Autism and Oral Surgery


Lucas needs his wisdom teeth pulled.

For most of us, having wisdom teeth out is NOT an experience that we look forward to. For someone with autism, oral surgery will need careful planning, before, during and afterwards.

Fear and pain - There's a sense of apprehension, fear and even dread about having any kind of surgery. After oral surgery, there's usually pain, swelling and stitches. A person has to watch what they eat and watch for any unusual symptoms.

Autism view - For a person with autism, oral surgery and all it entails is difficult to imagine. For instance, we have no idea how Lucas will react to:

  • Having to go without any food or drink for 12 hours before the surgery.
  • Being placed on a gurney and wheeled away from Mom and Dad by strangers.
  • Having a needle inserted into his arm with a tube attached, and being expected to keep it there.
  • Being surrounded by strangers wearing masks in a strange room that he's never seen before.
  • Being told to count backwards from 100 (he has trouble counting forward!)
  • Waking up in strange surroundings, with people he doesn't know talking to him.
  • Having numbness, stitches, and/or pain in his mouth, and seeing his face swollen.

But it needs to be done, so I made an appointment with an oral surgeon.

Explaining to the surgeon - I explained that Lucas' autism needed to be taken into account, not just before the surgery, but also during Lucas' recovery period. I was assured that this surgeon had experience with autism and oral surgery, and would definitely know how to work with Lucas' needs.

We took Lucas for a visit, and he had an x-ray done of his entire mouth. Then we all went into an exam room, where we met the oral surgeon.

He walked us through the process, and we all agreed that it would be best for Lucas to be under general anesthesia for it, which means having it done in the hospital.

Trouble - He also said that he always performs surgery after 1 p.m. That wasn't good.

You see, because of Lucas' autism, oral surgery will be done under general anesthesia. This means Lucas won't be able to eat or drink ANYTHING (not even a sip of water) after midnight the day before the surgery.

Lucas will be asleep at midnight, but it will be very hard to keep him from having anything to eat or drink once he wakes up in the morning. That's why when I made this appointment, I told them that the surgery would need to be as early as possible if Lucas was not going to be able to eat from midnight the night before.

When I asked how Lucas would be handled AFTER the surgery, the doctor stated that Lucas would be treated just like his other patients after tooth extraction.

Did he forget? Thinking that maybe the doctor forgot that Lucas is autistic, I tried to explain our concerns about once Lucas was home:

  • When he had stitches in his mouth that he was messing with.
  • When he had pain in his mouth that he didn't understand.
  • When he could only eat certain, soft foods.
  • When he looked in a mirror and saw face that was swollen (that he might try to "fix" by banging against a wall).

I was interrupted by the doctor and told that he handles all patients the same.

This won't work - Neither Alan nor I felt that this was the guy we wanted working with Lucas. We also felt frustrated and deceived, because when I made the appointment they said, "oh yeah, we'll work with you and your son's condition".

Now we (and our insurance company) were out money for this visit, and we had to do it all over again!

Frustration - This is one of the most frustrating things about having a disabled child. If people would just be honest up front, how much time (and money) would parents save?

No database - Of course, there's no database for "Autism and Oral Surgery Needs" (I looked). But I finally figured out that there ARE "Children's Hospitals", and maybe I should start there.

I called the nearest one, explained the situation, and they put me in touch with an oral surgeon who practices there.

A new oral surgeon - We took Lucas to this new oral surgeon last week.

Lucas liked this new doctor right away because he commented on Lucas' Notre Dame University hat. Lucas is a big fan of the movie "Rudy" and the oral surgeon talked to him about the movie, putting him right at ease (a good sign).

An individual approach - This surgeon also took the time to answer ALL our questions and he listened to our concerns. He asked questions of his own about how Lucas might react to certain things.

It quickly became obvious to us that this doctor truly understood that autism and oral surgery require a much more individual approach, based on the autistic person's specific situation.

Benefits of a Children's Hospital - In addition to agreeing that the surgery should be scheduled as early in the day as possible, he even recommended that it occur before Lucas' 18th birthday, so that it could be done at the children's hospital.

His attitude is that for a child with autism, oral surgery should take place where everyone involved has loads of experience with disabled kids. And of course, a children's hospital fits the bill perfectly.

Oral surgery is scheduled - So the surgery has been scheduled for mid-April. It will be done first thing in the morning, too.

Before the surgery - We'll take Lucas up to the hospital to get some blood work done. We'll give him a tour then, and talk to the anesthesiologist and nursing staff, to make sure they fully understand about Lucas and his autism.

We'll find out then if one (or both) of us can accompany Lucas at least until he's under the anesthesia, so that he won't be surrounded by total strangers.

We'll hope for the best, plan for the worst, and pray for the easiest! Stay tuned...

See other articles on parenting an autistic child on the left, next to our current article.

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