In her mother's own words.
"I don't know anyone who looks forward to a trip to the dentist, but for our daughter Mandy, who has autism, it is extremely traumatic. Fortunately we have been blessed through the years to have wonderful dentists such as Dr. John McReynolds, Dr. Stan Hess, and now Dr. Ray Lyons. All of these patient men have done their best to take care of Mandy's teeth with as little trauma as possible, but it has still been very difficult for her.When Mandy was a small child we had relatively few problems with her teeth, but when her permanent teeth came in we were faced with a disaster. None of her permanent teeth had an enamel coating on them, which left them discolored, soft, and brittle. Making matters worse, her overbite was terrible and her teeth did not close properly leaving her without chewing surfaces. Normally, braces would be used to fix these problems. However, even if her teeth would have been able to withstand them, they would not have been an option for Mandy. Thus, we were left to ponder the long-term question of how we could save her teeth. We feared decay and tooth loss, but, even with the help of our dentists, we were unable to find a plausible solution.
Finally, after examining Mandy last fall, Dr Lyons offered some hope. He knew of a dentist in San Francisco, Dr. David Blende, who did entire mouth reconstructions under general anesthesia. He offered to contact him to see what options were available. He told us that Dr. Blende was willing to look at Mandy's case to evaluate what could be done. With help from Dr. Lyons and Dr. Hess we were able to get some X-Rays and then went to see Dr. Bob Supple for additional photographs of the inside of her mouth. After viewing these items, Dr. Blende called to speak with us directly. We asked him to create a functional mouth for Mandy, as that was our principle concern, although we also told him we would be delighted if he could make her mouth aesthetically pleasing as well. Many phone calls and faxes later we left for San Francisco on a snowy Wednesday in early February.
Upon our arrival we met Dr. Blende and his staff. After a quick look (that was all Mandy would permit), Dr. Blende told us he would do his best, but warned us that because many of Mandy's teeth were quite worn, he could not promise to save all of her teeth.
We arrived at the hospital to check in at 6:00 AM the following morning. Dr. Blende had told the anesthesiologist that despite hospital protocol my husband and I would need to stay with Mandy until she was asleep because she wouldn't understand what was happening. Mandy was in surgery for the next 8 _ hours. Throughout it, Dr. Blende had to make numerous critical decisions as to the best way to fix her mouth. For example, Mandy's impacted wisdom tooth had an infection around it and had to be removed; the baby tooth that had prevented a permanent from coming in had to be pulled along with the impacted tooth above it; and so on.
When Dr. Blende finished the surgery and returned to the waiting room he had good news: it had all gone better than he could have even hoped. Mandy's teeth had great roots which meant that all of her front teeth had been saved by doing 3 root canals. In all he had extracted 5 teeth, constructed a bridge, and had made the molds for 27 crowns that he would place on her the following Monday. He also told us that the minute her breathing tube was removed, we could go into the recovery room and help her to wake up. When we saw her she was happily snoring and her face was surrounded by ice packs to prevent swelling. We were finally able to take her to her room and she was able to swallow and keep down apple juice. That night she wanted my husband rather than me to stay with her; she's always been a daddy's girl. The next day we took her back to my cousin's house where we were staying and although she did not want to eat much besides oatmeal, we had a good weekend. On Monday it was back to the hospital for the placement of the crowns. After an additional 4 hours of surgery they were in place and the process was finally finished.
In the end, Dr. Blende had been able save Mandy's teeth, correct her overbite as well as make her chewing teeth meet in the back. However, not only had he given her a functional mouth, but he also gave her beautiful white teeth, as he was able to only place metal on her chewing surfaces. The surgery had gone so well that he asked if we would be willing to sign documents to allow him to use her case as a teaching tool, which we were delighted to do.
We as parents would not advocate this extreme type of dentistry in all cases. We decided it was right for Mandy on the basis that her mouth was going to deconstruct if we did not do something. Moreover, due to the difficulty she poses as a patient, this "extreme makeover" was by far the simplest method for her and for the professionals involved. The mouth she has now will last her a minimum of 40 years, but probably more. At that time if something further needs to be done we are hopeful that dentistry will have come far enough along we will have even better options than today.
If anyone would like additional information please contact me through the Blende Dental Group.
Ruthie Robbins
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