Teeth

For those of you who are dentist or whose spouses are dentist, this post may be more interesting to you! S1 has always had a penchant for falling on his face. Luckily his teeth have usually been spared. Even in the beginning it didn't matter so much if his teeth did get hit, they were just his baby teeth. But now that he's almost twelve, they are permanent and that's a whole new ball game! It just makes my stomach churn even thinking about anything happening to his adult teeth.

In July 2004 S1 had his first two teeth knocked out at the age of 4 1/2 by his two year old brother. Basically S1 had been using the computer and S2 wanted a turn-no joke. Due to his lack of coordination, it took S1 some time to turn around and get down from the chair. While S1 was facing the back of the chair trying to get his foot down, S2 was impatient and grabbed the top heavy chair and pulled it over. As S1 fell he did manage to put his hands down, but in between his hands was his solid, hard, plastic fisher-price drum. It knocked two front top teeth out of place, loosened a third and sent blood everywhere. Unfortunately it was on a Saturday of a holiday weekend so finding a dentist was a pain. The dentist put the two back into place the best he could and told us to see our regular dentist as soon as possible. We went in the next business day and he scheduled S1 for surgery to remove the teeth the next day. If the dentist had to remove all three teeth, he'd also have to pull out the fourth top front tooth to preserve spacing. Luckily S1 ended up only having to have F and G pulled because E firmed up. He went a few years with a funny side gap before his adult teeth came in. When his permanent teeth did come in, they had a couple of spots from all of the banging but were otherwise just like his mom's big old beaver teeth. I was very grateful.

Fast forward to fall of last year, 2010. For six years he'd had minor falls and such but no damage to those permanent teeth that finally came in. But even though his front teeth, all eight, had come in, none of the rest of his primary teeth had fallen out. Finally a couple of his teeth fell out. One I found just lying on top of the entertainment center, the other I never found so I figured he swallowed it. Yet, his secondary teeth were coming in all over the place! He actually had a third tooth getting loose but the permanent tooth came up too quickly and trapped it between his other permanent tooth and the baby tooth wouldn't come out! We had to go into the dentist to have it extracted. During the exam the dentist got a good look and discovered that pretty much all of his permanent teeth were coming through the gums to the outside of his baby teeth, which were not loosening. We figure his teeth weren't loosening because he doesn't eat certain things due to his autism and sensory issues (think raw carrots, apples, celery-anything hard and crunchy) so they don't get used. He doesn't chew most of his food very well so it really wasn't a big surprise that they weren't falling out.

So on the Friday before I was due with D1, S1 and I headed for the hospital to check him in for the extractions. He ended up having to have eight teeth removed!!! He came through like a champ though and was back to normal by Monday for school. All of his other teeth looked good so I thought we'd be in the clear for the next couple of years. That's how often autistic kids usually have to go to the dentist and be knocked out to do their dental work. Once again I was grateful for how well things went, that and the fact that S1 had already maxed out his deductible for the year so it didn't cost us anything! But I was not to be so lucky, well, and neither was S1.

The end of March 2011 rolls around. As many of you know, S1 likes to escape. We essentially live in Ft. Knox. Anyway, the morning before I am to go out of town for the weekend, I open S1's door to let him out and get ready for school. When he greats me his face, shirt, pillow, and hand are all covered in dried blood! He didn't seem upset at all. His room only has two pieces of furniture in it - his bed and his toy "shelf" that has rounded corners. Of course he can't talk so he can't tell me what the heck happened. But upon investigating him and his room (blood down the side of the cupboard and on the rail), I drew the conclusion that he tried to get back into bed, slipped, and caught his teeth on the edge of the bed frame. His bed is kind of a loft style with cupboards underneath with a round metal rod frame. He has a stool to help him climb up but he may not have used it or possibly had a seizure. Either way he caught his teeth on it and pulled numbers 9 and 10 forward totally out of place. I immediately called his dentist only to find that he was in surgery until 2 pm that day!

So I took S1 to our family dentist- which although S1 didn't appreciate (no cartoons on the walls) he was fairly cooperative. The dentist moved his teeth back into place and used fishing line and bonding agent to splint his front six teeth together. I wondered what the insurance code for fishing line was. He literally had to send the dental assistant to Wal-Mart to go buy some fishing line. Anyway, S1 did need me to hold him down, the assistant to hold his head still and the dentist to do the work but he didn't melt down and opened when the dentist told him to. We also were able to get x-rays. So I'd call it successful. But the x-ray revealed that he would probably need at least one root canal, if not two. Only time would tell. We went back one week later and things were healing and firming up well so we were hopeful even though things were starting to discolor a little. The dentist felt it was prudent with S1's falling and tongue thrust to leave the splint on and have S1's regular dentist take it off at our next regular appointment.

*I should note here that I felt so bad I hadn't heard S1. Usually I hear everything. I hear when he wakes up at two a.m. or at five a.m. or anywhere in between. I hear him babbling, laughing, knocking on his door, jiggling his door handle, and then after I ascertain that he's just entertaining himself, (sometimes after getting up, turning off his light and telling him it's still time to sleep) I roll back over, tune him out and go back to sleep. It's a little harder when he's playing his french horn though! Anyway, I must have been sleep deprived due to the baby because I had heard nothing. No crying (it must have hurt) or door knocking made it through to my consciousness.

End of April, beginning of May comes around and it's time for S1's cleaning. At this point it's obvious that S1 needs the two root canals-but his pediatric dentist doesn't do root canals on permanent teeth. We get S1's splint off and teeth cleaned. Then we go through the circus of trying to find someone to do the root canals. Since I want to make sure things get done right, we really need an endodontist but none of them have hospital privileges. We needed a hospital because none of the anesthetist want to work with him outside of the hospital due to his seizure disorder and meds. We didn't want a dentist with hospital privileges because if he got in there and it was more complicated than he could do, we'd have to pay for all of that plus repeat it for an endodontist. So FINALLY we found an endodontist about 40 minutes away who uses the same anesthetist as our pediatric dentist and had sedated S1 in the past. We finally were able to get all the scheduling arranged and at the end of the first week of August he finally had them done. Due to the sensitivity of the tooth after the root canal, number 9 couldn't be bleached (something to do in the future), but other than that, S1's mouth was back to normal and he seemed unaffected by it all. They got x-rays while in there and everything looked good with the rest of his teeth too. "Hooray! No more mouth issues," I thought.

Well, this summer brought an increase in drop seizures for S1. We'd been working on changing his meds and they seemed to be helping. But while he was at school last week, he started to take off running and had one. He tried to get his hands up but didn't get them there in time and instead broke his fall with his face. More specifically, he stopped his fall with his teeth. The ones he just had root canals on. So I had to run to his school and rush him to his dentist, again. Luckily teeth #8 and #9 were not loose enough to warrant anything being done, not even a splint. However, he did knock a sizeable chunk off the corner of #8 (his right side) but the nerve was not exposed. If it discolors in the next six weeks, he will need a root canal! If not it will just be sensitive since the nerve is now closer to the edge of the tooth. To fix it, he'll probably need to be sedated since the white stuff they use to do it with is really sensitive to touch and moisture (keeping his lip off of it while it is formed and sets is the issue at hand-Dentist said he has really strong lips, who knew? Must be all that trumpet and french horn playing). So that fix will have to wait until the root canal or his next sedation. Tooth #9 already had a root canal and is dead. He did chip off part of the bottom of that tooth so the next time he is sedated, we'll file it down. Other than that his lip was a little swollen but he went back to his normal cheery self. The "best" part is that right now we have no dental insurance (it kicks in Nov 1st). But his dentist is the best and he didn't even charge me for the visit! So, I'll count this whole incident as a blessing because it could have been so much worse.

However, I really am praying for a respite from anymore tooth damage. With his natural gap, a slight increase in it from the March incident and now the chip, it looks like his two front teeth are miles apart. Yes I am that vain. I love my baby boy and want him to look and feel his best. I worry that people won't get past the physical appearance to get to know how sweet he truly is. I also don't want others to think I am not taking good care of him because I try so hard to do so. Hopefully we'll get his meds figured out because I really don't want him to always have to wear a helmet and face guard- if he'd even do it now. I also can't bear the thought of anything else happening to his poor teeth. Unfortunately we can't do anything about capping them, crowning them or dental implants because his mouth continues to grow into adulthood and until it stops growing and the teeth stop moving, they can't do any of those things to his front teeth at least. So please, pray for his teeth and my sanity.