Open W I D E — 5 Minutes for Special Needs

Open W I D E

by Lee


Does an Apple a Day Keeps the Dentist Away?

Some say YES, others say NO.

Apples contain properties that can kill up to 80% of bacteria that form in the mouth. But dentists suggest that apples can be as bad as candy due to the high sugar content.

For my daughter Melissa, the answer doesn’t matter … because she won’t eat apples.

Over the past decade there have been significant advances in dentistry for special needs children.  Now some dentists focus their practice on Special Needs Dentistry.  Just do a Google Search and you will find many of them.

But this wasn’t the case twenty years ago when my daughter Melissa was growing up.

Over the past 20 years we have endured many dental challenges.

BRUSHING.  As I have previously written, Melissa has an oral aversion resulting from her Propionic Acidemia metabolic disorder and as has been tube-fed for most of her life.  It is well-documented that people who are tube fed develop dental issues.

The big offender is plaque.  We know that plaque is that sticky mix of bacteria that builds on the surface of our teeth.  And the bacteria in tooth plaque releases acid that damages tooth enamel, creating holes that we know as cavities.

But what I didn’t realize is that you don’t have to eat to develop plaque.

I always thought that it was the food that we eat that creates the plaque.  But I have discovered that plaque buildup can be worse for those who don’t eat because chewing our food, in part, helps to dislodge some of the plaque before it hardens into tartar.

As every dentist or hygienist will tell you, brushing and flossing is the way to rid your mouth of plaque.  But what happens if you can’t stand to put a toothbrush in your mouth?  Or when the taste and texture of toothpaste makes you gag?  The answer of course is that you FIGHT.

This was the situation with Melissa.  Since she was a child, we had to fight daily to get her to brush her teeth.  And that fight continues to this very day!

SWOLLEN GUMS.  Tooth eruption (breaking through the gums) can be delayed in young children with growth disturbances.  When she was little, you could barely see Melissa’s baby teeth in part because gums were swollen—a common side effect from phenobarbital.  We gave her phenobarb for a couple of years, following a series of seizures she had during a hospital stay when she was about two.  And even when we stopped the medicine, the gums remained enlarged.  As her permanent teeth were ready to appear, her baby teeth were still stuck in her gums.  To correct the problem she had out-patient surgery where they extracted the baby teeth allowing her permanent teeth to come in.

CROWDING and MISALIGNMENT. Many of us have had crooked teeth and braces to correct them.  And if you have had braces, you know that keeping them clean is challenging.  Now what if you have difficulty brushing because of an oral aversion?  Should you forgo braces or struggle to keep them clean?  That was the question that we faced with Melissa.  In the end, we decided to try braces.  She had four teeth removed to make space and then had braces installed.  We fought with brushing for a year.  During that time the teeth moved and while they are not perfect, they look straight.  She now wears a retainer to bed every night.  We found that the end result was worth the struggle.

Interestingly, Melissa has done some “modeling”for the company where my wife Kathy works.  The company UCare is an HMO and Melissa has been featured in a variety of their marketing materials.  Most recently UCare has sponsored a “mobile dental clinic”.  They decorated the side of the bus with a variety of pictures … including Melissa’s.  If you look closely you can see that her gums are slightly red and inflamed which is her “normal”dental state.  We find it so ironic that her picture would be used for anything “dental” related!

Melissa is third from the left

Our dental challenges continue.  We have just scheduled our next dental adventure … removal of her wisdom teeth.  We are confident that she will do fine and are keeping our fingers crossed that she does not develop any complications.

Some of the things that we found helpful during our dental journey include:

Make Visits Routine. Melissa goes for a cleaning every six weeks.  While this is costly, it is now a routine and she no longer fights these visits.  It also helps to keep her mouth in better condition due to her less-than-effective daily brushing.

Offer Distractions. The noise and smell of the dentist office makes many people apprehensive from the moment they walk through the door. We have asked our dentist to use a clear shield (not a mask) because Melissa is frightened by masks.  And she brings her own music player with her so she can control the sounds she hears.

Physical Restraints. In the past it was not uncommon for dentists to suggest using physical restraints for children who would fight during procedures.  I’m not aware of the current practices but after several very challenging visits, we reluctantly agreed to the use of a “papoose board” as a way of restraining Melissa during dental procedures.  While it was successful in holding her still … but it was also unsuccessful because it made her even more frightened to go for the next visit.  In retrospect, I think it was a mistake.

I hope that some of our experiences might help you with your parenting dental challenges.


Email Author    |    Website About Lee

I am the father of a 22 year old daughter with a rare metabolic disorder called Propionic Acidemia. I hope to provide a "fathers view" of special needs parenting and maybe engage and encourage other men who face a similar challenges with their special needs child. Thanks for following me.

View all articles by


This post may contain affiliate links. When you use them, you support this site. Thank you!
See our Disclosure Policy for details.
1 Desiree Ashkar December 14, 2010 at 10:07 pm

Lee, nicely done, good concise information. As a dental hygienist I would add that good preventive dental care has significant other health benefits. Heart health, immunology health, diabetic health, and extension of life expectancy. If I could ever help or be a resource let me know. I have certainly noticed great results in Melissa’s smile :) Take care, Des Ashkar

2 children educational support Mary December 15, 2010 at 11:12 am

Thanks for sharing the experience!

3 Kimberly December 15, 2010 at 8:01 pm

Just wanted to agree on the daily brushing and flossing and frequent dentist visits. At our first dental visit we were told our daughter had no visible cavities but they hadn’t been able to do xrays so they couldn’t check in between her teeth. Due to some other big expenses and no dental insurance I put off another visit for 1 year only to find out that EVERY molar had a cavity. Luckily these are baby teeth, but we still had to do fillings because they will be in her mouth til she’s 10-12 (3-5 years from now). The intermediate visit might at least have helped us catch them earlier when they would have been easier to fill and less expensive…and maybe we would have started flossing earlier. It is challenging to do our daily dental routine, but it is so worth it to try to avoid more big bills.

4 Kate J December 15, 2010 at 10:50 pm

Lee, I have enjoyed your posts here and at your blog as well. I had a question about special needs orthodontic care (where to go?) Our 8 yr/old daughter with Cri du chat syndrome just had 8 ankylosed molars plus her last loose baby eye tooth extracted, and when I happened to be at my sons’ regular orthodontic appt. later that week, he mentioned that if she were a “typical” child, he would place spacers… how come none of my daughter’s doctors bothered to tell me that? We have encountered the attitude of “Well, she’s retarded anyway, so you may not want to bother…” just as Tiffany had mentioned about the eye doctor. By the way, we do live in your area of MN – where do you go?

5 Lee December 16, 2010 at 12:02 pm

Kate: Thanks for the kind words.

Sorry to hear about your doctors who don’t seem to “get it” about our special kids. In the end, it comes down to advocacy. We begin every conversation by explaining Melissa’s unique needs and “demanding” special consideration. In most cases, we need only have this discussion once! This has allowed us to use dentists that do not “specialize” in special needs but rather who are “sensitive” to our special needs. Unfortunately, even some special needs dentists can be a problem.

Regarding our local providers …

We live in Plymouth a suburb on the west side of Minneapolis. We have tried several dentists over the years, including the University of Minnesota dental school (Melissa goes to the U for her metabolic condition).

For routine dental care, for the past few years Melissa has been going to:

3900 Vinewood Ln N # 13
Minneapolis, MN 55441-1155
(763) 557-6893

Dr. Salo is not a special needs dentist, but she and her staff have been wonderful with Melissa and her “challenges”.

For her braces, she went to:

Dr D Orthodontics
3475 Plymouth Blvd Ste 300-1
Plymouth, MN 55447
(763) 559-0559

Again, Dr. D doesn’t specialize in special needs dentistry, but she and her staff were extremely sensitive to Melissa’s special needs. Dr. D also referred us to the oral surgeon for the required extractions.

I hope this is helpful.

Best of Luck with your daughter.


6 Kate J December 16, 2010 at 12:36 pm

Thanks, Lee. Dr. D has an office near us! Great.

7 Claudia Biasoli December 19, 2010 at 11:20 pm

My son has MMA and we have the same dentist visit routine. He goes only for cleaning and he hates to brush his teeth.
Thank you for your posts, Claudia

Comments on this entry are closed.

Previous post:

Next post: