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Old 06-30-2015, 08:15 AM
 
Location: Kansas
19,184 posts, read 15,929,562 times
Reputation: 18315

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We took our son with Down syndrome into the dental clinic and they said he needs his wisdom teeth looked at but that they didn't think they were probably causing him any pain at this point. They gave us a referral to an oral surgeon.

I decided to wait until after vacation which starts this week to delve into getting an appointment set up. Today, the oral surgeon's office called me to set up an appointment. I explained that we start vacation this week and we are weighing our options since our son also needs 3 fillings that the dental clinic wants him to see a children's dentist for. Our son, age 28, has always saw and cooperated with just our regular dentist in the past, prior to moving here.

I told the office person that we wanted to find a local dentist to do the fillings because we felt that after having the oral surgery that he might not be as willing to submit to a dentist. She said that they would put him under with an IV and he would wake up not knowing what happened so that shouldn't be a problem. I told her that I had 3 wisdom teeth out and that I was VERY aware after having them pulled that something had happened although I just had the regular pain medication as for any dental procedure. She sounded young so maybe she just doesn't have a clue!

My son has never had an IV before and since he has the Down syndrome, I am concerned. We are very limited in choices and this oral surgeon actually does 4 cities, one of the largest and 3 smaller cities.

Is this now common to be put under with an IV? Does anyone know of any other choices? I know many fear people with Down syndrome but my son is passive and cooperative when it comes to the dentist.

I will inquire of the regular dentist that I am hoping will see my son as to choices also. It is SO difficult making decisions for another adult and it is not like making decisions for underage children like many think. Generally, we have to sign a paper relieving everyone of any responsibility should something go wrong. Ah, that is not in the least bite reassuring.

Thanks for any thoughts.

I did read the other recent thread below mine but I am thinking our issue has more to do with my son having Down syndrome, it always is.

Last edited by AnywhereElse; 06-30-2015 at 08:42 AM..
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Old 06-30-2015, 09:08 AM
 
595 posts, read 2,400,965 times
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There are a lot of misconceptions running throughout this post. First, it is actually very common for Dentists and Oral Surgeons who do wisdom tooth extractions to offer IV sedation if they are licensed to provide it. The other choices for pain relief during the procedure would be General Anesthesia (done in a hospital setting by a certified Anesthesiologist) or Local Anesthesia (which is just numbing of the nerves in the jaws.) IV Sedation is done by administering a sedative through an IV. It's a bit like being drunk and sleeping if off. So your son actually would not realize what had happened upon waking up.

As to signing a release that is common in ANY medical procedure. I've signed them when I gave birth and when I had a biopsy done.

I think you are primed to think that this has to do with your son having Down Syndrome, but I don't think it is. I'm sorry you feel that way. They are merely offering you what they feel would be standard of care for the treatment and options recommended.
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Old 06-30-2015, 09:45 AM
 
Location: Kansas
19,184 posts, read 15,929,562 times
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What my son will realize is that he went to that particular office and came out with a great deal of pain afterward. He is sensitive to medications in general. It is going to be very difficult for him after this procedure as he functions at the 40 month level. Once the oral surgeon is done, he is done and then the responsibility for his care and what happens after is mine.

Yes, I do think it has to do with my son having Down syndrome. I have the 28 years dealing with it being about my son having Down syndrome. I thought the office was a little aggressive calling me this morning since it was only Friday afternoon that he got the referral and this is Tuesday.

Both my husband and myself were told over 25 years ago that we had to have gum surgery or we would lose all of our teeth. Thank God, our insurance would not cover it because as it turns out, it wasn't true. We went to another dentist who said we were fine. Caution is always warranted. We also use homeopathic medicine with our son because of "stuff" with the medical community in the past. Thus, my horror!

Thank you for your comment. I do appreciate it.
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Old 06-30-2015, 09:38 PM
 
1,552 posts, read 1,939,048 times
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If you're worried about your son remembering anything, then IV sedation is the way to go. The majority of oral surgeons use midazolam which has an amnesia effect so there is no memory of the visit. Numbing medicine is still used. Yes he will be sore later in the day when the numbing medicine wears off and this is true for any surgery. If you're very concerned, schedule a consultation with the surgeon to address all your concerns and plan for the surgery on a different day.
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Old 07-01-2015, 05:29 AM
 
Location: In a house
13,253 posts, read 38,143,135 times
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He won't remember the procedure. That's what the girl was trying to tell you in your explanation in your first post. He won't remember anything that occurred during the procedure. He will be aware that his jaw is a little sore (from being propped open during the procedure) and that it's numb (they give lidocaine in addition to the sedation, it's SOP), and that he's probably holding an ice pack to his cheek (which would've been given to him when he became somewhat lucid again). He'll be woozy and have silly thoughts, he might try to smile and discover his mouth isn't working properly. Though he -might- panic for that, it isn't likely, because the sedative doesn't just snap on and off like that. It wears off, and he'll still be under its effects to some minor degree.

Explain to him prior to the procedure that he's going to get some teeth fixed. Explain that you'll all go to the doctor, and he'll take a nap, and when he wakes up he'll feel sore but he won't have to be afraid because you'll be there. Explain that he'll be sore for a few days, and that's okay, because it means he's getting all better and his teeth will be better than ever.

Explain all this the morning of the procedure, before you get to the dentist's office. Have him explain it back to you while you're waiting for his turn in the reception room, and clarify any information he gives you that you feel he should have clarified.

When he comes out of the procedure, he won't remember the procedure itself, but he will remember his conversation with you. Point it out to him, tell him that - just like you and he discussed before he went in, he'll be sore but he'll be fine because you're with him. Praise him like you always do when he does well, and he should be okay.

Definitely discuss with the surgeon about sedatives given to people with Downs Syndrome, and make sure you're comfortable with his knowledge about dosages and types of meds that are appropriate for that. I don't know if any are contraindicated but the surgeon should know if there are, or not.
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Old 07-01-2015, 06:16 AM
 
Location: Kansas
19,184 posts, read 15,929,562 times
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AnonChick: Good information. My son's comprehension isn't very good and he is non-verbal plus he is very wimpy about pain. I know that "wimpy" sounds bad but I don't have a better word. A slight bump to him is traumatic. He is also sensitive to medication and had hallucinations from ibuprofen when he injured his foot. It is just so complicated and hard to care for him which I do 24/7 so at least I know him well.

I went to their website and read all the materials about the surgery and aftercare. The possibilities are daunting in his case as he'll have to be watched constantly after the surgery since he'll want to mess with the area that hurts.

I see from the internet that the office has 4 oral surgeons, 2 are very young and that is probably the ones that travel but I will check. We are located in a city with a larger workshop (yes, we still have them) so there is a larger population of people with special needs so it won't be like they have never worked with someone like this before but his functioning level makes it difficult for everyone. He answers "Yes." to any question that he doesn't understand which is most. Despite my telling people that, they usually don't get it.

I know there is no choice and that is the worst part.

I will try to remember to update the thread after the procedure so that anyone finding it in the future will know how it went.

Thanks again.
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Old 07-02-2015, 08:10 PM
 
Location: In a house
13,253 posts, read 38,143,135 times
Reputation: 20198
He's non-verbal, but does he Sign with ASL? You and he could come up with a sign for this procedure, something that's just between the two of you so you know he's communicating about his tooth pain and/or fear, and you can help guide him through it. Maybe even teach it to the surgeon and the anasthesiologist, so they can let him know that THEY understand him, and they can try to calm his nerves if he's getting panicky. Not being understood has got to be frustrating as heck to him. Afterall, he understands himself just fine
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Old 07-02-2015, 09:57 PM
 
1 posts, read 1,696 times
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My son with down syndrome that is 16 just had his wisdom teeth removed yesterday at a Children's Hospital. I can not say enough good things about dealing with the trained staff at a Children's Hospital. I was not expecting to have this issue so young with him but the dentist said the younger the better - as only one tooth was erupting through the skin at this time. There was not really a reason to know that there would be a problem later, they just felt it would be better to do it now. So we did. I understand everything you say about having to make these decisions for another person that could mean life or death.... and I am his main caretaker 24/7 also. My son was put to sleep and intubed. It was scary. Recovery rough. He is generally combative against anything that causes pain. But he did very well. Lots of swelling day after, but doing better than I thought he would. I know that people with DS are more sensitive to medications - I would consider having the surgery done at a hospital if possible.
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Old 07-06-2015, 07:12 PM
 
Location: Kansas
19,184 posts, read 15,929,562 times
Reputation: 18315
Quote:
Originally Posted by AnonChick View Post
He's non-verbal, but does he Sign with ASL? You and he could come up with a sign for this procedure, something that's just between the two of you so you know he's communicating about his tooth pain and/or fear, and you can help guide him through it. Maybe even teach it to the surgeon and the anasthesiologist, so they can let him know that THEY understand him, and they can try to calm his nerves if he's getting panicky. Not being understood has got to be frustrating as heck to him. Afterall, he understands himself just fine
No, he doesn't sign either. He refuses to try to communicate. He is regressing actually. Yet, another concern. BUT, he does trust me but also feeds from my emotions so the bigger part may be my being comfortable. I read the "stuff" on their website but that made it worse. It will just take a little time for me to psyche myself up to present it in a positive way. I will have a LONG discussion with the clinic prior to making an appointment. Good idea with tweaking since if the surgeon or assistant knows what words he is more likely to understand, that could make a lot of difference. When they just ramble on, he gets lost as do I. Thanks!

Quote:
Originally Posted by DSmom1328 View Post
My son with down syndrome that is 16 just had his wisdom teeth removed yesterday at a Children's Hospital. I can not say enough good things about dealing with the trained staff at a Children's Hospital. I was not expecting to have this issue so young with him but the dentist said the younger the better - as only one tooth was erupting through the skin at this time. There was not really a reason to know that there would be a problem later, they just felt it would be better to do it now. So we did. I understand everything you say about having to make these decisions for another person that could mean life or death.... and I am his main caretaker 24/7 also. My son was put to sleep and intubed. It was scary. Recovery rough. He is generally combative against anything that causes pain. But he did very well. Lots of swelling day after, but doing better than I thought he would. I know that people with DS are more sensitive to medications - I would consider having the surgery done at a hospital if possible.
Thank you. This clinic where we have been referred is in the medical complex which includes the hospital. For us, there is always something either with programs, services but luckily rare with medical and dental. Swelling will be a problem because he can't tolerate cold packs which they will insist on. He is very skin and pain sensitive. I fear the point when I can no longer care for him.
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Old 07-16-2015, 02:08 PM
 
Location: Kansas
19,184 posts, read 15,929,562 times
Reputation: 18315
Default Update

We saw the dental surgeon today and he said that his wisdom teeth did not need to come out. He explained the whole structure, bones and stuff and said unless the teeth got a cavity or became a sight for infection, they would could no trouble. He said he could take them out but if it were him, he would leave them alone.
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