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Dental Issues for the Child with Autism
I have two sons on the Autism Spectrum. My ten year old is considered higher functioning. He has been to the Dentist several times in the past to get x-rays and a crown. The steps of taking the X-rays were very difficult since he did not like the feel of the cotton in the mouth and then the large X-ray machine coming towards him was frightening. Thankfully the process of getting X-rays does not happen often.
Bad teeth happen to run in my family with both my parents getting Dentures. My first dental appointment was at the age of thirteen as a result of a telephone altercation with a friend over talking to a boy. I chipped my front tooth and had to walk around like that for a few months before I was allowed to get it fixed.
Back when I was in elementary school in the early 1970s they had a Dentist that would come to the school and check the students teeth and mouth. I always got a clean report so was not taken to the Dentist. That summer before high school I spent going to the Dentist to get the 37 cavities filled that he found inside my mouth.
I spent high school visiting the Nurse very often for pain medicine for the toothaches I frequently suffered from. While in my early twenties I developed a relationship with a Dentist and Oral Surgeon where I could call the Dentist and tell him which tooth hurt and he would advise to have it removed.
I moved to California at the age of twenty-five and quickly found across the street from my employment a Dental office that helped me with emergencies. I begged this Dentist for false teeth instead of dealing with all the root canals, but he was against getting Dentures at such a young age and wanted to save my teeth. I just wanted the pain to go away!
After my children were born I was able to find a female Dentist who gave me Dentures. This was relatively simple since I did not have many teeth left to begin with and they accommodated me with my children staying in the double stroller while the procedure was done.
Almost two years ago I was able to get a new set since you can do this after five years through Insurance. I no longer have to deal with adhesive to keep my teeth secure in my mouth. My son's teacher actually asked me if I had a face lift after I got the new set of Dentures! I was a smoker for many years and did suffer from gum disease.
The Dentist I found for my now ten-year old son worked with the special needs community. I often sat among wheelchairs in the waiting room while she was attending to other patients. The caregivers always had a folder for the person with notation being done on the days visit. It was always well organized so I felt comfortable with this Dentist and chose her to get my new set of Dentures after she worked on Nicholas.
On one occassion when I had to stop by for a fitting I brought Matthew with me and she looked quickly into his mouth while in the waiting room and recommended he be seen through the Hospital as an out-patient. At the time I was not really ready for such a procedure. It had been on the news around that time of children not making it through procedures in Dental offices due to anesthesia issues and I did not want to even consider it at a Hospital - just yet.
Now that Matthew is nine and cannot verbally tell me he has a toothache and has had some changes in his eating habits I feel it is time for a visit within a Hospital setting for him to be checked and treated accordingly. This is where the obstacles started since Matthew receives Social Security he has Medi-cal insurance. However, instead of straight regular Medi-Cal I opted for an HMO so he could get his diapers covered instead of some generic brand that would not suit him well.
I called the Dentist and found out they moved to another location that is not in close proximity to us, plus we have no experience with the affiliated Hospital. I contacted Denti-cal for referrals and received ones out in Santa Monica when we are closer to Downtown Los Angeles. Then I placed a call to his Pediatrician asking for a referral and left a message.
One of the referral Dentists mentioned Children's Hospital to me and I found their Division of Dentistry. After dozens of options to press for more information and several calls later I got someone live on the phone to assist me. Their recording mentioned they took only current patients and those newly diagnosed with medically compromised issues. Well my son is not newly diagnosed since that occurred in 1999 so I was unsure of where to turn.
I was informed that as long as a referral from his Doctor was faxed over stating his diagnosis and insurance he could go there. This seemed easy enough so I called the Pediatrician and spoke to the Nurse. She told me that they do not do referrals for Dentistry and was very negative and unhelpful. I called Denti-Cal to make a complaint and ask for guidance and they said to try Children's Hospital again and explain the issue with the Pediatrician or to go to a regular Dentist and get a referral.
This seemed really time consuming to find a Dentist and then one who would refer to Children's Hospital. I called our Hospital and their affiliated Dentist does not do anesthesia through the Hospital. Matthew also sees a Developmental Pediatrician who prescribes his antipsychotic medication where he goes for his feeding therapy. She has been on jury duty so that was not possible, but might be in the coming weeks.
I finally got through to the Pediatrician and she said her Nurse would fax over a referral letter. That was over a week ago and still it has not happened. I called Children's Hospital and they never received it, so back to square one.
Children's Hospital says first they verify insurance and will call in a few days after receiving referral. The first appointment is for a consultation. I doubt my son will even get inside a dental chair for anyone to look inside his mouth. This whole process is stresfful and has me anxious wondering what they will eventually find in his mouth and how this will all be handled.
I inquired if I could be there for the examination and was informed that does not happen. I worry about general anesthesia and what I will have to sign in case they do find something and need to take care of it. I would rather that instead of having to be put under again for another visit.
From what I have been able to decipher the general anesthesia is covered under the health insurance with the actual dental procedure and examination part of Dental Insurance. I have no idea if they use the blue board for keeping the child secure. Once when Matthew needed stitches on his forehead they used the blue board in the Emergency Room. This has velcro slots on it to keep the patient still. Matthew fell asleep in this setting while in the middle of getting the stitches.
One other time he needed a blister popped on his finger. The Pediatrician had a Nurse get the blue board and another Doctor needed to assist just to get Matthew in this position so they could remove the blister. The Dentist had this and utilized it for the procedures when Nicholas had a filling and a crown. This board is similar to what emergency rescue workers use to carry people.
Nicholas needs reminders to brush his teeth and sometimes has bad breath. We have tried products to alleviate this. He endured 18 xrays in one sitting at a dental office in November of 2007. We need to find an Orthodontist for a consult since it appears he needs braces.
I was able to get the consultation appointment at Children's Hospital at the end of this month. It turns out that Matthew had his feeding assessment and a consult with a GI Doctor at Children's Hospital, so he is in their system and considered an existing patient. We can bypass the referral to get the consultation, but Children's Hospital will have to get the surgery aspect with the Anesthesia approved through Insurance, which should not be a problem due to his medical diagnosis.
Dental Anesthesia for the Autistic Child
American Academy of Pediatric Dentistry
X-ray use and Safety
Preparing your Child for Surgery
Directory of Dentists treating children with autism
A Healthy Mouth for your Baby
Educational Autism Tips for Families 71 page resourceful ebook for families entering the school system with a recent autism diagnosis. Find out what issues take place over the course of a school day and meet these challenges head on.
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