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Where There’s a Will, There’s a Way by Erika Skorupskas

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In 2001, it became clear to Duenna Karner that her autistic son, Will, would require extensive orthodontia treatment. Cautioned that Will had no chance of help beyond treatment in a hospital under anesthesia for braces, and couldn't possibly see a "regular" dentist, Duenna and her family were able to find Dr. Steven D. Lasser of Providence, Rhode Island, and embark on a near 10-year relationship.

Will became a dentistry and orthodontic patient of Lasser and maintained a regular appointment on Wednesday at 1:30 p.m. in the same room, with the same hygienist, Susan Maguire, with his favorite magazine and mirror kept with his chart. Will liked to watch the procedures as they were being done. Trust comes hard to the autistic; it took only three visits for Will to trust Lasser. According to Duenna, "My son has learned to trust and discern those who can be trusted from those who cannot - Lasser can be trusted." Based on this mutual trust, Will was able to get through five years of intensive orthodontia, as well as regular check-ups and cleanings. As Will was shuffled from school to school, doctor to doctor, medication to medication, he delighted in the Wednesdays he got to see Maguire and Lasser, regardless of the fact there might be pain involved or even a new appliance. They were a predictable encouraging rock in his swirling world of change and difficulty.

To most people, it would be hard to imagine that a pediatric dental practice would serve the role of comfort and strength to an autistic boy and his family in the difficult years of fifth through 12th grade. However, Will continually looked forward to those Wednesday afternoons, and as he became more mature and controlled, Will would even tease Lasser about Lasser's dislike of dogs, and threaten with a smile to bring his companion pug, Bruce, to an appointment.

For more than 30 years, Lasser has overseen his Pediatric Dentistry Limited practice in both Cranston and Providence, Rhode Island. His practice prides itself in treating many patients with special needs and he "believes they are quite skillful in this area, and from a selfish point of view, derive a great amount of satisfaction from treating patients who truly need our help." Lasser and his staff have worked hard to integrate many of these patients into their normal routine, although they also set aside specific periods of time during the day and during any given month to interact with those patients who do not do well in the normal, quite hectic, "busyness" of their pediatric dental practice.

In response to how his practice was able to always guarantee Will a 1:30 appointment on Wednesday, Lasser explained, "In our office, this time slot is not our busiest time of day. Mrs. Karner was aware of this fact, and knew that Will needed a time slot when the waiting room and operatories were not crazy. In addition, because Will took up more doctor time, this time slot also benefited my schedule. Our entire staff was aware of this scheduling preference, and always made this appointment time work. It was as easy as this."

Lasser continued, "It goes without saying that I (and Susan Maguire, the assistant who usually worked with Will) developed a very warm relationship. Will is extremely charming, and very bright. As you know, he is autistic, and has trouble fitting in with many of his peers. Will's initial behavior was quite difficult, however, once we gained his trust, he became a cooperative patient. It was this challenge, the goal of making Will comfortable in the dental environment that was so appealing to me."

Will was referred to Lasser at nearly 10 years of age and - while he had been receiving dental care elsewhere, as occurs with many children with special needs - the care was pretty superficial. Lasser stated, "When it became obvious that Will required full orthodontic care, he was referred to my practice. I am not a formally trained orthodontist; my specialty is pediatric dentistry. However, I have obtained many, many hours of orthodontic training, and orthodontics now comprise a significant part of my practice. As you can see, Will's malocclusion, truly of a handicapping nature, also made this case very appealing to me. I believed that if this occlusion was not corrected, Will would be saddled with a lifetime of significant dental problems. I knew that I could correct his bite, and without sounding too full of myself, was not sure who else in Rhode Island possessed the skill set required to satisfy Will's needs."

Lasser concluded, "Will's mother, Duenna, was immensely helpful during the course of his treatment. She always accompanied him into the operatory and her presence was a source of reassurance to Will. However, she deferred to me and to Susan in terms of patient management. On those many occasions when we needed to ‘push' Will a bit in order to gain his cooperation and accomplish our tasks, Duenna just sat back and let us proceed with our (often protracted) negotiations. It is this level of trust on her part that made Will's mother such a valuable part of the process."

As Lasser's hygienist, Maguire's experience in working with autistic kids has been exciting, challenging and sometimes exhausting, but very rewarding. According to Maguire, "All kids in the autism spectrum are different, so it is very helpful to have the parent's input on the best way of helping a child. I never had specific training for treating kids with autism. With all children, we show them the tools that we will be using along with a hand mirror so they can watch. Usually they become more comfortable with those steps and also how often they come to see us. It gets better at every visit."

In reflecting on her time with Will, Maguire replied, "Will always had the same private room for each visit. Duenna always sat next to him, usually reading a book or magazine and Will and I talked about things that he loved - Bruce, movies, books, plays that he would try out for, and his family. Often, we would need to take a break just so he could talk! He was respectful, witty and thankful at every visit. Some visits were quick adjustments, such as changing an archwire, or having his appliance adjusted by the doctor. Sometimes we needed longer appointments to remove braces or add new braces. I always told him what we needed to do and showed him. He would sit back and be ready to work. As you can see in the before and after pictures, his end result was great. Every child should have the opportunity to have a great smile. It isn't one person who makes a great smile, it is several people; his parents, Dr. Lasser, myself and other staff members. Together, we make a great team."

Maguire remembered, "Will started this process nervous and with many questions. He learned to trust us and have fun at each and every visit. He is quite comfortable now, coming to see us for his regular cleanings. I look forward to seeing him every six months. I will never forget Will and his mom. I have taken a great interest with children who are autistic since working with Will and have read a few books on autism, as well as read any new articles that I come across so I can improve myself, which will help me in treating the kids.

"Duenna and Will are very special to me. I go to work each day hoping I have helped a child and now I have. I have worked with Dr. Lasser for 25 years and I'm still learning. He is a great dentist, wonderful teacher and a good businessman. It's hard to find an office that has all of these. There are several girls who have worked there 25 years or more! I don't like to think about the day he retires as it will be very sad!"

Incredibly, when Will was three years old, Duenna was told that he had an IQ of 50, and warned that he would never have the ability to talk or read. Will defied this diagnosis and graduated from high school with honors, and is now enrolled as a theater major at the local community college, where he maintains an Agrade point average.

Remembering his first visit with Lasser and Maguire, Will said, "I met them in 2001. I was nine years old and my history with dentists was not promising. However, once I met the lovely and charming Miss Susan, my mind was changed forever. She never was impatient with me, and is beautiful besides. She let me take my time to get used to things. I loved to have my own room, always the same, and to know that I could have my special blanket if I needed it, and she would always give me the game plan. That means, she would let me know what she was going to do and what Dr. Lasser was going to do. We always got to practice with new tools and I could see and hold them. Now that I am older and more experienced than when I was just 12 or so, I did not care for bright lights, and always got to wear dark glasses, like a film star. This was most helpful to me. Plus, they never messed with my schedule. Wednesday at 1:30 p.m. in the Providence office - blue balloon, blue toothbrush - I love people who always get it right."

He continued, "I am also an observant kind of chap, and I always was able to observe the procedures with my special hand mirror. Miss Susan was quite keen on the mirror, but sometimes it got in Dr. Lasser's way and I yielded to his wishes to move it for a bit. You see, doctors have their own ideas about things, and I had to get used to Lasser being in charge, but he always seemed to make the right decisions for my teeth, and Miss Susan backed him up. Dr. Lasser and Miss Susan have so many friends who work in that office I could hardly keep track of them all. Everyone always came into my special room to say hello, and the welcome ladies downstairs couldn't help but recognize my ever more handsome smile. I never even had to say, "Will Karner here," they always knew me, and treated me like the Duke of Cambridge, whose name, and now smile I share. Who would ever think that everyone would get so excited about the colors I chose for the bands for my braces? I should be in People magazine!

"Now that I am older I know more about the advantages of having an autistic brain. But, when I was younger, it was harder. People, even doctors and teachers, didn't know that every touch, sound, smell, light and taste was harder for me. Putting something in my mouth, sitting in a chair with a bright light, listening to a drill in another room, smelling the match to bend a wire, or the smell of fluoride (which I still hate), or having that stupid clay mold stuff in your mouth can make someone with an autistic brain get out of control. An autistic out of control is not something anyone wants to see. We work hard not to be out of control. But we aren't like other people with other brains, so it is very hard. I never once got out of control with Miss Susan or Dr. Lasser. I am very proud of that. They even helped me to get ready to go have my wisdom teeth taken out, all four of them, and I was proud I did not have to go to sleep. I was awake. That dentist told me even adults without autistic brains usually can't do that! So Miss Susan and Dr. Lasser aren't just good in the dentist's office - they are good teachers for the next big things in life," Will concluded.

In the eyes of Duenna, Lasser is a hero. She wonders, "Would Will have had the lead in his senior musical without the facealtering orthodontia or sung in that brilliant tenor without it? Would he have secured a date to his senior prom without his handsome face and smile? Would he have had the enormous confidence without the monthly dose of attaboys, and delight shown him by the staff of that practice, and the praise and encouragement of Lasser himself?"

As Duenna pointed out, "Many highly paid orthodontists resent a pediatric dentist's practice who takes on the orthodontic needs of his special needs patients. But as we have experienced firsthand, these practitioners and their staffs and operations make no room or allowances for the particular needs of patients like my son. He would have never survived any other practice. Just recently, he needed his four wisdom teeth removed. Dr. Lasser referred us to the one oral surgeon who would be able to talk to Will, explain the procedure in terms he could understand, and then complete the procedure in his office with nothing more than an IV of Valium. No general anesthesia. No hospital. Just trust and confidence. He knew he could trust Dr. Kaplan as he was referred by Dr. Lasser. And Dr. Lasser had proved to be trustworthy for over eight years. He speaks the truth, then does it, as does his staff. This is not just a mark of a good dentist with his pediatric patients, but of a bond of doctor, now with my special needs son, with his most trusted physician."

It is Duenna's fervent hope that, by sharing Will's journey, more young people on the autism spectrum can benefit from dentists like Lasser, and that younger dentists will be inspired by Lasser's example.

Duenna added, "It is amazing how respect, a little extra planning and care, and the commitment to do what's right, can actually change a young person's life. It happens far too seldom these days, whether in dentistry or any other profession. Dr. Lasser and Susan and Will's story can help to demonstrate that wonderful tradition doesn't pass away with the advent of technology, computerized patient records and the squeeze on profit margins.

"I have been a multiple cancer patient and special needs advocate, and I have never seen the complete consistency with which this doctor and his practice integrate integrity, care, individual treatment and the vow to heal his patients. He is beyond any of the more than 30 doctors Will has seen in his 19 years, not including the more than 85 professionals with whom he has worked. I can only tell our story. There is such a fear of dentists in our society. Someone should tell this story of triumph, and care and joy. You probably get a lot of bad stories - this is one of the best ever."

Despite all of Will's accomplishments, there's still one thing he needs to do. According to Will, "One day my pug, Bruce, and Lasser will meet and it will be true love - that is my mission."

Author's Bio
Erika Skorupskas is the Public Relations Senior Manager for the American Academy of Pediatric Dentistry. This article first appeared in the September 2011 issue of Pediatric Dentistry Today.
Dentaltown Magazine
April 2024
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