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Learning the dental basics.



We were on our way to town and Matt had only been up and moving for about an hour.  "Did you brush your teeth"?  I asked.   "Um, yes!" he replied as he headed down the hall.  "Did you put on deodorant?" I asked. "Um . .." he turned on a dime and headed straight for his bathroom.  Sometimes Matt needs a little reminder when it comes to personal hygiene.  A little reminder is nothing if you could have seen the early years. Teaching an autistic child to brush their teeth, comb their hair, take a shower, put on deodorant, and for males, shave, are all an adventure in persuasion techniques. Let's start with brushing teeth.

Parents brush a child's teeth for them until they can take the reins and do it themselves.  An autistic child has obstacles to overcome that other children do not. The taste, the feel of the bristles, the gag reflex.  We were lucky in that the taste wasn't too bad.  Matt started trying different candies including candy canes at Christmas and that same mint flavor was in toothpaste. Compare that flavor to brands with backing soda and soon you realize that baking soda toothpaste was a waste of time and money.

As for bristles, we started with a very soft toothbrush and had him explore the feel on his teeth at his own speed - a slow, timid sweep across the teeth, then another, and another. The back teeth caused a gag reflex and he had difficulty overcoming this - and until he did those back teeth didn't get much of a cleaning.  I worried myself sick thinking about all the cavities he would have because his teeth were not getting the proper brushing.  I knew it was time to see a dentist.

The first dentist trip was a complete disaster. Matt was 4 years old and absolutely refused to sit in the chair.  I had to hold him ... tight.  Once we were in the chair he refused to open his mouth. The dentist never saw Matt's teeth that day.  I needed to find a special children's dentist - a specialist with struggling, refusing kids that didn't open their mouths.  I called for an appointment and almost in the same breath explained that Matt was autistic.  At that time most people had never heard of autism and I simply followed my statement with and short explanation of what autism was (as usual). The weeks prior to the visit we practiced opening his mouth on command. "Can I see those pretty teeth?" I asked. After several minutes he would smile and I would tickle him.  "Can I see those pretty back teeth?" I ventured a little further.  Matt would open his mouth to show me - and I tickled him again.  The game was simple enough - but would it work at the dentist's office?  

It sounds like a nice smooth transition - but it took more perseverance than you think. It took weeks of practice just to get him to open his mouth and let me see. Sometimes tickling wasn't enough.  Sometimes it took bribes of cookies and candy and toys. It required a great deal of patience.  Matt's dental exam with a pediatric dentist lasted all of 5 minutes.  The dentist got a quick look, but that was all.

I continued to worry about his teeth and finally decided I would take Matt to my dentist. I took both my sons; Christopher and Matt.  The first visit was my appointment.  Matt met the dentist and explored the waiting room and watch as the dentist looked at my teeth. Then I made the boys' appointments coinciding with my next visit.  Christopher and Matt were both a bit anxious come appointment day.  So was I.

Matt, hands flapping, watched as Christopher headed right in when his name was called.  If Christopher had flinched, even a little, then Matt would have fought us. Fortunately, Christopher did exactly what he was asked to do, showing no fear. Matt willingly came back with me and watched as they looked at my teeth.  When it was Matt's turn he climbed into the chair on his own. The chair hummed as it lifted. I caught his eyes and smiled and pointed at my teeth.  Matt understood immediately and smiled.  The dentist asked him to open up and I caught his gaze again and open my mouth real wide.  Matt again understood and responded by opening his mouth real wide. The dentist lightly touched each tooth. We had practiced this at home.  Matt expected it and thus allowed the examination to continue.  Afterward, I took the boys to McDonald's.

Sounds a bit strange, taking them to eat after having the dentist clean their teeth, but a bribe is a bribe and Matt had been promised a treat if he allowed the dentist to look.  Besides, breaking routine at this crucial point would have been disastrous. The next big step was changing toothbrushes. Matt never did like using a manual toothbrush.  His brushing technique needed changing and I couldn't get him to brush thoroughly with a manual toothbrush. Then the automatic toothbrushes came on the market and that changed how well Matt brushed. The battery-operated spin brush was a blessing. Matt didn't mind brushing his teeth if he could use the automatic spin brush.  Matt  finally began brushing the back teeth because the spin brush did not cause a gag reflex. 

Matt didn't have a cavity until 2009, at the age of 23. I dreaded the day he would need a cavity filled, but I didn't need to.  By then, Matt was well known at the dentist office, knew the routine and liked his dentist. I explained what would happen and gave him every single detail of the procedure. I told him his face would feel a bit weird but that it would wear off.

On the day of the appointment I was the one that was anxious. Matt went in when his name was called. I watched him march through the door determined.  A few minutes later I was called for my own scheduled cleaning. I sat in the chair straining to hear anything that resembled a fearful cry, pain, anger . . . but no sound ever erupted.  After my cleaning the dentist walked in to check my teeth. "Matt had 2 cavities filled and he's all done", he said matter of fact. I sat stunned. Really? Already? "He needs to focus on his gums more . . ." the dentist went on. But I didn't hear him finish.  My mind was still on the fact that Matt allowed a needle in his mouth, allowed the sounds of drilling and the feel of packing a tooth with filling.  I was awe struck.  Could it really have gone that well?

I met Matt in the waiting room.  He didn't look happy, but he didn't appear fearful or mad either.  Actually, he looked fascinated by the numbness of his face and that was all. I schedule one more appointment for him to get a third tooth filled. On our way to the car I explained to Matt that we would have to come back in a few weeks to do it again.  "Yes" he replied. There was no fear in his voice. He never even flinched. 

Matt is now 26 years old. He brushes his teeth and sees his dentist twice a year.? It's just another routine now.  It wasn't always this way - it used to be stressful and worrisome. 

Now, taking care of his teeth only requires a simple reminder. "Matt, did you brush your teeth?"


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