True story: A mother brings her two young children into the dental office for a checkup and cleaning. The older child, Jon, is a boy of 10, and he is well mannered and easygoing. He sits compliantly for the entire session. The younger child, a girl, is 6. She is antsy and can’t sit still. She gags whenever the dentist comes near her mouth and she bites him. Fortunately, the dentist is wearing a guard. With great ease Jon’s exam is finished. Emily, the younger girl, requires more attention and time. Her behavior does not improve much for a few more years. What is remarkable is that Jon, the young boy, the easy patient, has Down syndrome and congenital heart disease. He grows up to own a home, drive a car, graduate college, and work on a golf course. The girl, what is sometimes referred to as a neuro-typical child (a term I dislike), is a very difficult patient. While she eventually grows up to be a successful attorney, there was no predicting it that day in the dental office. I should know. They are both my children. The lesson here is the same one that my family tried to instill in me and that your family hopefully taught you—don’t judge people by how they look on the outside. What matters most is on the inside.
If you think that you can judge your patient’s behavior on how he or she looks, let me tell you—you will not be able to take a look at a patient and determine his or her attitude, behavior, or even if the individual will pay his or her bills.
I am writing this chapter so that if someone like me walks into your dental office with a child with a disability, or with an adult child with a disability, you might take a moment to see the individual and not the disability. I hope you will see a child or an adult with a disability as a patient needing your care. Because I will be looking for a competent dentist with compassion and warmth.
Those characteristics—competency, compassion, and warmth—are ones that you should be hoping you have for a successful practice. In fact, they are good characteristics for success because nobody is interested in a competent dentist with a lousy attitude.
When a child is born or diagnosed with an intellectual disability/developmental disability (ID/DD), after the shock and awe, the family begins to look for acceptance. Usually, it is family members and close friends who provide the support that is essential for the family to regain their footing and strength as they enter a world they are largely unprepared for.
I was lucky. When my son was born, I was surrounded by a supportive family and a medical team of unmatched expertise. My father actually built a virtual mountain for Jon to climb, with goals that many might have said were unrealistic. But every goal was reached: reading, writing, going away to sleep-away camp for 8 weeks every summer, breaking 100 for a round of golf, graduating high school, owning a home, having a job, having a girlfriend, and driving a car.
There are hundreds of people who can claim to be part of Jon’s success and my healing. And they are proud, and should be, of their contributions to a good life.
For me, part of my healing came from a dentist. I was at the beach, many years ago, with my toddler son, who was born with Down syndrome and tetralogy of Fallot. A handsome young man approached Jon and me. At first, I thought that this young man was flirting with me (or at least I hoped). As he began to speak to me, he showed more interest in Jon than me. In fact, he made many positive and affirming comments about my beautiful baby. As our conversation continued, I learned that he was a pediatric dentist and had experience with children like my son. Ironically, 6 months earlier, I had been given his name as a dentist who was as skillful as he was kind. That day on the beach, we both found gifts; my son found a dentist and I found my dear friend Dr. Steven Perlman.
You have an opportunity right now to decide what kind of dentist you will become. Will you be inclusive of all people needing your care, or will you cherry-pick ones that look or act a certain way? It is your life and your career and soon it will be your time to decide whether to stand up and be counted or just show up.
Many families with children with ID/DDs feel different. They fight for acceptance for their children from schools, sports leagues, and even religious organizations. They do not want to have to fight for access to quality dental care. They want the same thing as you want for yourself and for your family—good care.
What kind of reputation do you want? Someone who will be recommended for both his or her competency and decency? Do you want to be known as someone to avoid if you have a child with a disability? Do you want to treat whole families? Do you want to be inclusive?
Regardless of whether you intend to be a general dentist or specialize, individuals with ID/DDs and their families are potential patients. They have the same need to have access to quality and compassionate care. While ID/DD may not have touched you personally, at least not yet, you have certainly attended school, attended religious services, or played on sports teams with persons with ID/DDs. You know that they are more alike than different from you.
In fact, as you have learned from other chapters in this book, they often have unique dental needs. They are often interesting patients.
In my son’s case, he has no dental caries, which is not unusual for someone with Down syndrome. He is able to keep his wisdom teeth, a gift from his fat/>