First dental visit

We had made an appointment with the dentist at Gillette (Children's Specialty Health Care) figuring they would have better luck working with Krassi than just a regular dentist who may not have as much experience with children with developmental disabilities.

The first appointment they had was March 13th. Yikes! But we went with it. Krassi doesn't visually have any serious dental problems besides the fact that his front upper jaw (not just his teeth, but the jaw itself) appears to be misshapen from eight years of being bottle fed. As a result, he can not touch his front teeth together - there is about a 1/4" vertical gap in the front when his molars are closed against each other. No biting chunks of foods for this guy!

But then we got a notice that the visit had been rescheduled for April 10th. Um. With a baby due on April 8th, I wasn't really comfortable with planning a dental appointment at that time! And the next available appointment after that was April 24th. We took it, but now we needed a plan B.

Because, you see, when conditions in Krassi's orphanage were brought to public attention almost two years ago and proceedings began to investigate and eventually remove the director from her position, she was removed not based on some of the more significant charges of severe neglect, but on the technicality (easily documentable and thus a timely solution) of her failure to provide dental care to the children. The Bulgarian government requires orphanages to provide dental care to their charges, and she didn't, so she lost her job. (Seriously - dental care - after all of the other significantly more serious things that were lacking for those children! But it worked.)

We are required to report back to the Bulgarian MOJ every six months for the first two years that Krassi is home, and he'll have been in our care for six months on April 14th. I don't want to hit that six month mark and have failed to provide professional dental care for our son!

So plan B involved just taking Krassi for a checkup at our regular family dentist - a super small practice (a dentist, a hygenist, and a receptionist in a remodeled basement unit of an apartment complex.) When I set up the appointment via email I included a fairly detailed description of Krassi's history and some of my concerns of not putting him in a situation that would be too traumatic for him, recognizing that dental care is a pretty foreign thing for him.

What a fun surprise it was to walk in the door and have the first word we hear be, "Zdrasti!" I had forgotten that the hygenist was native to Russia, so also has a fairly good handle on some Bulgarian. Many of the words are the same, and many are similar, and if nothing else, her speaking in Russian has got to be more familiar to him than someone speaking in English about dental care! We really don't know what his comprehension level is, or his dental vocabulary, but it was really neat to have someone explaining to him ahead of time step by step what was going to happen in the best thing we had to something he would understand. He did not love it, and we got a bit of "the lip," but it never developed beyond that, and she was able to polish most of his teeth (with very minimal polishing paste since he's unable to cooperate with something like "don't swallow" or "spit now.") She also flossed (a braver woman than I am!) which resulted in some bleeding of the gums, which didn't surprise me because I also see some blood when I brush most nights. The dentist was pleasantly surprised by the good condition of Krassi's teeth. Our best conclusion is that he had the right combination of good genetics and losing his baby teeth and getting his adult teeth at the right time (ie, when dental care started being part of his routine at the orphanage). He does not need any teeth extracted - a great contrast to a number of the other children from his orphanage, some of whom prefer to count the teeth they're keeping because it's hard to keep track of how many have been removed. The deformation of his front upper jaw is something that could be corrected with surgery, but it's apparently very expensive and very painful, and may not be necessary. He will never be able to eat a whole apple right off the core, for example, but if his crunchy food were cut into bite size pieces, there is no reason (dentally) that he could not learn to eat just about anything. He will also likely need crowns, and early, because the brunt of all the force is carried on his back molars (in addition to his grinding), but overall, we left the dentist with a plan to floss (with a flosser, so my hands don't have to go in) and brush with just water once daily (to keep the gums from getting overworked at the beginning.)