tooth simply came out from the force of the door opening. It was his second tooth! His bottom front pearly white. I took him to his first dental visit the next day, but Dr. Waltner hadn't been overly concerned and told me it would eventually grow back. At age 4 1/2 it still hasn't, but he's young still. Chaim's first tooth fell out at age five.) Holding him down as he was writhing, sweaty and slippery, trying to kick his way out of the papoose took superhuman strength. He wouldn't bit down on the gauze of course. The dentist warned me to stop his juice bottles. I felt like the worst mother in the planet and began diluting his juice bottles the very same day. (By now, he loves drinking plain water, thank G-d; and he drinks from cups more than from bottles.) Dovi was really mad that day, and I could see a hatred and fear of the dentist forming. But miracle of miracles; after that extraction his appetite came back with gusto. The crying at night and mouthing of anything in sight decreased, and we all breathed a sigh of relief. At the same time, I felt awful for the poor child, who was unable to tell me in simple words or otherwise, "Mommy, my teeth hurt." Instead, I had to be super aware of his behavior patterns and figure out when he had a toothache. After that, I learned that his signs were a severely decreased appetite, hands migrating to his mouth a lot, and biting on anything in sight.

Unfortunately, that was far from the end of the Dovi dental saga. This kid has absolutely terrible teeth. Although we have virtually cut out sweets from his diet and he drinks mostly water, they continue to sprout cavities and bother him all the time. Taking him to the dentist is extremely difficult. The long wait in the crowded waiting room, with him running on all the chairs and grabbing food out of other kids' hands isn't even the hardest. Holding him on my lap during the initial exam isn't even the hardest. It's the treatment portion of the appointments. I simply don't have the physical strength to keep his head straight, and witnessing the pathetic screaming, wriggling, and desperation to run away from there is emotionally wrenching.   Whenever I get told at school that he is once again mouthing and biting things and seems to be in discomfort, my heart sinks down to my shoes and I reach for the Valium. If I would have Valium, that is.

It's not that we didn't try to explore sedation dentistry. At one point last winter I kept him home from school and shlepped to Boro Park with him - not an easy trip - to Maimonides Dental. They looked into his mouth and said he has two really small cavities and they would not put a child out for two small cavities. I called Columbia Presbyterian's Pediatric Dentistry and was told that I first had to come for an initial exam, where they would determine if he is a candidate for sedation dentistry. That kind of defeats the purpose; even examining him is extremely difficult. I was told that there are dentists who do everything under anesthesia; exam, xrays, cleaning, fillings, root canals, extractions, and voila, the mouth is good to go. But I still don't know who those miracle dentists are. I was told of someone amazing in Suffern, New York - but I have no way to get there. Making Dovi fast for hours in the morning is not feasible either. The very minute he is out of bed he eats and drinks everything in sight. Last winter he needed an infected tooth extracted under anesthesia - yes, a different tooth - and my husband handled that appointment. We scheduled it for 9 a.m., and we didn't take him out of his crib until 8:55 a.m., dressed him, and off my husband ran to the oral surgeon, located 3 blocks away - where he waited for an hour. I wouldn't be able to withstand Dovi's cries for food or drink; I'm a mother. I had to let my husband handle that. (Note to self: Write that Binah article already!) Traveling for an hour prior to an appointment and withholding food or drink from him would be torture - I wouldn't be able to do it.

So we are still stuck. I have been to the dentist with Dovi too many times to count. Last spring, he was in pain yet again. I discovered that his two upper teeth are ground down to nubbins, and the nerves are almost exposed, which is causing sensitivity. Dr. Gabriel lacquered the teeth - or whatever you call it - with a layer to reduce the sensitivity. Just a month ago, two more cavities were filled - and I sent my husband with him. As Dovi grows older and larger, he kicks his way out of the papoose very often, and I simply lack the upper body strength to hold him down. Just a week ago, he started putting his hands in his mouth again - and both my husband and I shook our heads, thinking, Oh no. We can't POSSIBLY need the dentist again! For now, whatever was bothering him in his mouth seems to have gone away, and his appetite is as good as ever. But I know that another trip to the dentist is in the not-too-distant future.

So I put this question out to you, parents of special needs children or otherwise difficult, sensory, high-maintenance, phobic kids: How do you handle trips to the dentist? Any ideas? Can you share names of dentists who can handle kids like Dovi? I need some advice, and stories from the trenches. 


Forgive me for doing this, but from this point on, I will be posting the Donate button in every post. Please, if you can, make a small donation to Dovi's Educational Fund. At this point we are barely at the quarter mark for his lawyer's retainer - nevermind the actual costs of his tuition. We need tens of thousands of dollars!!!


  1. we do sedation dentistry at the one place locally that will sedate for cleanings without putting kids completely under. but luckily for both twins, they've never needed anything more than cleanings. Brushing teeth daily is an absolute here. except Shabbos and Yom Tov (kids are always happy when we skip it of course). :) It took a year of OT to get Fred to have his teeth brushed without trying to bite us and without 2 of us needing to hold him, but now it's all good. No cavities or root canals or extractions here. yet?

  2. My dd was taught brushing teeth in school (special-ed preschool), they do it after each meal and luckily, she loves it!! she does have a low sensory issue in her mouth which is now treated with electric tooth brush, which she got used to and by now loves the vibration!! I really hope this will prevent cavities...Can simply not picture taking her to any dentist, (she simply gets wild and develops full-fledged tantrums wheneve we arrive to any such place....)Good luck!! not easy....


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