The last procedure that my son had at the dentist was when he was 10 years old. He needed to be put to sleep in order to put caps and sealant on some baby teeth. Now, at 16 years old, he needed an extraction. In this situation, he is highly motivated to remove the source of pain. Interestingly, he never verbally communicated that he was in pain with his tooth. I had been seeing paper clips pulled apart all over his desk. My first thought was that it was serving a sensory purpose - he was pulling them apart and stretching them out. But then I noticed him putting it in his mouth. When I asked him to show me, that's when I saw that he had been digging in his tooth with the paper clip. I asked if this hurt him and he said yes. So, a dentist appointment was scheduled. We did a General Diagnostic appointment with x-rays. He did great. I remember seeing him sit in the chair and when the dentist walked in he immediately opened his mouth and pointed to the tooth and said, “This hurts.” I was wondering why he didn't say that to me. And then I got another perspective from his Autism Specialist (my staff), who said, “Well you are not a dentist, so maybe he thought that you are not the person who is going to resolve this problem. But when he went to the dentist he immediately recognized that this was the person to resolve this problem so now let me tell him what is wrong. That makes sense to me. So fast forward to the actual appointment. He went in the dentist chair and the doctor gave him the numbing gel before the anesthesia shot. When the dentist came to give him the anesthesia shot, my son kept closing his mouth. The doctor began to say, “If he's not going to keep his mouth open, we're going to need to reschedule and he's going to have to get put to sleep.” I told my son that if he wanted the pain to go away he needed to listen to the dentist, follow instructions, and keep his mouth open. I sat on the chair with him rubbing his legs and squeezing his toes - this has always been calming for him. The dentist came to give him the anesthesia shot. At first he turned to look at it and pulled away with his mouth closed. I reminded him that the medicine helps to remove the pain so that the doctor can remove the tooth. He opened his mouth and the doctor gave 1 injection and then the next. We waited for some time for the medication to numb the area. When the dentist came back, my son opened his mouth and within less than 2 minutes, the dentist twisted and twisted and pulled the tooth out. My son gave a big heavy sigh of relief. I was so proud of him. He did so well! The dentist even said so.
Fast forward to a few days after the extraction, I have noticed that he seems to be in a better mood. Quite possibly, in addition to all of the other frustrations that he had been experiencing, he was also in pain, but did not communicate it.
For parents with a child on the autism spectrum who may be exhibiting new behaviors, or who are putting new things in their mouth, quite possibly they may be in pain. Check yourself and then get a professional opinion. With our children, even if they are verbal, sometimes communicating discomfort may not always happen. We continue to need our detective hats and the power of observation to decipher what might be triggering new behaviors (actions). Stay diligent, eventually, you will figure it out and your child will thank you.
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