My Boy Loves To Chew

 

Discussion of topics to build awareness, increase knowledge-base, and ultimately assist in conquering the challenges of being special parents of kids with special needs, such as those with autism or adhd.

   

  After being in school for a few weeks, I noticed that my son started chewing on things more than usual.  I understand that children with adhd have oral fixation, or a strong impulse to stimulate their mouths.  Kids with sensory issues chew to calm themselves.  Children with autism will also try to self-regulate by means of chewing, to deal with anxious feelings.

    In my mind, his school is a cesspool where Covid, RSV, and the Flu (among other things) thrive.  I cringed when I received a message on one of his daily reports saying that he had chewed up a part they were using during their math activity.  Constantly having the urge to chew on random things would most definitely expose him to more germs.  Seemed logical to me to send him to school with something purposed for him to chew on. I thought that maybe something that hung around his neck would be less likely to get dirty and germy. I looked and pulled out a couple of chewy necklaces I had purchased some time back which he had never  used.

    

    But then I started wondering...  Is it really a good idea to encourage my son to chew?  Should he be given unlimited access to chewy accessories?  Could all the chewing from his stimming be damaging to him?

    I decided that I would reach out for some professional advice.  I received a very quick, knowledgeable, and helpful response from Dr. John Hansford, Pediatric Dentist and Dental Anesthesiologist; Owner of Greenpoint Pediatric Dentistry.

  My question(s):    

    

    My son has oral sensory issues and chews on things a lot.  Are chewy toys/accessories harmful in any way or damaging to teeth?  Should my child be limited in how long he chews on it?  Does it matter if the chewy toy is smooth or textured?

  Dr. Hansford's response:   

    

    In general, the risks associated with chewing habits are breaking teeth, jaw muscle growth (hypertrophy), muscle soreness/stiffness, and temporomandibular joint disorder.  If the habit is continuous, a risk is malocclusion.  Essentially, the slow, constant force will move the teeth the way braces move teeth, but the result will be misalignment rather than alignment. 

    

    In regards to texture and time, if the object is soft and chewy, there is probably no difference in risk to breaking teeth between chewing for a short time versus chewing for a long time.  However, depending on how hard the object is and/or how hard the person is biting, then there could be an increased risk of breaking or chipping teeth.  Pressure is defined as Force divided by Area.  If the texture allows the patient to bite on one tooth surface as opposed to several teeth all biting down on the surface, then the reduced surface area will increase the pressure on the tooth.  Chewing small things increases the risk of swallowing the object or aspirating it (it goes into the larynx/lungs).  If a patient can't help but chew, the risk is probably lowered by ensuring the object is bigger, softer, and smoother rather than small, hard, and textured.

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    My question:   

    What can be done at the dental office to make the visit easier and productive for a parent and an autistic/adhd child who has difficulty sitting still, or who is excessively anxious?

  Dr Hansford's response:    

    Desensitizing: Seeing a board certified pediatric dentist who will do behavioral management visits to desensitize the conscious patient may be beneficial.  This extra time and care at cleanings and other appointments is generally an out of pocket expense.  

    Anesthesia: Patients may be sedated so that they are unaware of the procedures being done, and don't have to cooperate or participate in the procedures.  Sedation licenses are available to all dentists.  However, the children who cry for cleanings and cannot tolerate radiographs (aka x-rays) generally require providers with a high level of training  and expertise i.e. they completed an anesthesiology residency.  The best way to determine an anesthesia provider's level of competence is to ask:

1) Did they complete an ANESTHESIOLOGY residency?

2) When is the last time they placed an IV, manually ventilated a patient, and intubated a patient?

The answers should be "Yes" and "This week".  Anything less would indicate a non-anesthesiologist or an anesthesiologist who has let their skills get too rusty.

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    These are all very good things to be aware of as parents and I'm grateful for the information.  Greenpoint Pediatric Dentistry can be contacted through its website www.GreenpointPediatricDentistry.com.

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HonorPraiseThank someone at hptsomeone.com.

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