Orthodontics- and SN child - Is it possible?

[magso]

Ds is 12 and has very overlapping protruding front upper teeth and large 'overjet' so no bite. This is getting rapidly worse and his lips are always sore due to the upper teeth breaking the skin. It will only get worse. He also has teeth trapped in the gum from too small a lower jaw. Normally teeth would be removed to make space and braces fitted to rectify the problem, but ds has autism and MLD so any treatment has been shelved.
Has anyone managed orthodontic treatment with a sn child with MLD and ASD + the sensory issues that go with it? I wondered if some gradual desensitising approach might help?
Having just spent several difficult nights in hospital with ds for an injury I know he would find struggle cooperating with anything even slightly uncomfortable. he struggled accepting a bandage on his arm poor child!
I welcome any ideas or stories from others. TIA

dd1 has damon braces, which we would/ will use when dd2 needs them (she's only 8yo so a way off) she has had extensive dental work done though to put titanium caps on her back teeth for protection, which was done by the dental service at the children's hospital under sedation. damon braces work faster and require less tightening etc usually.

that said, i would suggest any form of desensitisation would be a great start. braces are going to be uncomfortable until he gets used to them. i would discuss the art of the possible with his dentist (i assume he sees an sn dentist anyway). it does make me cross that kids with sn often don't get offered the same treatment as nt kids. no uk specialist would offer dd2 squint surgery because of her disability. when we moved o'seas the first question was 'why hasn't she had squint surgery?'

DS has AS, so not the same, but also has all the sensory stuff - I just treated as non-negotiable, he had to have them, I gave him lots of sympathy and painkillers as needed, but just never let him think that refusing or taking the braces off was an option.

He did understand what they were for though (correcting a very similar issue actually) which does make a big difference.

His were functional appliances to pull his bottom jaw forward - if it's something like that I don't see any reason why they couldn't be put in too loose to start with to adjust to them simply being in his mouth and then gradually tightened until they actually do something if you see what I mean

Thank you everyone for your replies. Yes ds is under the sn dentist at the hospital. He was due to have one of his bottom teeth out by gas sedation but was horribly sick (side effect of the gas) and they were not able to get as far as removing his tooth. Any tooth removal will have to done now under general. He is terrified of the gas that makes him sick.We worked very hard to get that far! The orthodontic specialist at the main hospital was very dismissive and saw no point in doing anything because ds is not interested. He wrote to our little hospital that ds has a digit sucking habit (he does not!!!) I clean his teeth and it is a struggle especially the teeth now getting pushed behind where I cannot get to them. I think they will decay because they are unreachable.
I do not really know anything about the type of appliances this has not been discussed with me. I do know that any appliances would be fixed and worn for 1-2 years followed by removable appliances. Do they put the braces on at the same time as removing teeth?

We are about to start orthodontic treatment with DS at 17. Would delaying help? We have used special dental clinic for fillings, and are hoping the extractions can be done there.

dd2 took oral sedation which was far easier than any time we've had to give her gas tbh... i would have thought that it would be a separate appt for braces fitting after extraction, but don't have any experience.

you could ask about the titanium capping if you are having trouble keeping teeth clean, as well...

My first instinct Jandymac was to delay and so was not upset by the slowness of the system, but since ds was referred by our dentist 2 years ago now, the overjet and overlapping has got so much worse. His lip is split from his teeth. I worry that his teeth are getting damaged and that it might be irreversable. It is good to hear that treatment can be started later.
Oral sedation sounds a good idea Outofbody, - as long as it tastes OK. He used to be quite cooperative in the dentist until he broke a tooth and would not let anyone near him with a syringe! After this weeks experience of a GA( he woke up in recovery red with anger and shouting at the top of his voice!) I would struggle to do that to him for anything short of life threatening! I have asked about preventative treatments and was told it was too late now. I will ask about titanium tipping. Is it very expensive?
This is all complicated by the lovely sn dentist ( who had some orthodontic knowledge) at the hospital leaving and the other dentist at the unit (whom ds was sick over) is at a loss and barely knows my son.

dd2 went through a huge fear of hospitals. the last time she had a GA i could hear her screaming as they brought her up from recovery. she was trying to climb out of the bed as they wheeled it along to the ward and they were having to restrain her as they went. there were bits of bed rail all along the corridor.... she continued to scream for the next thirty minutes until they took the canula out. they couldn't get near her to do obs, but presumably could tell she was ok by the amount of noise she was making... . they discharged her rapido to give the other patients some peace and quiet, and she shut up the minute we left.

it came in a little cup and she drank it ok (has had it a couple of times now) looked/ smelt vaguely orangey. have seen one poor family trying desperately to persuade a mid-teens boy to drink it and he was adamant he wasn't going to though. they did experiment with using scented gas as well - she could try a whole heap of fragrances, but i think wnet with watermelon, or strawberry or somesuch... she does still get flouride coatings periodically...

it does take a good couple of hours to come around from though. dd2 was always completely convinced she could walk straight away, but really couldn't. and they always tell her that she can leave when she can walk across the room without help. so i spend hours trying to dissuade her from trying, as i'm the one who has to try and keep her upright. and she keeps insisitng on try again.(and failing) endless entertainment.

Oh I can guess at the entertainment! Ds escaped the trolley as soon as he was awake from his GA tearing off the bleepy machines as he sprang off (I was in recovery too) and then i and several nurses had to run along side him in his fetching gown, as he rather drunkenly marched angrily back to the ward! They made the mistake of bandaging up both sets of fingers (line in the uninjured hand) The last thing the nurse had said to him before he dropped into aneasthetic induced sleep was about playing with the ward Wii and you can't play with fisted up fingers!
I think oral sedation might be the way to go, thanks.

the power of wii....