Ronan chipped a tooth a few months ago. Thankfully, it didn’t cause him any pain that I could see. But because he can’t tell me verbally if it bothered him, I called the dentist to see if we could have it checked out. In the past, having Ronan’s teeth checked hasn’t been an easy task. Watching big sister’s braces adjustments have helped him know that there is a routine at a dental office – come in, sit and wait, be called back to the exam room, sit in the big dental chair and wait some more – but that’s where easy street ends. Ronan is incredibly nervous when it’s his turn to sit in the dental chair.
The sensory issues, the lack of understanding that people in lab coats are there to help him and not hurt him, and the fear of all that pointy, shiny equipment those lab-coated people want to put in his mouth can make for a traumatic event. Add the insanely long wait time just to get on the special needs practice’s list, when we finally get him in the dental chair Ronan could be on edge long before we get into the building.
I’d like to keep Ronan away from situations that cause him fear, but that chipped tooth needed to be seen by a dentist. If it was like the last tooth he’d cracked, this chipped tooth might also require extensive work. So, back in early May, when I noticed the problem, I made an appointment. I prayed it was nothing to worry about and that he could be quickly seen.
When the appointment came around, one of Ronan’s therapists came with us. What a blessing to have an extra pair of hands to help keep Ronan calm. Not only did the dentist get to do a thorough exam, we were able to get an x-ray of the problem tooth. The only other time we’ve ever been able to do that is while Ronan was under anesthesia. The film confirmed that yes, the tooth is chipped, but as a precaution because of Ronan’s medical history and special needs, the dentist wanted to send the film to the endodontist. Assuring me it was still a clean image, she wanted to get another set of eyes on it just in case. More hoping to rule out potential problems that come with a chipped tooth, namely nerve damage, it seemed a simple enough request. I gave her the okay and waited for the results.
Weeks went by. In the meantime, I read up on what people can do when they chip a tooth. Ronan had never shown any signs of discomfort or distress and continued to seem to be fine. He showed no visible signs of tooth pain, discoloration, decay nor any infection. He ate hot foods and cold foods and was able to drink cold drinks. He continued to allow two brushings a day. The only change was that he went from tolerating a daily flossing to letting me floss his teeth occasionally. All seemed to be going well, and as spring turned to summer, I’d completely forgotten about the worry that had come over me when I’d first discovered the chipped tooth. Imagine my surprise when I got a phone call in August from the endodontic office scheduler. She asked us to come in for a root canal consult. I had the young woman repeat herself, “You need to bring Ronan in for a root canal consult.”
The receptionist continued and told me that the first available appointment wasn’t until mid-September. Could I be there? I said, “Well, if it’s just a consult, yes.” I only know a little bit about root canals. I wanted to hear what this specialist had to say. I especially wanted to hear what he knew about root canals plus autism plus mito dysfunction plus anesthesia concerns. Thinking the worst, it wasn’t Ronan’s turn to be nervous. It was my turn.
I cleared the day on the calendar as did my husband. I can do most of the Ronan-related stuff on my own – therapies, educational meetings, and medical specialty appointments, but I did not want to do this particular appointment alone. Hearing that another tooth may be having a big issue and that this new doc’s go-to treatment was a root canal made me sick to my stomach. I’d now read enough and heard enough stories to know that root canals, even as popular as they are, may not be the best option, especially for a kid like Ronan. With his extensive special needs, and with all the precautions we must take when he goes under, my husband and I were not just against the root canal; we were dead set against it. But, since this was only a consult visit, we thought that having a conversation about our options wouldn’t hurt. Even so, I was ready to put my dukes up if the endodontist told us a root canal would be the only option.
The day before Ronan’s appointment I got a call confirming when we needed to be at the dental clinic. The visit would last about 45 min. Great, I thought. That would give us plenty of time to talk, to go over everything, and to maybe get a new x-ray to see if any further damage had occurred since the last dental exam. Before the receptionist hung up, she said, “Oh, before I forget, if another patient cancels their appointment, don’t be surprised if the doctor does the root canal during your scheduled appointment.”
Dumbfounded, I blurted out, “WHAT?!”
She repeated, “Ronan could have the root canal as early as tomorrow…so, don’t be sur—”
“Oh, no,” I started, “We are not doing that. We are not doing any root canals tomorrow. When we agreed to this appointment, it was for a consult, not to do the actual procedure! Ronan’s got very complicated medical issues. You can’t just “do” a root canal. Plus, what if he doesn’t need one? That’s why we’re going there. We were told that this is a chance to go over things and to talk about what to do next, if anything, not to have any sort of surgeries!”
I didn’t mean to sound as emotional as I probably sounded over the phone, but come on! People don’t just agree to needless medical procedures as quickly as this gal hoped I would, do they? What about taking time to educate the patient and the parents? What about going over options, including alternative ones? What about giving people time to weigh the pros and the cons? What about informed consent? What if we don’t like what this guy has to say? What about second opinions? Shouldn’t a parent, especially a parent of a child like Ronan, have some time to put all the pieces together? We sometimes have no idea what to do until after we find ourselves knee-deep in a situation. Parents need hand holding in those kinds of instances, not intimidation. I was shocked.
“Wow!” the young receptionist replied. “Parents are usually very eager to get that procedure done.”
“I’m not like other parents…” I started to say.
She continued, “This doctor’s schedule is so busy, it takes quite a long time to get on his schedule.”
That may be true, I thought to myself, but I am not signing my kid up for anything, especially for a procedure that comes with risk. I’ve done that before, and the results were devastating.
I kindly reminded the young gal that yes, we’d be there, and that yes, we were ready to consult with the doctor, but that no, we would not be signing up for any root canals. I wanted to add …no root canals then or ever! but I remained polite. Cheerily thanking me for me time, she hung up. I put the phone down and thought, Good grief! I didn’t really want to put my dukes up, but after that phone call they were up and remained at the ready.
Friday morning, we set out for the appointment. As we expected he would, Ronan hesitated when it was time for him to open up and say ahhh. Even though we’ve been working for months on prompts: open your mouth, say ahhh, show me your teeth, first the back teeth…now front teeth, now let’s brush them, good job! This simple hygiene routine is a huge feat that took time, patience, and a lot of trust to create. Unfortunately, Ronan was too anxious to share any of those learned skills on Friday. Even with Daddy there to encourage him, Ronan kept his jaw clamped shut. Even after we tried to distract him, he stayed tight lipped. Even after we started the countdown that usually helps him relax, 10-9-8…Ronan’s mouth stayed firmly closed. There was no way this endodontist, as nice as he turned out to be, was going to take a peek at Ronan’s chipped front tooth or any of his teeth for that matter.
While we waited Ronan out, because I kept hopeful that he’d at least let the endodontist do a quick brushing of the teeth, the doctor went over Ronan’s dental history with us. He reviewed the one film we’d gotten at the last visit and said that the x-ray actually looked good. He detected no issue beyond that Ronan’s front tooth was chipped. As far as the root looked, he saw no cause for concern. I wanted to jump for joy. We all turned to Ronan and gave him a big smile. He must have cued in on how relieved we were because a few minutes later, Ronan opened his mouth wide enough for the endodontist to do a quick exam.
Having now been able to physically examine Ronan, he confirmed, “It’s chipped. But it’s not in need of more than observation at this point.” Then, he added something that calmed my nerves even more, “If this was my child, I’d do nothing. I wouldn’t want to put my child through any unnecessary procedures, and I don’t want to put Ronan though any unnecessary ones either.” I beamed. I looked around, too. Where was that young secretary? She needed to hear this and to also take note: do not scare parents into thinking the worst. Do not worry parents of special needs children any more than you have to. They have enough on their plate as it is.
We thanked the endodontist and the dental hygienist thoroughly. I felt a huge weight lifted as we walked out of the exam room and into the hallway. Waiting to high five Ronan, I looked at him and thanked him. “You did so well, buddy. I know you were nervous. I was, too. You did great.”
My husband commented, “That doctor lost a lot of money today. Easily, a procedure like that secretary said we could have…that’s not cheap. But he looked out for Ronan, and that’s exactly what Ronan needed.” I agreed and added, “I love that he put himself in our shoes. ‘If it was my child…’ That solidified it for me. He was human. Not all doctors we’ve run into treat us like we, or Ronan, are human. We’re a casefile to them. This guy was nice. I’m glad we don’t have to see him again, but I’d actually be happy to—he’s one of the good ones.” We both agreed and wished there were more doctors like him.
As we made our way back to the front entrance, we walked past a small cafeteria. I said, ‘Let me grab some snacks for the ride home. I’ll meet you and Ronan at the car.” Ronan was tired. He was walking slowly, so I thought I’d give them a head start to the parking lot. By the time I got some food, Ronan should just be getting buckled in.
I ordered some food from the deli and grabbed a tea for me. It took about 10 minutes since they did a made-to-order for Ronan. Thinking surely the guys would’ve made it to the car by then, I walked quickly out of the cafeteria only to stop myself in my tracks. There was Ronan. He was standing and waiting at the top of the walkway. What’s going on? I wondered. As soon as he saw me, Ronan turned around and started for the door.
“He wouldn’t budge,” my husband said. “No matter how many times I asked him to keep walking or promised to play his movie as soon as we got in the car, he wouldn’t go. He’s not going anywhere without you.”
I cracked a smile.
I caught up with my fellas.
I laughed a big, happy laugh and reached for Ronan’s hand.
“Oh, Ronan. I need you, too, buddy. I need you, too.”
Cathy Jameson is a Contributing Editor for Age of Autism.