GOING to the dentist is never a fun event for most of us. Yet, it’s something we should all do. Some people visit their dentist annually; others prefer to make an appointment only when there’s a problem.
That’s when waiting for an appointment while trying to deal with the pain can feel like the longest day of your life, unless it’s an emergency where your dentist may make an exception to see you immediately.
What happens when the loved one in your care needs a dentist? How would you know? With my son, Omar, who is non-verbal (he doesn’t speak), a lot of what needs to be done is based on guesswork, what the doctors recommend and what we’ve read. Of course, the general rules of charting milestones apply. We’ve also gauged many of his conditions from the signals he sounds out, not all of which are clear.
We’ve been very lucky in that we’ve had several doctors to guide us on how to chart his milestones and what to look out for. Since I’ve been taking Omar to see many doctors from birth, I’ve been thoroughly guided on when to see whom. From the neurologists who diagnosed his condition, we’ve had other specialists looking in — neurosurgeons, ophthalmologists, psychologists, psychiatrists, dentists (oral and maxillofacial dental specialists), orthopedic surgeons, rehabilitation teams and speech therapists.
That’s not counting all the other departments that do blood and urine tests as well as his EEG (electroencephalogram), x-rays and other diagnostics. Truly, it takes more than just one village to take care of this one boy.
The most recent event was Omar’s visit to the dentist. It was quite a process for what seemed like a routine dental check-up and “general servicing” of his teeth with fillings, scaling and polishing. For him, all this had to be done via general anaesthesia.
Why general anaesthesia for Omar? It’s simply because he refuses to be “handled” by anyone. You can’t have him in the dentist’s chair and hope for him to calmly sit there while people put fingers and equipment into his mouth. There’s definitely no chance of getting a drill in. You can’t logically explain to him what’s going on. He just doesn’t understand, nor will he take instructions like “be still” or “just a little bit more”.
Knowing my son’s level of tolerance and what he can understand and cope with, Omar’s doctor referred him to the Special Needs dentistry team. Patients who need this special care for dental work are usually put under sedation, whether it’s oral sedation or general anaesthesia.
A SPECIAL TEAM
As a child, Omar was attended to by the pediatric dental team. But now as an adult, he has been referred to a different team. It never occurred to me that such a team of specialists existed, simply because I’d never met anyone who needed it, until now.
The Special Needs dentistry team treats people who have intellectual disability or who are affected by other medical, physical or psychiatric issues, like cerebral palsy, autism spectrum disorder, Down’s syndrome, developmental delay, and stroke patients.
This dental team also deals with patients with complicated medical problems, the elderly, those who’ve undergone radiotherapy for neck and head, oral and maxillofacial trauma and more.
This sounded perfect for Omar. When he was referred to this team, he had to be examined and assessed for the work required. Unfortunately, the members couldn’t get a look into his mouth. He kept it tightly closed. The Special Needs Dental Team, however, was very skilled. In those short bursts when Omar opened his mouth to protest, they managed to get a glimpse of what needed to be done.
Omar needed to go under general anaesthesia for the full inspection and treatment. Before this could be done, several things needed to be covered. The first was to list all of Omar’s medications, how long he had been taking them and why he needed them.
Aside from the obvious, knowing the patient’s history also helps the medical team to look out for side-effects of medications. Anti-seizure medication taken long-term, for example, can give gum and teeth issues.
He also needed to test his blood to ensure that everything was in order and that there were no surprises that could disqualify him for the procedure. So many things to do before Omar could go for that dental “check-up”.
Oral hygiene and health are important for everyone. For those who are terrified of going to the dentist, remember that old adage: Prevention is better than cure. Toothaches are horrible. Special Needs Dental Care is now available in government hospitals, as well as privately.
Next week: Omar’s dental experience — how his mother reconciles with the situation and fate
Putri Juneita Johari volunteers for the Special Children Society of Ampang. She can be reached at juneitajohari@yahoo.com.