Something to smile about
By Denise M. Baran-Unland For Sun-Times Media June 12, 2013 10:42AM
Keeping his eyes shielded from the light helps to calm Jeremy Sharp, 12, as Dr. Lena Qawash works on his teeth. Jeremy has an autism spectrum diagnosis and excess stimulation upsets him. SUBMITTED PHOTO
The American Academy of Pediatrics recommends children see a dentist when that first baby tooth appears.
Unfortunately, many parents of special-needs children disregard that advice for fear of traumatizing a child already struggling with severe health or sensory issues.
The result is that the first visit is for emergency reasons, said Dr. Fred Margolis, who treats special-needs patients and is the author of several books, tapes and DVDs about dentistry for the special-needs patient.
“Many times the parents will see a hole in their child’s tooth or enlarged, puffy, red gums,” said Margolis of the Institute for Dental Education in Buffalo Grove. “Maybe the child has a toothache. Sometimes it’s simply because of school forms signed. In Illinois, we have a law that says kindergartners, second- and sixth-graders have to go to the dentist.”
Still, it’s not uncommon for Margolis to treat special-needs children who, at age 8, 11 or even 19, have never gone to the dentist.
However, with advance planning, which includes finding a dentist who can make your child feel comfortable, that dental trip can be a successful one, as two area mothers, Machell Klee and Diane Sharp, both know.
Klee’s daughter Samantha, 11, suffers from a seizure disorder. When Samantha was 21 months old, a diphtheria-pertussis-tetanus vaccine caused seizures lasting over six hours. Samantha recovered, but four months later, she was taking four seizure medicines to control the 200-300 tonic clonic grand mal seizures occurring daily.
Eventually, Samantha was weaned off the medication to a ketogenic diet, which has reduced her seizures to about a dozen per day. This high-fat, moderate-protein, low-carbohydrate diet helps stabilize difficult-to-control seizures. An electric toothbrush with rotating bristles simplifies home care.
Samantha was 3 when she first visited pediatric dentist Dr. Rita Tamulis Shea in Joliet. Shea allows Klee to sit with Samantha during all cleanings. She uses special bite pads to keep Samantha’s mouth wide open for X-rays and cleaning, as the stress of pushing objects into Samantha’s mouth increases her seizures.
Most of the time, if Samantha has a seizure, Shea keeps going. The seizures only last several seconds and involve facial, lip and limb twitching. Only if Samantha’s tongue is involved will Shea pause, Klee said.
“Seizures are so commonplace to us that we’re not jarred by them,” Klee said. “It’s just a matter of watching and making sure she comes out of them fine.”
For Sharp’s son, Jeremy, living with an autism spectrum disorder means also living with multiple sensory issues. Without plenty of planning, a dental exam quickly becomes an agony of unbearable stimulation.
To keep Jeremy calm, Dr. Lena M. Qahwash, who practices in both Shorewood and Plainfield, explains each procedure before she does it. For instance, she might say, “I’m turning on the water now. It’s going to feel cold.”
Jeremy also wears eye coverings to block out the light.
Qahwash takes her time, even spending half an hour working on one side of Jeremy’s mouth if that keeps him calm. Once, Jeremy passed out from anxiety, and paramedics were called.
At home, Sharp accommodates Jeremy’s limitations by using a three-sided toothbrush; this limits the amount of time the bristles actually touch his teeth and gums.
“You have to find someone your child is comfortable with, even if it takes more than one try,” Sharp said.
Margolis offered additional suggestions for parents and dental providers for a successful dental visit. These include one or more pre-visits so the child can see the dental tools, try out the electric chair and meet the dentist or hygienist who will be working on him.
“I have Muppets puppets in my office and we tell young children, ‘We’re going to count your teeth like Grover,’ ” Margolis said.
Other helpful tools include watching a DVD or reading a book about going to the dentist. Parents should tell dental providers what triggers negative reactions.
For a list of area dentists who work with special-needs children, visit www.specialparentsforspecialkids.com/dentist.html. Additional resources can be found at www.fredmargolis.com.