Whenever I took my autistic son in for a dental appointment, they couldn’t get any x-rays out of him. Because he has sensory issues, he really didn’t like anyone touching his mouth or his teeth. It was really hard for him. The most they could do was some basic cleaning.

We got to a point where he needed to go under anesthesia so the dentist could do X-rays and any necessary work. We first tried going to a dental surgeon. He was affiliated with a local hospital and the anesthesia would take place there. He had limited access, so the wait was several months. In the meantime we tried to get preapproval from our health insurance. They denied it, citing the lack of medical necessity. The dentist tried to appeal and explained the situation with our autistic son. They still denied it.

We felt desperate, so we offered to pay out-of-pocket. The dentist advised against that. He said in prior experiences he had seen the hospital bill as large as $10,000.

The search for alternatives

So we ended up back at square one. I started asking around. Surely we weren’t the only ones going through this. A couple people mentioned dental practices where the anesthesiologist comes to their office. So I started looking into that. I found a place that not only had an anesthesiologist, but they also worked with special needs kids. Bonus.

So we trekked out there and they did the basic cleaning. As they examined his teeth they suspected some cavities. So we went through the paperwork for kiddo to undergo anesthesia, and once again filed a claim with insurance. I knew they’d probably deny it, but you never know. In the meantime the dental office gave us an estimate for out-of-pocket costs. We could expect to pay $800-1200 for anesthesia, depending on what the X-rays showed. Not bad we thought. Beats the $10k that a hospital would charge.

You might be wondering why it costs a lot less to have anesthesia done at the dentist office instead of a hospital? For starters, if something were to go wrong during the procedure, the hospital is available with various specialists to help in a pinch. So when you’re going to an offsite dental location, you may not have access to those services.

Then as you’re probably familiar with hospital visits, there are various charges with staying in a hospital. It all adds up.

We felt that the dental procedures presented a low risk. Mainly X-rays and cavity filling. So we proceeded.

The Day Arrives

When the day approached, our son had to fast from food and drinks. He also couldn’t have any liquids 4 hours before the procedure. This includes water. Because of all this, we had him scheduled first thing in the morning.

The anesthesiologist wanted to use IV sedation. I squirmed at the thought of my son resisting a needle in his arm. So I requested that they administer gas to put him to sleep, then apply the IV line. So on the day of, I was surprised when the anesthesiologist said he wouldn’t be administering the gas. He explained that it’s hard to do it effectively with children. They would need to be able to breathe it in properly. I felt dismayed and wondered how this was going to go.

He then explained he was going to give him a shot in the arm. And that would make him drowsy and fall asleep for 20 minutes. So I sat with my son and held him in a bear hug. Then the anesthesiologist applied the shot. My son protested as he felt the effects. Within minutes I could see he was starting to feel drowsy. We then walked him over to the room where the procedure would happen. They asked me to leave the room and wait in the lobby.

I knew from the treatment plan that it could take a good hour. Every so often someone would come in to the lobby and give me an update. The x-ray showed that he had a couple cavities. But the surprising news was that he was missing three teeth! Two of these were adult teeth in the front area of his mouth.

I felt bad for the kiddo. I started to feel guilty as a parent. I started to question what I could’ve done to take better care of his teeth. The feeling of failure started to sink in. It’s easy as an autism or special-needs parent to fall down this path. We do our best, and we’re only human. We can only do so much. Sometimes things like this fall through the cracks. And sometimes it’s completely out of our control. Once I realized I was spiraling into this mindset, I snapped myself out of it. There is nothing wrong with these feelings. But it’s not a good idea to stay there.

Recovery
They filled the cavities, applied sealant and did the deep cleaning. Once they were done, they got him onto a wheelchair and into another room for recovery. He started to dry heave, then fell asleep. I sat with him for another 30 minutes while he peacefully snored away.

Then it was time to go home. I got the car prepared, and they wheeled him out onto the curb. He was able to get up and move into the car seat. Thankfully I had an extra towel in the back. It came in really handy for the times when he was dry heaving.

Once we got home I helped him to bed. He was still nauseous so I got him an extra towel so he can spit into that. As I write this, it’s been a couple hours. He’s still sleeping. Every now and then he’ll wake up and dry heave. I didn’t realize how long it would take for the effects of the anesthesia to wear off. I also did not anticipate the side effects of nausea. It’s probably going to take days before it leaves his system.

The discharge instructions said to wait two hours before I feed him some thing to drink. Then wait another couple hours before I introduce soft foods. It has to be cold. As the doctor explained the kinds of foods he could eat, all I could think was that he doesn’t like any of that! My sensory kid has a hard time with textures. But I was able to brainstorm and come up with a smoothie I could feed him.

My advice if your child is undergoing anesthesia for dental work

• Request to have the procedure done first thing in the morning. Ask for the first time slot. It’s hard for our kids to fast very long.
• Prep ahead of time. Pick out a room in your home as the recovery room. This ideally will have easy access from your car.
• Make plans while they are working on your child. This is your “me” time. The dentist office may allow you to step out for a bit. Maybe you can grab yourself a cup of coffee and relax. Maybe you could bring a book and do some reading. Or maybe head to your car and take a nap.
• Have someone help your child into the house, if possible. Your child will be drowsy, they may not have the ability to walk into the house. They may also need assistance getting to their room.
• If that’s not possible, drive around and run errands. Maybe you need to get gas, go by the ATM, go through food drive-through. Kill some time while you wait for the anesthesia to die down. Then hopefully your child will be awake enough to go into the house without much assistance.
• Bring towels for the car ride home. If they have nausea they’ll be dry heaving. They’ll need something to spit into.
• Prep the front passenger seat. Your child will need a seat that can tilt back. It’ll make it more comfortable for them as they’re sleeping.
• When your child is ready to eat food, have cold soft foods available. Yogurt, jello, smoothies.

Anesthesia is no fun for our kiddos. Unfortunately it’s necessary, especially if the dentist office can’t get basic x-rays. Hopefully this post gives you an idea of what to expect, and how you can prep ahead of time and make the recovery smoother.