As many of you know, we've been debating for MONTHS what to do about Jacob's dental situation. He has at least one cavity and several more suspected. Not a big deal in themselves because they seem small and he's at the age where he will probably start losing teeth soon. But for months he has been complaining about "owie tooth" and displaying behaviors like chewing on his clothes, pushing up on his front teeth with the palm of his hand, and biting. So I have been very worried that he is in some pain and not sure how to proceed.
Two or three weeks ago I took him in to a new dentist who treats special needs patients in the hospital under general anesthesia (should they need fillings or more invasive work done). He was able to get a good look in Jacob's mouth and we got a couple attempts at panoramic x-rays. Not crystal clear because he wanted to move his head to follow the machine's movements, but enough for the dentist to get some idea of the condition of his teeth. He told me there wasn't enough there to justify general anesthesia and he didn't think it was causing Jacob any or much pain.
The explanations range from him feeling his permanent teeth moving in and not understanding the pressure sensation (or processing it differently), a sinus issue, to pain as the result of him grinding his teeth (which could have just started as a sensory issue).
Lately he has been grinding and pushing his teeth VERY LOUDLY at school. He does it at home too (mostly at night) but more often at school. It sounds awful. He will often make this horrible face when he does it, as though it really hurts. Some of his punching has happened right after he is seen making that face. But he won't stop. One IA reported that at school he had a pair of scissors and looked like he was going to try to cut a tooth out of his mouth. Thankfully she was observing and able to get the scissors out of his hands!
He came down with a cold the other day and was really complaining about his ear, so yesterday I brought him to the pediatrician to get checked out. Looked like the start of an infection in his right ear (I can't remember his last ear infection...he has had very few in his life) so the doctor went ahead and prescribed an antibiotic. We also discussed the biting issue and the doctor ordered a sinus x-ray to help rule out any other issues. I was so relieved!
Well, last night everything seemed to come to head for Jacob. I think the combination of the head pressure/ear pressure and whatever is bothering his mouth was too much. He woke up around 11 pm and proceeded to FREAK OUT. That's the only way I can describe it. His face looked like it was in so much pain, and he was in a panic. He was trying to bite me, head butt me, hit me, etc. I had to hold him down on his bed at times, while trying to calm him down. I think he just didn't know what to do with himself and there wasn't anything I could think of that would immediately help him.
Chris and I discussed taking him to the emergency room, which I would have agreed to had we not been able to calm him down. Chris got an ice pack and we forced him to put that on his jaw for 10-second increments (not an easy feat). It did seem to help though. I also did some behavioral momentum stuff for him (this is the method his therapy company uses to get him back in control and so he understands it and seems to appreciate it) which I think made him feel safe and he was able to get a little more control of himself. But every now and then he'd get that wild look in his eye again and almost lose it. After several hours, and some melatonin and tylenol, he finally fell back asleep.
I'm planning to take him in early next week for the x-ray and hope it gives us some answers...
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