Dentist refusal - DS age 8

[AliMonkey]

DS is 8 and still refusing to open his mouth for the dentist. He went to my dentist appointments with me from when he was a baby until he started school, he now comes when his older sister goes, but we have never got him to open his mouth.

A couple of years ago, our dentist referred him to a special care dentist, but whilst there's been a bit of progress in terms of him smiling a little in the sessions, he is still absolutely refusing to open his mouth - or sit on the chair. The dentist has tried making him laugh, asking him to brush his teeth, asking him to let me brush his teeth, using a puppet, relaxation techniques like "imagine you are on a beach ..." (which he hated), sitting him on my lap, getting him in once a month, taking a break for a few months. We've seen two different special care dentists (the first one retired earlier this year). They seem to have run out of ideas so am hoping some wise MNers have got some!

For background, he has general anxiety issues and selective mutism, so there is I think a connection. The SM has hugely improved in the last few months at school, but no improvement at all at the dentist.

Has he told you why he won't open his mouth? I would want to try and work out whether this is a dentist issue, a general anxiety issue or related to the SM. Knowing the root might help you work on a solution, a journal to write his feelings in might help if he isn't comfortable verbalising them. He might need some professional help, but with the SM that could be tricky. I wouldn't worry about the SM improving in school but not so much elsewhere, school is probably his second most comfortable place so it makes sense (and well done your ds for making a huge improvement).

The saga of the dentist's chair...oh how familiar that is to me! DD will not sit in it when it is moving, the feel and sound of it freaks her out and makes her feel utterly terrified. When she was able to articulate this, the dentist started moving the chair into position before she went in. That solved one problem but she has now been able to explain that when she was younger, the sheer size of the chair scared her. She then got stuck in a behaviour habit she couldn't see a way out of, the dentist gave her a path out without embarrassment and she was able to try (she then explained about the noise/movement and we have a workable plan for now).

I'm rambling a bit but what I'm trying to get at, is that the strangest things can be the cause of problems...and our dc don't always know how to change the pattern (however much we reassure them).

Thanks Andro. He can't tell me the reason but as far as I can work out it is basically like the SM - an extreme anxiety that he can't explain that means he is just physically unable to open his mouth. He does get anxious with anyone except his "inner circle" of close friends and close family entering his "personal space" so I think that is part of it.

The problem is that the techniques that have worked with the SM have been "baby steps" so breaking everything down into tiny steps and not moving on until he's happy with each one, but as he will currently sit in dentists room on ordinary chair next to me I'm not sure what alternative is to the next step of "sit on the ordinary chair next to me and open your mouth, and we promise the dentist won't come any closer".

I really relate though to your tale of resolving your DD's problem of entrenched behaviour by giving her a way out. If DS is refusing to do something I often have to dream up a way for him to change his mind - eg "oh, is the problem that you wanted to put your blue coat on first, is that why you won't get in the car?"

There is a website I'd like to recommend for you:

www.dentalfearcentral.org

It also has a forum on it. The site itself covers UK and USA, it has lots of info on dental fear and how to help. The forum might help give you some ideas (either the paediatric section or in the support section) for where to go next. Good luck breaking this down for your son, the personal space aspect combined with the nature of dentistry makes this really challenging.

I would also recommend asking in sn chat for advice, a lot of the posters have to manage their dc's anxiety and you'll at least find a supportive atmosphere there.

Thanks for the website. I've had a quick look at it and will look properly later in the week.

Have you got a dentist mirror at home, for him to play with?

Thanks for the idea re dentists mirror. I'll see if I can get hold of one.