Isaac is almost thirteen years old. He’s never had a cavity. Neither have his brothers.
Isaac can barely sit through a dental exam, but he seems to behave much better if Chris takes him to the dentist, so that’s what happens. Isaac was sobbing this morning because his bus wasn’t coming to pick him up for school. (I had told the bus driver NOT TO DRIVE BY, or all hell would break loose.) Isaac lost it when Chris drove into our driveway at 8:15 this morning, but he pulled himself together for the appointment.
The pediatric dentist who treats Isaac – and many other kids with autism -- is fabulous. We learned about her through word of mouth. (No pun intended.) She was highly recommended. When Isaac was younger, she allowed him to come to the appointment extra early so he could explore the office, flush her toilets, and finally get comfortable. She has young kids of her own and usually is wearing running shoes. She is genuine. She treats all of my sons with respect and understands our dental challenges. She also accepts Medicaid, which is a rare and wonderful thing. Most dentists aren’t willing to accept the dismal Medicaid reimbursement.
I had several cavities in my baby teeth and even two silver caps (horrors!) when I was growing up, but after my permanent teeth came in and I had braces for two years (along with a monstrosity of a head gear to correct my terrible overbite), I vowed to take good care of my pearly whites.
About five years ago, I called my orthodontist -- whom I hadn’t seen for more than twenty years -- to alert him that my retainers had broken. I wanted replacements. The receptionist said my name wasn’t in the computer. She called me back after she had dusted off my files, which were found in an old box in the basement. When I came in for the appointment, all of the dental assistants hovered around me to gawk at my paper medical records and the retainers I had been wearing since I got my braces off in 1983. One of them said seeing my retainers was like going back in time. Apparently I’m the only adult in the history of that orthodontist practice to waltz in after decades, demanding new retainers. I’m possibly the only adult who still wears them. What can I say? Old dental habits die hard.
When I picked up my new retainers, the orthodontist said, “I guess I should see you in a year.”
“You haven’t seen me in over twenty years,” I replied. “You told me my teeth haven’t shifted. I’ll see you in another twenty.” He told me he would be retired by then or likely in the nursing home. I told him I’d be in touch. I haven’t talked to him since.
It’s silly, but Isaac’s cavity somehow feels like a reflection of the job we as parents are doing. It’s nothing the dentist said; in fact, she says we do a good job. It’s just me and my dental neurosis talking.
Isaac can brush his teeth, but he doesn’t do a very thorough job. He has a sensory issue with having a toothbrush in his mouth, particularly way in the back. His lips are strong and can prevent even an adult like Chris from getting in there to brush off the plaque. Sometimes I try to hold Isaac’s lips while Chris brushes. The problem is that Isaac is almost as tall as I am. He’s strong. We’ve worked on this in occupational therapy. It’s been worked on at school. It’s gotten a lot better, but Isaac will never initiate brushing his teeth each morning or evening. (I know, I know, neither will many other kids or adults.) It’s a good thing our bathroom is small because generally he needs to be cornered and forced to stay in there until the tooth brushing is over. Occasionally I floss his teeth, and he tolerates it pretty well but typically runs screaming afterwards into his bedroom. Oh, the drama.
Isaac will need to have his cavity filled in the hospital. Hospital? Say what? Yes, it’s true. It’s the only way the work can be done. He’ll be given anesthesia while the cavity is filled, x-rays are taken (for the first time ever), and sealant applied to his teeth. He has a dark mole on the bottom of his foot that needs to be removed, so we’ll try to coordinate a dermatologist/podiatrist to be there so it can all happen at the same time.
Our dentist said this day would come – and when it did, we’d take care of several things. For many families with special needs, this is old hat. They’ve been through it many times and know the drill. (Pun intended.) I’m grateful we have dental insurance and Medicaid to cover the cost of the cavity and hospital charges. It will be unbelievably expensive.
I guess this is a rite of passage – like learning to ride a bike or having a crush on a girl or getting a driver’s permit. Our rites of passage are different: graduating from physical therapy, getting the first speech generating device, using a daily schedule without pictures, going to the hospital to get a cavity filled.
It is what it is. I’m sure Isaac will do fine when the time comes, after he’s sedated. It just shouldn’t be this difficult, should it? And it won’t be the last time. Odds are good he will have more than one cavity in his lifetime.
Tonight I’ll tell Noah and Henry about Isaac’s cavity. My guess is that they will both brush and floss a bit more diligently. The first time Noah went to the dentist, he waved goodbye on his way out and yelled, “I hope you have a good dental career.” The poor kid didn’t realize he would need to come back every six months. He does well enough that he could get a cavity filled in the office. I have my fingers crossed he checks out fine at his appointment in two weeks.
I still can’t believe it. Isaac has a cavity, and now we need to make plans. I’ll brush, floss, and mull all of this over tonight while I’m tucked in bed, wearing my retainers.