Dental Surgery – A Worrying Time For All

When this hits your screens on Saturday morning we will be at the hospital with James. The culmination of months and months of planning which has led us to this point. Today James is having dental surgery under general anaesthetic. Sounds drastic to have to do this under GA and it’s not a decision we have taken lightly.  

Even after many years of dental appointments with the special care dental service they have not been able to get a good look in James’ mouth. On a good day we might be able to get him to sit in the dentist chair.  The dentists have been very patient and really persevered: we’ve done lots of regular familiarisation visits, I’ve made him a social story about going to the dentist, we use lots of encouragement and distractions, but still they have only had a brief look at James teeth.

James has always been somewhat reluctant to have his teeth brushed, he barely opens his mouth so we know they are not being looked after as well as we would like and that there has been a considerable build-up of tartar as a result. A few months ago, a visible gap appeared in the bottom row of James teeth. We don’t know what happened. The dentist also now feels that the tartar build-up behind his teeth is so significant that it may affect the movement of his tongue.

Let’s See What’s Going On

Having a general anaesthetic means that the dentist can take x-rays and fully establish what is going on in James’ mouth. We don’t even know if his teeth are his baby (deciduous) teeth or second (permanent) teeth. We don’t know if the new gap means a tooth has broken off and the root is in the gum, in which case it needs to be removed. The tartar can also be removed and a protective coating applied to James’ teeth.

No GA is completely without risk. It has been several years since James has had one. I am anxious about it. The dentist has said that there is a very real risk that James’ teeth will break when the tartar is removed. They may be weak or rotten. As James will never wear dentures this is concerning. He is already on a soft diet and doesn’t bite with his teeth so losing teeth shouldn’t affect his diet, but the dentist said ‘he will look very different if he loses his teeth.’ I do not want him to lose his teeth.

When it became clear that James was going to have a GA for dentistry purposes, the realisation dawned that this would be an opportunity to get some bloods done too. This has also been a long term and problematic issue with many unsuccessful attempts from the GP to take bloods under sedation last year.

Co-ordinating Services

To cut a long story short, the GP and dentist spoke directly to discuss how taking bloods can be done. On principle the dentist is very happy to take the bloods. The issue is that whilst James’ GP is local to where James lives, the dentist is in another area and so is the hospital where the dental surgery is taking place. It would normally be the case that the person who requests the bloods is responsible for any follow ups and treatment that may result. (This therefore needs to be done in the GPs name and not the dentist’s) Therefore I had to collect the blood form and bottles from the GP surgery. The issue then was around where those bloods would go on a Saturday to be processed within the necessary time frame as, technically, they should go to the phlebotomist linked to James’ surgery. It’s all been a bit complicated but the dentist has arranged for the bloods to go to the hospital phlebotomy department and be processed on the day and the GP will contact them for the results. Fingers crossed.

There is a long list of things that need to be checked regarding James bloods. The epilepsy nurse has also added to this list. We are aware with James’ syndrome that there is the potential for protein levels, electrolytes etc. to go awry. James has also had concerning kidney function results previously. Hence, I am really anxious that we do not miss this opportunity to check everything possible now.

As I write this it’s fair to say that I am more than a little anxious that this all goes according to plan and that James is fine with the GA, he doesn’t lose any more teeth, nothing significant is found and that the bloods get taken and processed as planned.

When I next post in two weeks’ time I hope that I can report that all went well. Fingers (and everything else) crossed.