If you’ve heard me talk about my two children, you have probably heard me say that my hard one, the one with autism, is actually my easy one. That hasn’t always been the case, of course, but it is right now. Kai submits to chores with almost no protest, whereas Ryan will throw a volcanic tantrum over them. Kai is getting As and Bs on his report card, and Ryan is getting a D in reading.
But probably nowhere is the difference between them more apparent than at the dentist. I learned a long time ago that you can pretty much to anything to Kai and he will just…take it. Cleaning, flossing, cavity filling, tooth extraction, whatever. The most he will do is make a sound like a mournful cat’s meow, the kind of lowing they do just before they cough up a hairball. And this is true across all medical platforms! You can give him a shot, draw his blood, lose those results and have to draw it again and he’s fine.
Ryan, by contrast, gets very anxious about going to the dentist. She won’t walk to the chair by herself and when she comes back, she’s red-faced and sweaty, often still crying, the very picture of misery. She requires so much nitrous when she gets a cavity filled that I’ve asked if it would be easier just to give her a Xanax (they didn’t realize I was serious).
You might be asking yourself, why does she hate the dentist? Does she brush and floss her teeth? The answer, of course, is no, she does not. And, you may ask, whose fault is that? Why, one could easily make the argument that it is my fault. I do provide her with a toothbrush, toothpaste, flossers and tiny Dixie cups. But it’s a fight. And after all the fighting over the brushing of hair and picking up of rooms and just do your homework and her asking me every damn day if we can go to the Rainforest Cafe, I just don’t have it in me. It’s a classic vicious cycle: no brushing (and no pressure to brush from me), bad check-up with extra bloody scraping.
So you could, if you wanted to, make a pretty good case that Ryan’s dentist aversion and lack of general dental hygiene results from poor parenting. I myself have made that connection many times, and each time I drive her home from the dentist, Ryan still sobbing quietly in the back seat, I vow to do better.
:::
I don’t know when Ryan’s doctor and dentist aversion began, but it crept up slowly and is now A Thing. She hates getting her ears checked. You have to hold her down to give her a shot, which is no longer a practical solution. Last year she flailed so hard that she kicked a pregnant nurse in the belly by accident. The nurse was really mad, which was understandable, but it caused her to be extra harsh with Ryan who was genuinely freaking out, as well as with me.
Later that same week, Ryan needed to have some blood drawn. It took an hour. Actually, the blood draw took 30 seconds. The rest of the time was spent trying to convince her to trust us to do it. I promised her McDonald’s afterward, which seemed to move her until she saw the needle, then she drew up into a fetal position. I promised her a beanie baby from the gas station that she’s always begging me fore. Then two beanie babies. Finally, I promised to take her to Chuck E. Cheese for dinner. Finally, she extended a shaking arm to the phlebotomist, sobbing the whole time.
:::
After Ryan’s dental appointment last week, the hygienist called me to the back to talk about Ryan. Ryan had been uncooperative, she informed me, and there had been much scraping of plaque.
“She really needs to do a better job at home, Mom,” she said, and I am not that woman’s mom and I know Ryan needs to do a better job and that what she means is that I need to do a better job, and I was thinking all of this when the receptionist ran back to find me.
Ryan had thrown up in the waiting room.
When I found her, she had vomit all over her dress and was crying. I took her to the bathroom and cleaned her up the best I could, then gave her a long, long hug. I vowed to do better.
“Are you okay?” I asked her.
“I don’t want to be here anymore,” she whispered.
I assured her that we would be leaving soon and went back to finish my consultation with the dentist.
“I was much firmer with Ryan this visit,” she said, and at first I thanked her. I am always looking for ways to spread the villainy from me to someone else—like why should I ruin my relationship with my daughter fighting about homework when I didn’t assign it? Perhaps Ryan could take some more responsibility for her dental hygiene and at the behest of this lady instead of me.
Almost by way of an apology for my uncooperative child, I told the dentist that Ryan is becoming more averse to doctor and dentist visits, and recounted the story about the blood draw that ended in me eating bad Chuck E. Cheese pizza.
The dentist fixed me with a look.
“You know,” she said, “kids sometimes know that they get rewarded for going places and, you know, up the ante. I think you rewarded a lot of negative behavior promising Chuck E. Cheese that time.”
I said nothing, rendered temporarily speechless. I hadn’t asked her opinion and I didn’t think I had reinforced bad behavior.
But my parenting esteem was already kind of low and I questioned myself. Did I positively reinforce a negative behavior? Is “anxiety” the same as “behavior?”
“Kids are smart,” she went on. “They figure out, ‘Oh, the more I act out the bigger the reward when I’m done.’”
“I don’t think Ryan is quite that evil,” I said, and I was ready to go. I wanted to get out of there so I could think, get my daughter out of there so she could relax.
She kept talking and I let my mind wander. Negative rewarding is giving a kid with an oral fixation gum after he bites another kid, not before. Was this the same? I’m by no means a perfect mother, but I’m not stupid, and Ryan seems to have a genuine anxiety. And why had Ryan thrown up after a visit to this dentist? What had this lady said to her? I let my face go completely neutral and reached in my pocket for my Chapstick, popped the cap and applied it to my lips. She was still talking, but she watched me do this and seemed to sense that I was no longer interested in her advice.
She tossed her hair. “I’m just telling you what I know as a mother and a pediatric dentist.”
As a mother. Right.
“I’ll consider it,” I said, as neutrally as possible.
My eyes were drawn to a group of kids behind a closed glass door in an office. They were playing Monopoly.
“Are those your children?” I asked.
“Yes,” she said. “They have the day off from school.”
I surveyed them, wondering which one would turn up with an eating disorder or get a face tattoo just to spite this woman who so clearly thought she had all the answers.
Then I collected my own children and left.
:::
My sister called as I was driving home.
“My dentist just told me that I am a bad mother,” I said, and I told her the story.
“You know,” my sister, who is a doctor, said, “dentists don’t understand anxiety. A lot of people don’t like going to the doctor. But almost nobody needs a Xanax to go see their physician. That lady is in a profession where grown men and women need prescription drugs to go there.”
I laughed. This is true.
“You know what Ryan needs?” I asked, realizing at once what I should have known months ago. “She needs some freaking cognitive behavior therapy and a dentist who won’t be an asshole to her.”
And it was like the clouds parted, sun came out and doves started flying all around the car. Yes! Yes of course. My job isn’t to verbally harass Ryan into liking the dentist. It’s to help her find a way to manage her anxieties. What would I do if it was Kai? Does Ryan not get the same consideration because she’s neurotypical?
I drove home and took Ryan inside to change her dress, then drove the kids to school, feeling not like a crappy parent who can’t get her kids to brush but like I was back in command of the ship. I had stumbled across a high-level solution to a problem that was obviously not going to go away. And that dentist? There are a million dentists. I spent the rest of the day feeling pretty good about myself.
:::
That evening, I had a little talk with Ryan.
“Honey,” I said, “we are going to put you into a little therapy to deal with your anxiety over doctors and dentists. I don’t know if it will make you less afraid, but it will help you find ways to deal with that fear so that the visits are less stressful.”
“Okay,” she whispered.
I regarded her for a minute or two.
“I’m not mad at you,” I said.
She looked at me.
“On the contrary. I’m mad at the dentist. I thought she could have been…”
I cast about for the right word. Nicer? Less judgy? More solution-oriented?
“Kinder?” Ryan supplied.
And you know those moments when your heart breaks because you realize how wise and grown-up your child is getting? Kinder. What a word. What a sentiment. The dentist did not treat her with kindness. Those are not the thoughts of a girl who wanted Chuck E. Cheese for her efforts. Those are the thoughts of a girl who knows that ultimately she’s okay but man, the dentist sucks. And you know what? She’s right. The dentist sucks. And telling a kid with a phobia or high anxiety that “it’s fine, you’re fine” isn’t a solution.
We got this, Ryan.
I’ve already asked for Ryan’s dental records to be sent to a new dentist, one I hear is good with reluctant patients. The old dentist’s office asked for the reason I was transferring her file.
“Looking for someone kinder,” seems like a good one.