I took Anna to the dentist yesterday. She really wanted to go. She wanted “happy teeth” that were clean and sparkly. I had warned the office the she has ASD and that she will be anxious about getting her teeth cleaned. They assured me that they deal with special needs children all the time and they could deal with whatever she’d throw at them.
My first warning sign that all was not well was when the hygienist came to get us. She didn’t explain to Anna what was going to happen. She didn’t let Anna feel the toothbrush vibrating on her finger before putting it in her mouth. She didn’t squirt the water from the fun “water gun” to show Anna what it was like. She just had Anna lay down on the chair and went at her teeth with the special whirly toothbrush. It took only 10 seconds before Anna started to scream. She shrieked, kicked, and jumped out of the chair and started crying that she didn’t want to lie down and she didn’t want her teeth brushed. I tried reasoning with her that we were almost done but she was past the point of return. The hygienist tried talking her into laying down again but Anna screamed “no!” and would not stop crying.
Then, it got worse. The hygienist told Anna to stop crying because she’ll upset the other children. Of course this had no effect on Anna other than to make her scream louder. The hygienist told Anna “Don’t yell at me” and walked away. She came back and said “please stop crying, you are scaring the other children and they won’t want to come back to the dentist”. Anna continued screaming. I looked at the hygienist, incredulous, and said “Are you aware that she has autism?” The hygienist looked at me and said “yes of course”, but I think she really didn’t or didn’t know how to deal with this scenario like I had been assured that she would.
Anna was still shrieking and I started crying. Then the hygienist told ME not to cry, that it’d be okay. (Yeah right…my child is acting like a frightened wounded animal and I’m sobbing in front of everyone staring at both me and Anna, and everything is fine. Sure, lady, it’s all good.) Then the hygienist said the thing that everybody ALWAYS says to me, the thing that always surprises everybody…”But she’s so high functioning!”. That statement gets me going every time. Yes, she is high functioning, but she STILL HAS AUTISM! Just go ahead and make me feel worse about the situation. I had to tell you in front of the whole office that she has autism because I had no choice and you come back with “but she’s so high functioning”. Like it’s not enough to bear that my daughter is on the spectrum, I have to also feel bad that people think she should do better because she's smart, and be able to get a grip. But the reality is…autism is a spectrum disorder, and everyone on the spectrum shares CORE DEFICITS no matter if they are high functioning or low functioning. I feel penalized twice by my daughter being on the spectrum…the fact that she’s on it, and the fact that people don’t get that a high functioning individual still has significant difficulties that influence the way they interact with their world.
So the hygienist says “she’s so high functioning, she’s smart as a whip. She’s intelligent and using reason with me, she knows that lying down means getting her teeth brushed. So she understands intellectually about visiting the dentist’s office, but she is not emotionally ready to deal with the new place, the new people, the strange sounds and the strange senses she’s getting from the toothbrush in her mouth and people touching her teeth”. I wanted to say “well then why the hell are you getting after her for crying?”. It’s not like I have a disobedient, unruly child who’s being a pill. I have a child who’s scared spitless into a fight or flight response and she’s being told not to cry. Ugh.
Finally the hygienist said the best way to deal with this situation would be to get Anna onto the chair…I would lay down on her legs and hold her arms, someone else would hold her head still, and the hygienist would clean Anna’s teeth as fast as she could. Getting Anna into the chair was fun with her kicking and screaming. I held her like a straitjacket. She was screaming, and I was crying. We were a sight. But finally it was finished, and Anna sat up to give me a hug (which made me feel a little bit better). The dentist came over (with trepidation, I thought) to take a look into Anna’s mouth for herself. Anna sat on my lap facing me, and I laid her down and onto the dentist’s lap. The dentist was very calm and serene, explaining to Anna that she was going to look into her mouth with a special small mirror and count her teeth. Anna did not kick or flail, but she did scream and wail. Finally that was over too. Anna got to pick a prize. Someone tried to give Anna a special balloon but she was so agitated that she refused. I heard the dentist say something about a significant overbite. Then we went into an office to talk.
I had wanted x-rays done but didn’t want to push Anna any farther. Instead I mentioned to the dentist that I am concerned that Anna’s teeth are wedged so tightly together. She said yes, that’s a big concern since secondary teeth are twice as large as primary teeth. She mentioned jaw extenders and spacers and I looked at her, about to laugh. She looked at me and then said that tooth extraction might be easier, they could put her to sleep for that. And I said yes, that sounds like the best way to deal with that issue when it comes up. She said for Anna's next cleaning, bring her in the morning, and they’d have a special room flagged where Anna could be alone away from the commotion of the office…the doors to that office could be closed so her shrieking would not freak out the other children. And I wondered, why was this option not disclosed to me before this whole fiasco started?
At the end of the day, I like the dentist. I think she was very good with Anna. And I think Anna gave the hygienist an education about high functioning autism. And, we gave everyone in the office a story to go home with at the end of their day. Anna spent the rest of the morning feeling strung out, and I can’t blame her. I felt more or less the same way the rest of the day too.