“Look at that,” she said. “It’s bad. It probably needs to come out.”
My stomach lurched. Out? Needing to remain calm for him, I anchored my feet and took a deep breath. Zach was reclined on the chair, still holding his mouth wide open.
“Yes. Or, maybe we try a root canal first.” Her eyes looked serious but sad. She knew how hard this news was hitting me, and what it meant for Zach.
“Oh, my. Those aren’t very good options,” I said.
“No.”
“How urgent is this? Is it something we can think about and decide later?”
“No. I’d say it’s very urgent given the infection.” The word urgent hung in the air like a dark cloud.
My hands started trembling. Zach closed his mouth. Just days before, my husband noticed a grayish area on the back of Zach’s front tooth. He’s had a cavity there before, so we figured it had returned. We called the dentist Monday morning and went there Tuesday afternoon. By Wednesday afternoon, Zach was seated in the endodontist’s office awaiting an emergency root canal.
The gray area was not actually a cavity; the color indicated that the tooth was dead. I never really considered that teeth died. The dentist explained that trauma to the mouth or teeth can result in the nerve dying, which leads to tooth death. He had, in fact, had trauma to that area, twice. But that was years ago. Didn’t matter, she said. The damage came slowly. Prior to this, no exam or six-month cleaning ever revealed trouble.
I gazed at his sweet face. I didn’t know what Zach understood in that moment; vocabulary words like endodontist and root canal were probably not in his repertoire. If he heard his dad talking about his own root canals, then he’d likely understand that this meant pain.
In a flurry, we were seated in the office and connected with the endodontist. Information was traded, and the appointment was made for 24 hours later. After a sleepless night on my part, we were en route to another office for a procedure that we weren’t sure Zach would tolerate. To complicate matters, if he didn’t tolerate the root canal, or if things looked worse once the procedure began, there was a chance that we’d need to extract the front tooth. And that meant general anesthesia. And I was not fond of that.
For a person with autism, medical exams and procedures may not be easy. For some, that is a complete understatement. Amazingly, Zach was generally at ease and cooperative in a medical setting. As long as the person examining him narrated what s/he was doing, Zach seemed willing to let them look. Haircuts were a different story. But, luckily, exams were alright. I hoped with all my might that his tolerance would transfer to this root canal.
Outside the endodontist’s office was a small garden with a trellis and a fountain. Zach indicated he wanted to get into the dirt and the rocks, and I wished we had driven there just for that. He would have been content. With 15 minutes to the procedure, we had to go in and explain all we could about his needs, including the fact that anything minty gave him hives: in the dental world, mint is ubiquitous.
The very tall man with kind eyes behind his mask walked in and introduced himself. He said normally no one would be allowed to remain in the room while he worked on a patient, but in this case, we were both allowed to be there. You bet, I thought. Zach needs us there.
He began telling Zach how it would go, but when he said you just tell me if you’re uncomfortable in any way…I immediately tensed up. Didn’t he get the message about Zach being nonverbal?? I gave my husband a “look” and his look back said it’ll be fine. I wasn’t so sure.
The doctor began swabbing his gum with goo to numb it. “This is just to numb your gum, Zachary. It’s nice and minty…”
Talk about tensing up. “Um, he’s allergic to mint. Mint gives him hives.” Sweat was rolling down my back.
“I’ve never had a problem with mint,” he said. “We use it all the time.” I wanted to grab that goo from his gloved hand.
“Well, we need to watch for hives. Mint gives him hives.” I didn’t need one more thing causing worry.
When the needle was prepped, I looked at Zach’s shoes. And for the remainder of the procedure, I studied Zach’s shoes and the stitching in the chair and the way the hair on his legs turned up around his kneecaps.
About ten minutes into this, I realized there was a great deal of talking, a lot of bright lights, music in the background, dental office odors, and, for Zach, odd and uncomfortable sensations in his mouth. A recipe for sensory disaster. We countered the assaultive sensory input with skin brushing and the occasional supportive comments.
Telling Zach he was a rock star was the absolute truth. He handled this with patience and cooperation. Mostly. The assistant left the room at one point, which likely inadvertently cued Zach that all was done. He sat up, ripped the equipment from his mouth, including the rubber dam, took off the glasses, and tried to get up. The doctor sat back while we re-settled him, which was no easy task. He tried to put his fingers in his mouth which caused the doctor to emit a sound like ahhhhhh—ooooeeeehhhhh but we quickly held his hands and reclined him.
“We’re almost done,” assured my husband. But there was no telling if we were indeed almost done. I brushed the heck out of his arms and legs and provided sensory tickles non-stop.
“Are we able to complete the canal,” I asked, “or are we looking at something more?”
Music to my ears: “We are almost done, and I’m going to seal up the tooth. Hang in there, Zachary.”
When all was done and the equipment came out for real, Zach’s hand sprung to his mouth and began picking. There was that sound emitting from the doctor again. He looked and found a chunk of sealant hanging on the tooth edge, which he promptly flicked off, and Zach was fine.
We took him immediately out to the garden, where he spent 20 minutes in the dirt.
“Are you okay, bud?” I leaned over and kissed his head. He looked up at me and nodded yes.
“We are soooooo proud of you! Oh my goodness, we are proud. You handled that like a champion.” I saw his blond head nod again.
I spent the drive home feeling awe for this boy, this young man, who could not tell us he had discomfort in his mouth, who could not ask questions about this procedure, who could not tell the dentist if he felt uncomfortable. This is his life. And he handles it like a champ.
What he could tell us with his device when we arrived home is that he wanted pizza. I love this kid to pieces.
