The Dentist’s Shocking Reaction to Treating Nighttime Lows with Juice

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I’m a journalist, and in my career as a writer and editor I’ve been called horrible things. I mention this because—though it doesn’t exactly feel great—I have pretty thick skin.

But when it comes to my little boy’s type 1 diabetes—to what people say, even unintentionally and ignorantly—I’m surprised by how deeply some remarks hurt.

I’ve heard little kids who have said things to my eight-year-old son (diagnosed more than half his life ago), such as, “I’m glad I don’t have diabetes” or “Blood’s gross.” And I’m consistently impressed by the way my son—a happy and good-natured kid—handles things. He’ll shrug and carry on with whatever it is he’s doing.

A couple of months ago I brought my son to a local dentist who offers area school kids free sealants on their molars. Dental sealants are plastic coatings placed over the chewing surfaces of the back teeth to prevent cavities. Because my son has type 1 diabetes, an endless set of factors—adrenaline, fear, food, illness, growth spurts, you name it—can affect his blood sugar. In his case, hypoglycemia is especially scary, and unpredictable, at night while he sleeps. Maybe a few extra tosses of the football before bed? A low. An animated game of Yahtzee? A low. Tomato soup for dinner? A low. The wind blew west, a bird flew by, my son was wearing green? A low. Kidding. What I mean is, there is no such thing as completely steady BGs—at least in our experience with type 1 diabetes. I’m often asked by well-meaning acquaintances, “Do you have it under control?” Well, we keep our son safe and healthy. We help him maintain a good A1C. We regularly visit the endocrinologist. We teach our son what he needs to know. We empower him. That’s one form of management, I suppose.

Back at the dentist’s office, a dental assistant painted the sealants on my son’s teeth. After that, the dentist, whom I’d never met, came to the room to check my son’s teeth. I told him that my son has type 1 diabetes, that we were there, getting the sealants, for the extra protection. Very often, I explained to him, my son has to have a juice box in the middle of the night when his blood sugar plunges. My son always brushes at bedtime and in the morning, but I worried about his teeth.

“You give him juice in the night?” asked the dentist.

“Yes. He has type 1 diabetes,” I repeated. “Sometimes, at night, he has low blood sugar.”

“Does he brush after you give him the juice?”

“No,” I answered. “He barely wakes up.” My kid the pincushion, I thought. He never opens his eyes when we prick his fingers or place a straw on his lips. It seemed an injustice to rouse and drag the kid to the bathroom to brush his teeth every time he took a sip of juice.

The dentist whispered something to his assistant about fetching something. She quickly returned with an empty juice box and a Ziploc bag of white sugar.

He dangled them in the air.

“This is what you’re putting on his teeth,” he said.

I could feel my face get hot.

“Yes,” I answered. “When he goes low we have to put sugar in his body.”

“Isn’t there something else you could give him?”

“Juice, in the middle of the night, is what works best. It’s what our endocrinologist prescribes.”

“Is this what other people do?”

“Yes.”

And then. He went there.

“Maybe,” he told me, “you could do a better job of managing his diabetes at night.”

Just wow.

Like most parents caring for a kid with type 1 diabetes, I would do anything for my child. I do everything I can for my child. I do my best for my child. I had brought him here, to this office, because, beyond his vital organs, his eyes, his extremities, I also want the best for his teeth. But to balance his life—what those juice boxes preserve in the middle of scary, deep-night stuff—versus his teeth?

Honestly, I don’t remember what I said at that point. Maybe, too stunned, I didn’t say anything. (Full disclosure: Two years ago at the Legoland Park in Florida, I exchanged words with a lift operator when, as my son and I sat, ready to begin a ride after a long wait in line, I was told we couldn’t proceed with my son’s diabetes bag. It was a small satchel with a meter, juice box and glucagon that I had tucked beneath my arm. It was also a sweltering day, he’d had rollercoaster BGs and there was nowhere safe to leave the bag. As the ride froze, my little boy beside me, and everyone waited for us to stand up and leave, I yelled, “I know my rights!” The proper way to handle things? Probably not. But we went on that ride.)

Back at the dentist’s office, I realized my son, still reclining in the chair, was staring at me.

“Could you at least chase the juice with water?” the dentist asked.

“We could try to do that,” I answered.

We talked another minute or so, I don’t recall what was said. We shook hands. I thanked him for his service—four sealants, a $120 gift.

On our way out the door, his assistant handed me a piece of paper, some kind of receipt.

After we were buckled in the car, I read it: “Brush after juice consumption at night or discuss with endocrinologist diabetic management.”

That paper is still in my drawer, right beside my toothpaste.

 

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Annie Stoltie

Annie Stoltie is a mom to two children—one of whom was diagnosed with type 1 diabetes at age 4—editor of Adirondack Life magazine and a contributing writer to publications that include Slate.com, the New York Times, Newsweek, Modern Farmer and Good Housekeeping Magazines. She’s the author of the guidebook The Adirondacks (W.W. Norton, 2012) and is currently the Writer-in-Residence at the State University of New York at Potsdam. She lives in Jay, New York.

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