Dyspraxia and Dentistry

By Peter J Brown

A few years ago, I remember attending a one-day conference at the Railway Institute in York that discussed many aspects of the problems that were faced by adults with Dyspraxia. The retired occupational therapist, Dorothy Penso, did make a brief point about the problems that were faced by adults with Dyspraxia in the dentist’s chair and about the sensitive gagging mechanism that many people with Dyspraxia have. I am no exception – my sensitive gagging mechanism prevented me from approaching a dentist for help or advice to prevent dental problems in the future. I was not even registered with a National Health Service dentist. If I described myself as a nervous patient when it came to opening my mouth and submitting to dental care, it would be putting it mildly.

One Monday morning in late May 2004, I noticed it was uncomfortable when eating my morning toast. It continued to be uncomfortable when eating my morning toast. The unpleasant soreness in my mouth never seemed to fully leave me. I was always taking Paracetamol. I was worried in case I might poison myself with the Paracetamol. By late Wednesday afternoon, it was clear to me that I would need to do something I had dreaded having to do all my life, and that was to make an appointment with a dentist. On the Thursday morning I contacted a dental practice in the Berwick Hills shopping centre in Middlesbrough by phone and appeared to be accepted with enthusiasm as a NHS patient. An appointment was arranged for me at my convenience for the following Tuesday at 11am.

On arrival at the dentists’ surgery, I tried to complete the usual sickening paperwork that enables a patient to register with a NHS dentist. I was now aged fifty-one, and the first dental consultation of my adult life was about to take place. The last time I had undergone a dental examination was when I was aged 14 in 1967 when I was a boarder at a special school in Newcastle. “Sit in the chair, Mr Brown” said the spectacled dark-haired lady dentist, as I staggered into the dentist’s consulting room. When she asked what the problem was, I told her that I had been experiencing some soreness and discomfort in my mouth. I began to retch violently when the dentist brought the instrument that enabled her to make the dental examination towards me. The retching proved my point that one of the features of my Dyspraxia, which was gagging, was going to be a problem. I apologised to the dentist for retching, but explained that it was a symptom of the disability of Dyspraxia that I had suffered from all my life. She seemed to be sympathetic and appeared to know what I was talking about when I mentioned Dyspraxia. I suspect that she may have had experience of giving dental treatment to children with Dyspraxia. I did manage to relax and open my mouth so that the dentist could make her examination. After she completed her examination she said she thought, “I had difficulty in cleaning my teeth owing to my Dyspraxia”. She said that, “most of the trouble I was having was with my gums. I will prescribe some mouthwash and I will refer you to a special clinic in Billingham that specialises in anxiety control and sedation and is licensed to give an anaesthetic. They will give you a dental X-ray before they decide on treatment”. I felt extreme relief that there was not going to be any painful treatment that day.

During the next few days I felt a lot better knowing that the dental treatment I required was not as extensive as I feared. I began to use the mouthwash and change the toothpaste that I had been using to something that was more friendly towards my mouth. The discomfort in my mouth never seemed to go away completely. I appeared to need to take around five paracetamols a day.

On the next Friday I has an appointment with the practice nurse at the GP practice that I am registered with for my regular six monthly blood pressure check. My mouth felt a lot more comfortable. The practice nurse asked the usual questions about diet, alcohol and exercise. I told her that my main health pre-occupations were dental. I had been taking painkillers and drinking more alcohol than I would usually allow myself. My blood pressure was not surprisingly high. The nurse said she noticed that my face was bit swollen and that I might need antibiotics. When I left the medical centre, my mouth seemed to feel better than it had felt for a long time. The swelling that the nurse had noticed must have been going down. I wondered if I could get though the day without taking a Paracetamol. It would be the first day without taking a Paracetamol for nearly three weeks. That day was in mid June. I am writing in mid August and I have not needed to take any Paracetamol since mid June. The mouthwash and new toothpaste must have begun to kick in on that Friday in mid June.

One warm Monday morning in late June I boarded the number 36 bus for my appointment at the Queensway Dental, Oral Surgery and Anxiety Management Clinic, Billingham. I felt slightly apprehensive about my visit to the clinic. After a brief dental examination, I was taken into a nearby room for a dental x-ray. Owing to my Dyspraxia, I had difficulty in following instructions about how to move my head during the x-ray. After the x-rays were over, I waited in the waiting room. It appeared to be a rather long wait. Finally I was led into the consulting room. “You’re going to need to loose a tooth, Mr Brown”, said the dentist. “Just one tooth?” said I, hardly believing the good news. “There is a massive hole in one of your very back teeth. With your disability and gagging problem, the tooth should come out under anaesthetic. We will give you an injection in the back of your hand. We will not set any date for the extraction. You will need to have somebody to accompany you and provide transport”.

I left the clinic feeling pleased and relieved. Just one molar had been causing all that trouble and anxiety. Now, I often forget which side of my mouth the offending molar is on. I am quite happy about having the tooth out under anaesthetic.

There are two points I think I should make. Even though the extraction is yet to take place, the dentists I have met appear to be reasonably sympathetic towards my problem with Dyspraxia and the gagging problem that goes with it. Living in Cleveland, it is easy to get NHS dental treatment. In other parts of the country it is often difficult or impossible to obtain NHS dental treatment.