Olde Orchard Pediatric Dentistry – A Review

Like most autistic kids, Caleb has always fought us on the tooth brushing. We tried when he was very young, but at that point, we had bigger battles to fight. We were trying to figure out why Caleb lost his language skills. Then came the onslaught of therapies, one after another after another. I was basically a chauffeur for my son and his many therapists. When I finally got home, my energy was dwindling, but still, we did even more therapy together. Families that are still in that circle of exhaustion have no time for precious teeth issues. I know it sounds crazy, but it is true; people who are on the outside looking in don’t understand the burnout that comes with autism.

Thankfully, Caleb is in a place mentally and socially that we can take care of his hygiene. That includes regular bathing (kinda regular), but also brushing his teeth and hair, and cleaning and moisturizing his face twice a day. Caleb has keratosis pilaris, so we use a Burt’s Bee’s facial cleanser and we are just now trying a new serum: Serious Serum.

When we first started brushing Caleb’s teeth, we noticed there was blood in his spit. We checked out his mouth, and yup, he needed a visit to the dentist. His pediatrician suggested we go to Olde Orchard Pediatric Dentistry, and I am so glad that we did.

When you first enter the building, you notice how airy the waiting area is, with a domed ceiling and tons of natural light streaming in. In the middle were these large tree booths that were comfortable, but also gorgeous.

To the right was a smaller waiting room with just chairs and books. To the left was another small waiting room, but this one had a large flat screen television mounted on the wall, interactive toys, and Duplos, as well as more children’s books. Everything was clean and well taken care of.

Caleb had a meltdown the whole ride to the dentist, and then while we were inside the waiting room. The staff didn’t bat an eye – they deal with autistic children on a regular basis and know how to deal with the kids. The staff offered help when I was at the desk, but they let us deal with Caleb until we asked for help. It can be tricky for people to know what to do, but they were really good about knowing when they had an opportunity to help; when the receptionist heard that Caleb loved My Little Pony, she jumped up and put the My Little Pony movie on the television.

Caleb was still crying and whining as we were greeted by the dentist’s assistant and led down the hallway. I have never seen a prettier hallway. Seriously, they even had beautiful wooden tree cutouts with the room numbers on them. Each room has two doors, one for us, and then a slightly smaller door that the assistant and slip in and out of.

We were greeted by Dr. Maxwell, and she was totally chill. She knew how to talk to my husband and me and then how to talk differently to Caleb. She let him touch almost everything, and explained what she was doing as she was doing it. Within minutes, a previously scared and crying Caleb was happily lying down with his mouth open while Dr. Maxwell did her exam.

First of all, they are gentle. Even better: they are super fast. Dr. Maxwell knew how much to get done in a single session in order for Caleb to have a somewhat enjoyable experience; the last thing we want is for Caleb to hate the dentist and dig his heels in even farther.

Not a problem.
Caleb actually asked to stay. He didn’t want to leave the dentist.

Yes, Caleb has cavities, but I didn’t feel judged. I feel guilty, of course, but I also know that I am a good mother and I try really, really hard. Like, really hard. I also didn’t realize how easily Caleb can get cavities; my teeth have extra enamel on them so while they are a little yellow, I have never had a cavity in my life. My husband, however, has worked hard to keep his teeth in good condition, but he has cavities as well.

Dr. Maxwell created a schedule for us in order to come in so that Caleb can have his teeth treated. We opted for 4 short visits using Nitrous Oxide so that Caleb doesn’t feel pain and is more compliant.

After Dr. Maxwell finished her evaluation, Caleb was able to pick out a gift. He chose a righteous mustache that made him look like Mario, so he was over the moon.

I am really thankful to have found a dentistry that knows how to take care of autistic children. I would recommend Olde Orchard to any child, autistic or not; there were plenty of neurotypical children around us.

Olde Orchard Pediatric Dentistry is located in Novi, Michigan, near the Sears at Twelve Oaks Mall.

*Note: I did ask for permission to take photographs of Caleb and Dr. Maxwell during his visit. I also asked if I could review them. They were very supportive, taking a minute to hide any patient data so that no HIPAA violations occurred. I did not receive any compensation for my review, nor was it swayed by anyone.

Tracking and Feedback – How We Diagnose

One of the more frustrating aspects of Caleb’s autism is that he has a mental disconnect between his mind and body. He rarely recognizes pain; most of the time he gets hurt, he is more scared than feeling pain. I mean, this is the kid who, as a baby, never cried while getting his vaccinations. Of course, we have a pediatrician appointment today, and let me tell you, he is going to have an anxiety-feuled meltdown when the needles come out.

Because of Caleb’s disconnect, my husband and I track his behavior to find patterns. One pattern we recognized early on were his headaches. Headaches are very common for autistic people, but we still wanted to track and see when his headaches manifested.

We kept a calendar of when Caleb showed symptoms of head pain, such as squinting in bright room, preferring to lie down in a dark room, having bathroom accidents, and overall his behavior was chaotic at best and horrifying at worst. But, what we quickly realized was that the times and days Caleb was having his behavioral issues, my husband and I had migraines. We also were able to group Caleb’s behavior into 2 sections: minor headache or severe headache.

With the hunch that Caleb was getting migraines, we searched all over for a neurologist that works with children. Caleb was 2 and still mostly nonverbal, so he couldn’t tell us anything about his head pain. We called around and tried to find a neurologist for him; there were only 3 pediatric neurologists available in the whole state of Michigan and 2 of them required a diagnosis of migraines in order to see the doctor. I was floored – don’t you go to a neurologist to get diagnosed? Thank goodness for DMC and Dr. Sivaswamy. She listened to my husband and I describe how and why we thought Caleb was experiencing migraines, and in the end, she agreed with us. She started him on liquid Cyproheptadine, and we have increased the dosage to coincide with his growth. This preventative has proven somewhat effective, but not entirely. The only thing that seems to really help Caleb’s migraines is ibuprofen. We only give Caleb ibuprofen 3 times a month; any more than that, and Caleb could suffer rebound migraines.

Getting the right help for Caleb is tricky, because he can’t tell us the difference between what is and what should be. We have to use all of our tracking and feedback skills in order to make an educated guess as to what is going on with Caleb. For instance, he is currently starting to get anxious about things. Caleb will obsess over a fear, getting more and more worked up until he is in full-on panic mode with Caleb crying so hard he throws up. It isn’t good. As a mom, of course I want to protect him, and I want to make his life easier. I also don’t want to be a crutch. We have brought up his anxiety to our pediatrician and Caleb’s feelings doctor, but the feedback is the same: yes, he has anxiety, but there is no medicine that is safe for him. I worry so much about that amazing sponge of a brain because I want him to enjoy life and relax, but at what cost? Medicines of all kinds having lasting effects on our brain, and risking hurting Caleb is something I am not comfortable with.

Caleb has mentioned that he wants me to go to school with him. Even stay with him at school. I want to emotionally support him, but I also want him to be able to emotionally support himself. I keep on thinking about the goal of him being completely self-sufficient, but then I think, “um, he is only 6-years-old. I have clothes older than him. Pretty much everything I own is older than him. Maybe I can use kid-gloves.” I’m sure everyone has an opinion. Even in our own family, we disagree on what is best for Caleb. I don’t think that any one answer is right or better than another – I think that we just have to pick a strategy and be ready for push-back and unintended consequences.

Right now I’m still fighting with Farmington Schools to let me sit next to Caleb while he is tested. I seriously cannot understand the rationale. There is a teacher conducting the testing, so it isn’t like Caleb and I could cheat. Plus, if we did cheat, it would be totally obvious when he shows up for a class he is totally unqualified for. I am surprised that there isn’t a single ASD advocate who works for Oakland Schools. Oakland County is the richest county in Michigan, and yet they have no ASD advocate? 1 in 59 kids have autism (1 in 37 boys) and we don’t have people within the school system fighting for them? How is this possible? And no ASD pediactric neurologists in Michigan? I don’t understand how we are supposed to raise our ASD children without proper ASD support.

I want the very best for my child, and that means being his greatest advocate. I have to keep track of his behavior and adjust our behavior accordingly. I have to constantly be watching out for indicators of distress and then backwards engineer the cause. With Caleb’s migraines, we were lucky to have such a wonderful doctor who took us seriously. I am not sure why anxiety isn’t given the same kind of seriousness, but I have to find a way to help him. At the end of the day, it is my job to make sure that he grows up into an educated, self-sufficient, happy gentleman. Now if someone would just give me step-by-step directions on how to get there…