Wednesday, April 25, 2012

Look Mom No Cavities! (Taking a child with Down Syndrome to the Dentist)

Today was an excellent visit to the dentist for Cate.  She cooperated, verbalized when she needed a break, and her teeth looked great - no cavities!!!  This has not always been the case for us, as evidenced by the fact we are only allowed the first appointment of the morning on Wednesdays and Cate has to show up to the appointment ready for sedation if necessary.  My friends with children with Down Syndrome have had a mixed set of experiences at the dentist - some kids are perfectly fine with it, some have to be sedated every time.  Cate has matured into being able to handle the dentist but that has only been true of the last year.

No cavities!  And there front tooth waiting to make an appearance in the spot that's been open since October!

Think about it - why is anyone fine with the dentist?  You go to a person who is practically a stranger, let him chain a bib to around your neck, then allwo him to pin you laying down with your mouth wide open while he pick at your teeth and gums.  Crazy?  Well lots of kids with Down Syndrome are extra sensitive to this situation and can't be prep enough or convinced to let this craziness go on in their mouths.  Cate use to be that kid.  She started going to the dentist at 2 years old which she had an odd arrangement of baby teeth come in which did not include her front teeth.  She did OK for those exam only visits when the dentist let her sit in my lap then just lay back into his for a few minutes at a time.  It wasn't until the first real exam and cleaning that Cate lost it.  She cried so hard she had little pin pick marks around her eyes.  They got the exam done and a very fast cleaning but no floss or fluoride that time.  The next time was even worse. She cried so hard that there was blood in her tears - seriously it scared the living daylights out of me.  Needless to say we stopped that appointment and rescheduled since they haven't even finished the cleaning or x-rays.  Ric took her to the new cleaning appointment and he stopped it as well once she started going into hysterics.  So the next time we took her in with no food after midnight so that they could sedate her.  It still was pretty horrible - she moaned the whole time they took x-rays and cleaned.  For the next year and a half she was sedated for every appointment including a simple cleaning.  Unfortunately there were quite a few because she had 5 cavities by the time she was 5 years old.  This is actually against the odds for a child with Down Syndrome.  Although statistically as a group people with DS have higher instances of gum disease, they have significantly lower instances of cavities - no one knows why. 

Actually I think I might have figured out how I contributed to the cavity issue for Cate.  It was hopefully a combination of things - the first being she was on antibiotics about 20 times before was 3 years old, which can weaken tooth enamel.  The second factor may have been totally my fault - honey.  I give the girls honey when they are coughing and it works great for them.  Unfortunately I do this in the middle of the night most often.  So I was giving them straight honey from a spoon and it just sat on their teeth all night usually a few nights in a row.  OOPS!  It just hit me recently when I was doing it that might not be the best idea for cavity prevention.  I'm trying now to give it to them before they brush their teeth if I suspect a cough might be coming on.  Then if I do have give it to them at night, I at least get them to drink water afterward.  I say these are hopefully the two reasons because if so then maybe we can prevent it from happening as her big teeth grown in.

This last year Cate has done a little better every time we go for a cleaning.  A few visits ago I asked to try it without sedation and she did pretty well after lots of prepping and bribe of breakfast inside at McDonald's before school.  I told the hygienist about the bribe and every time Cate started to break down she reminder her and of the reward.  Ever since then we have gone prepared for sedation but never had to do it.  This visit she did awesome!!!  Never even cried once or had that pre-panic look.  She did ask for a couple of breaks but we got in the exam, cleaning, flossing, and fluoride paint with practically no issues.
at the dentist

So if you are a mom to a little one with Down Syndrome or other sensitivity issues I have some bits of advice.  First - find a pediatric dentist who frequently deals with children with special needs because they should have more options for your child - sedation, a papose (restraint system), sitting in your lap, breaking up appointments.  Asking around to your friends for recommendations then calling and discussing special needs options with those offices is probably your best bet.  I was lucky enough to have a friend who works with a dental association and she was able to get me a name based on reviews & listings for special needs - awesome friend huh!  Second - start early, in my experience Cate grew more comfortable as she got old and more used to the process.  I think she finally got comfortable because each time she remembered a little more and felt like she knew him a little more.  Lastly - be open to options like sedation or restraint when it makes sense but after some time give your child another chance to do it without those options.

Dr. Cate taking care of patient Monkey - he didn't have cavities either and "cooperated"

Drop off at school - yeah computer lab with our favorite para-pro today!!!

1 comment:

  1. SOOOOOOO proud of her!!!!! Wow, this is an awesome post, and one that is close to my heart. Sammi is one of those resistant children who will NOT open her mouth for the dentist. She's never had her teeth cleaned, even though she's been going since she was 1. She's going to have to have her palate expanded soon to correct her underbite, and I suspect it'll involve a *lot* of sedation. ugh. You give me a lot of hope with this post, with Cate being a little bit older than Sammi. Thank you!!!