We ran this post as a "best of" in 2018. That's when Summer wasn't such a bummer, eh?" The information is as important as ever, dental care is a huge issue for us. My own daughter had an appointment last week - in hospital - for a filling. The doctor extracted her tooth! Usually a cavity has no more than a few months to worsen, with twice yearly dental visits. But adults do not get twice yearly visits on Medicaid. And finding a dentist who accepts Medicaid AND patients with autism takes more time than you imagine. And then getting an appointment with the doctor takes a whole long time because there is a wait list. And then once in the chair, if you need a filling and general anesthesia, the next available operating room slot could be (was) several months away. And then when COVID cancels your appointment for another three months? Fuggedaboudit. How do you manage dental care?
By Cathy Jameson
"To promote the right to individual health choice and stand up for the victims of medical injury."
I scheduled my typical children’s dental appointments over their summer vacation. Sitting in a dentist’s office for two and a half hours on a sunny afternoon wasn’t on my top 10 things to do while on summer vacation list. Neither was defending medical choices I’m forced to make for my kids. But that’s what ended up happening on a hot July day.
I shouldn’t joke. Taking four children to our dental provider really isn’t that difficult; it’s more time consuming than anything. After a terrible experience with another dental group in town, I’m grateful that our current dentist knows us well. The staff listens to me. They respect me. They understand why I’ve made the medical decisions I’ve made for my children. It’s comforting that they recognize that some of my kids are medically fragile. What’s considered “industry standard” by some can send my children into a downward spiral with potentially long-lasting ill effects.
So, smack dab in the middle of summer vacation was just as good a day as any to bring my kids in for a teeth cleaning. I was prepared for the long afternoon and made sure to bring things for my kids to do while their siblings’ teeth were checked. Just when I thought it would be business as usual, a new dental hygienist greeted us in the waiting room. I wasn’t aware that the one whom I’d made a great connection with (she too had a young child with developmental delays) had recently left the practice.
Politely introducing myself and my two older children whom she’d be working with, I felt somewhat exposed talking to the new hygienist. Stating pertinent health and medical issues my children had, I went through a list of things we usually request.
Will she judge me? Will she understand why things must be a certain way? Will she give me any flack for what I want done versus what she’s used to doing?
Those questions raced through my mind as the hygienist opened the children’s dental files. Inspecting my children’s files, she began to ask me pointed questions the dentist and the previous hygienist knew not to ask us any longer.
“That’s correct,” I stated.
Sealants? It says here that you were thinking about them.
Actually, I was thinking about NOT doing them.
I smiled while trying to sound confident, “No, thanks. We won’t be doing those.”
For the quick second it took for the hygienist to look down at the medical records, I took over the conversation.
“My daughter just got out of braces so this will be her first cleaning without any orthodontic gear. Please use the gluten-free toothpaste and let me know how her teeth look now that the braces are off.”
The hygienist closed the files and said, “Okay, she can come back with me now.”
Whew! Interrogation over…
Can I ask you something?
“Um…yes?” I stammered.
Why don’t you want sealants?
I felt like I was backed into a corner. I had two choices: I could answer her honestly or grab my children and run while yelling, “Leave us alone, you nosey Nellie!”
I took a deep breath and sputtered, “I don’t want to put anything in my kids’ body that I haven’t had a chance to look up.”
Satisfied, the hygienist replied, “Okay, we can get you something to read.”
Oof. I meant that I would go home and look up MY side’s data, not rely on HERS.
“Uhh, okay,” my voice trailed off.
I wanted to hide. But cramming myself behind a waiting room chair in a 10’ x 10’ room wouldn’t make for the best hiding spot.
A few minutes later another dental hygienist, one who’s known us for a few years now, came over to me. She handed me a 4-page print out of information on the sealants our dentist uses. As she handed them to me she reminded me, “Remember, you do what YOU want done, Mom.”
From what little knowledge I have about sealants, I knew I didn’t want them. But when face-to-face with a dental professional who was asking me for a specific reason, I clammed up. I thanked our friendly hygienist and kicked myself for not having a better answer earlier. I should know what I want my provider to do or not do for my children. After all, I’m the Mom. Right?
Mother’s intuition told me no, don’t do it. These sealants are not all their cracked up to be. And even though I wanted to cite actual scientific data to back the uneasy feeling my gut had about this particular procedure, I had hoped that mother’s intuition should be answer enough.
While a former dentist several years ago convinced me to start putting them on my children’s teeth because of the sealants’ cavity-preventing features, at the time I never thought to take the next step to ask what was in those sealants. It wasn’t until last year when our new dentists suggested I get them for my children that I had the light bulb moment to question them.
Since I hadn’t taken time at home yet to really read about them, the response I gave to the new hygienist was that I wanted to research what sealants were made of and to determine what role, if any, they play in my children’s health. I thought that reply would buy me some time to formulate a solid and scientific answer. After I started reading the handout, and after I used my phone to search for more information, it wasn’t time I needed. I merely needed confidence.
After reading, I knew that the next time I was asked, my answer would be a not just no, but no way. From the American Academy of Pediatrics website:
Sealants are a plastic material applied to the chewing surface of permanent molars that provide a physical barrier to bacterial invasion of pits and fissures. Sealants are effective because 90% of caries in school-aged children occur in the pits and fissures of molars, the place a sealant covers.
While the AAP websites’ sealant description sounded somewhat harmless, I’m glad I knew to continue to read. Had I just gone to their website, which tends to promote a one-size-fits-all agenda while not fully considering nor disclosing how substances can and do negatively impact human development, I might have caved and let professional pressure persuade me.
Here is the first page of the paperwork about the specific sealants our dentist uses:
Note the Classifications column. It includes two codes: Xi and T. Xi denotes that an ingredient is an irritant. T means toxic.
Since none of the ingredients sounded natural, my eyebrows were already raised. Reading that each ingredient was either an irritant or toxic didn’t help lower my eyebrows or my suspicions. It only confirmed that this optional treatment would add to an extra burden to my kids’ bodies, a burden that none of them needed to bear.
I scanned the ingredient list again. Sodium Monofluorophosphate jumped out at me. The “–fluro” in the middle of the second word made me pause, so I looked it up.
It couldn’t be, could it?
Yep, it was. It’s a fluoride compound. Fluoride is a neurotoxin that we make every attempt to avoid.
In retrospect, I’m glad the dental hygienist handed me the papers when she did. The first page of this Safety Data Sheet confirmed the gut feeling I had—that these sealants would do more harm than good for my children. Now very curious as to what else the sealant Safety Data Sheet would reveal, I continued to read. Even though we don’t live in California, the Comments Warning toward the bottom of page three sealed the deal—my kids would NOT being getting them anytime soon.
It wasn’t more than 30 minutes later that I was presented again with the fabulous benefits of sealants. This time, the information came from our dentist while he was finishing my younger daughter’s exam. I nodded and smiled as he went into his spiel about those terrible cavities and the miraculous properties of sealants. Thanking him for his input, and reminding him politely that I didn’t want them, I said, “That’s nice. But we’re all set for now, thanks.” Assuring me that sealants are recommended only up to a certain age, I again thanked him for the information but stood firm in my decision.
With what I’ve had to learn for my 11-year old son who has regressive autism, and because of how he’s been injured by recommended and optional medical procedures, I’ve made it a habit of being fully informed for things I specifically face with his providers, his therapists and his educators. But for my typical kids, I’ve let some research slide. That included taking time to educate myself on why I would not opt for a standard operating dental procedure.
Fortunately, this time, my decision was respected. I’m glad that I’m only faced with making that particular decision two times a year. In six months, when we return for our next dental cleaning, only time will tell if our dentist, and the new hygienist, remembers my decision or not.
The reason why I booked my kids’ appointments when I did this summer was because I could devote time to my children’s healthcare needs. Questions that came up during that afternoon’s appointments are a reminder that I need to devote the same amount of time to be better prepared for all of my children’s appointments. This includes reading, researching and asking questions and making sure that when I have learned as much as I can that I remain confident on behalf of my children. Being able to make informed decisions, especially when those decisions are the exact opposite of what best practices state, is important. It’s important because my children’s health depends on it.
Cathy Jameson’s writing has been featured in Pathways to Family Wellness Magazine, Holistic Parenting Magazine, The Autism File Magazine and on Dr. Mercola’s website. Cathy is a Contributing Editor for Age of Autism and co-author of the The Thinking Moms’ Revolution’s book Autism Beyond the Spectrum.