teeth
9 January 2003

I’ll be honest, I wasn’t that concerned at first. Children hurt themselves all the time. They bump into walls, smash into headboards, crash into telephone poles, fall from beds and chairs and bookcases and god knows what else in their constant, intrepid explorations. And when they do get banged up, they sometimes cry, need to be soothed. Damian particularly. He tends to overreact. Fear of pain rather than the pain itself, I think. So I wasn’t that worried. Not until later, when the crying didn’t stop.

It didn’t stop for two and a half hours.

It started with a soft animal cracker, of all things. He took a bite. Said his tooth hurt. Sat in my lap. Said his tooth hurt. Cuddled against me, crying. Said his tooth hurt.

If we’d been home, I would have gone into the bathroom for Advil, called Dan to confer. If we were home, I’d have felt in control. But we were at school. We’d been sitting out in the bike yard. Eating lunch, our Wednesday ritual. So instead I left Damian cuddled up next to Kahuna, who had happened by at just the right time, and went inside to scare up some medicine. Surely a school, full of kids and their inevitable bruises, would have painkillers?

Apparently not. They’re not allowed to dispense drugs so they don’t have any around. When the hell did this happen? I remember getting Tylenol at my public high school in the ‘70’s. What ass-backwards lawsuit-wary ruling denies a school the right to help a child in need? I mean, get permission from parents, sure. Make sure it’s in writing, even. But for god’s sake, don’t deny a child in pain.

So I had to go back outside, tell Damian he wasn’t going to get his desperately desired medication quite yet, tell him that in fact he was going to have to endure a trip to the supermarket with all the bumps and jolts of a shopping cart ride before the holy grail of ibuprofen could be his. He agreed. I checked again in the car: we could just go home and get the Advil there. We’d be home sooner that way. Can you wait? No. He couldn’t wait.

Albertson’s is very close to the school. Only thing is, it was the wrong way – behind me as I pulled out of the parking spot. And going the long way around meant driving through a construction zone. I briefly considered just driving backwards for a block and a half in busy traffic. Which gives you some idea of my mental state.

But we got there, and it didn’t even take that long. I carried Damian in my arms from the car to the store. He clutched his sippy cup in the crook of his arm. Crushing it between us. His life support, that sippy cup. The cool juice was the only thing that seemed to help. He was drinking like a fiend, like a mourner at an Irish wake. Downing the stuff like a fish drowning on dry land.

Then I was standing in the pharmacy aisle, tearing at the Orajel container. They want you to cut the end of the tube with a knife. A knife? I bit it off. And bit again. It took a lot of chewing to get that sucker open. Then I squeezed a dollop onto my finger and – with Damian’s permission – stuck my finger in his mouth. Wincing as I did. God help me if I hurt his gum more. But he withstood it, whimpering just a little. Deed done.

Didn’t help.

On the ten items or less checkout line armed with drugs, pear juice and water (for the inevitable upcoming refill). I fumbled with the plastic seal on the Advil while leaning into Damian so he could grab onto my arms for emotional support. One woman let me go ahead of her. One man didn’t even look.

The man behind me said “It’ll feel better soon,” and “You’ll be okay.” Damian ignored him. Sucked down the medication. Cried some more. Quiet cries. Contained. Still clutching my arms.

Finally my turn to pay. The clerk gave me a bright smile. “How are you today?” I just stared at him. Are you kidding me? Handed him the money. Turned away as he said – so robotically cheery – “Have a nice day!”

The car ride home was a blur of tears – Damian’s were on his cheeks, mine were internal – and phone calls.

Leave a message for Heidi: “We’re not coming to OT today.” Heidi, calling back: “Don’t worry about it, take care of him.”

Damian’s pediatrician’s office: “Can you refer me to a pediatric dentist?” “Here’s one in Century City.” Great, I’m passing Century City right now, maybe he can see us this minute. Scribbling down the phone number while driving thirty miles an hour and trying to blot out the sad sounds from the back seat. Focus. Find help.

“I need more juice, Mommy.” Pull over. Unscrew cap on pear juice. Pour into sippy cup. Unscrew cap on water bottle. Spill water into my lap. Ignore wetness. Assemble sippy cup, hand it over as fast as humanly possible. Assemble a backup cup. Reseal various bottles. Get back on the road.

Then, finally, I called the pediatric dentist’s office.

“We only do oral surgery.”

Fuck. “Can you give me a referral to someone else?”

“I’ll have to ask the doctor and call you back.”

Desperately fumbling again with phone and headset cord and bag. Why on earth did my Palm Pilot pick now to lose the ability to respond properly to the stylus point? Don’t open that person’s info, open this one. Recalibrate the damned Palm.

Leave a message on our friend David's answering machine. Hope he calls back soon enough to see someone today. Flip through the numbers on the Palm. Didn’t Ilene say she knew of a good peds dentist?

A renewed burst of crying from the back seat. Sounding like his heart was breaking.

“Mommy?”

“Yes, Damian. I’m here for you. What do you need, sweetheart?”

“I need to pee!”

All that juice. Of course.

We were driving through the heart of Century City. Tall office buildings, a few shopping malls. No stand-alone stores. A nightmare of ten dollar parking lots and complex escalators.

“Can you wait just a minute more?” Until we’re in Beverly Hills, until we’re on a proper shopping street.

A shaky yes.

We passed a splashing fountain. Damian gazed out the window. Envying its ability to let loose?

Thank god for the ubiquitous Starbucks. Never thought I’d say that; I don’t drink coffee. But they have clean, big bathrooms and a pleasant atmosphere. Damian appreciated the former, I appreciated the momentary sanity of the latter.

I carried him across the street in my arms once again, on into the dark interior. Passed a man cradling a baby, feeding it with a bottle. Oh new daddy, you don’t know what you have to look forward to. It gets ever more complicated, and their cries still tear at your insides.

Pee accomplished. Back into my arms, back into the car. And on to home. A blur, this part, though I do remember a point where Damian was crying so loud, he was screaming. It felt less like pain and more like anguish.

The woman at the oral surgeon’s office finally called back, her voice coated with sympathy. “Hi Mom. I have a number for you. I’ll call them now, tell them you’re calling.” But the dentist was in the western edge of Beverly Hills, behind us, and we were in the home stretch.

Should I have called? Should I have turned around, driven all the way back, probably half an hour , when my child could already recognize the streets near home? When what I had in my notebook was a scrawled phone number of a secondhand referral to an unvouched-for dentist?

I didn’t call. Just saved the number, kept it in reserve.

Finally. Our driveway. Home. “Damian, if you can walk” (and I knew he could – at least, physically he could) “we can go in together. Otherwise I have to get everything in the house and come back for you.”

“Carry me.” But he was scream-crying again, scared and frustrated and probably yes, still in pain.

I was quick. Didn’t even drop the keys more than once. Got him inside, on the couch, TV on, juice at the ready, Mommy’s lap finally completely available. Also the phone. Because Mommy was making calls again.

Ilene didn’t know the dentist, her friend did. And her friend was in Israel right now. But didn’t Linda say she had someone good…?

Linda did. Linda also had a new baby in her arms and the phone number was downstairs.

Linda called back with the number within a minute.

Three twenty p.m. Nearly two hours since the animal cracker. Damian was still in pain. And I finally talked to a pediatric dentist. On the east side of Beverly Hills. A ten minute drive from home, fifteen at most.

"Can we come in this afternoon?"

"I'll have to check."

Call waiting beeped. David coming through with the number of his son's dentist. Thank god. A reliable back-up.

Switch back to the dentist's office: “We leave at 4:30 today. How soon can you get here?”

Give me wings, I’ll fly there.

The moment I got up from the couch, Damian burst into loud tears. “Damian, we have to get ready. We’re going to see a dentist who can help you, but only if we hurry.”

“I have to poop, Mommy!”

Pear juice has a diuretic effect in large quantities. Stress and pain tie your stomach in knots. Not a good combination. Poor kid.

But we got there in time. 4:10 p.m., I checked my watch.

He cried in my lap in the waiting room. One arm wrapped around him, I clumsily tried to fill out the admittance form with the other. He cried while I carried him down the hall for another bathroom trek. He cried while I brought him into the examining room.

He quieted as soon as the dentist came in. Like a spigot turning off, he was completely fine.

I wasn’t, though.

It seems Damian has cavities in his molars. Not just one. Molars in all four quadrants of his mouth. Bad cavities. Serious decay.

We’re going in Saturday morning to get the work done. The dentist and anesthesiologist will meet us at seven a.m., put Damian under, take X-rays, and do what needs to be done. We won’t know for sure until they see the X-rays, but it looks bad: she'll probably need to take out the two molars on the left side, and then perform root canals and probably put crowns on the right two.

I feel like the worst mommy on the planet. My kid is going have his teeth removed. I’m supposed to protect him from harm. I should have watched out for this, caught it way earlier, made sure it never happened in the first place.

Yes, these are just his baby teeth. Yes, if we’re vigilant, his grownup teeth will grow in just fine. But this is a hell of a way to begin his dental history. I can’t help feeling like it’s all my fault.

In a perfect world, parents start brushing their baby’s teeth pretty much as soon as their baby has teeth to brush. In a perfect world, parents take their toddlers to dentists for check-ups starting – I don’t know, two years old? Three? It’s logical.

But this isn’t a perfect world. And this hasn’t been a perfectly normal household. This is a child who gagged and even vomited when he saw us brushing our teeth. This is a child who needed months of occupational therapy before we could start brushing his teeth at home. Heidi massaged Damian’s teeth with a bare brush at first while bouncing him on a therapy ball. Using an infant nubby finger-puppet of a toothbrush, at that. Oh, and only after she’d desensitized him with a tiny hand vibrator buzzing along his jawline and lips. And still she had to stop after a moment and press her finger to his lips, providing deep pressure to help him get past his extreme gag reflex.

It’s called tactile sensitivity, and it’s especially strong on and around his face. He simply feels too much in his mouth.

We do brush his teeth every night now. But we started late, and that may – probably did – give the bacteria a wide open playground before the toothbrush ever came along. Brushing is prophylactic only, it can't wipe out bacterial colonies once they're established.

And the dental visits? Two years ago, he’d have cried through the whole visit. A year ago it might have been better, but to have a stranger put her finger in his mouth? I can’t imagine. Yesterday he opened his mouth at her request, let her finger in to feel around, told her how it felt. Calm and interested. I’m not sure he would have been ready any sooner.

That all explains our – my – negligence but does it make it okay? It sure as hell doesn't feel like it. I’ve thought before that we need get him in to see a dentist, but I kept putting it off, worrying about how he’d take it. Reassuring myself that at least we were brushing his teeth every day now. Letting myself off the hook. And now that hook is coming around, a nasty boomerang.

Robin, one of Damian’s floor time therapists, was very reassuring on the phone today. One of her sons had perfect teeth. The other had seven cavities by the time he was seven years old. She did the same things with both. I know her well enough to guess that this means absolute vigilance. And still the younger boy ended up with a mouthful of fillings. So maybe this was inevitable. I have susceptible teeth. Damian seems to have inherited them.

But that’s too easy. Because we didn’t do the things you’re supposed to do. We didn’t because we have a special needs child and we had to make a choice. Which issues were paramount and which we could let slide. It’s a devil of a choice.

Damian cried again early this morning after the night’s dose of Advil wore off. He w
as miserable until we got antibiotics into his system. But he actually played and had fun this afternoon until the Advil wore off again. I hope tomorrow’s better still. And I hope to god everything goes smoothly Saturday. I’m going to have to live with this guilt for a long time. I don’t want Damian to have to suffer for it any longer.



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