Little Bournouss, 4 years old, opens her mouth to reveal yellowed and blackish incisors. His molars are cracked, attacked from all sides by decay. Out of 20 teeth in the mouth, the child has 14 cavities. Her mouth is “a disaster,” summarizes pediatric dentist Tasnim Alami-Laroussi.
Bournouss, his three brothers and sisters, as well as his parents, are originally from Chad. They fled this country with precarious security, and, after a long journey and a passage via Roxham Road, ended up in Montreal, explains his father, Abderaman Bahradine. The mother was pregnant when she arrived in Canada.
Let’s just say that in recent years, the family had many other things on their minds than dental care. And the bottles of milk, with which they let the little one fall asleep, ignoring the ravages of infant tooth decay, made Bournouss’ life hell.
“Sometimes she can’t sleep because her teeth hurt so much,” says her father.
“She has difficulty eating too. When we sit down to eat, she often cries. »
Bournouss is a case of general anesthesia. But the parents, asylum seekers, are not covered by the Health Insurance Agency and do not have the means to pay the astronomical bill for this treatment, which for their daughter would cost around $10,000. But thanks to the Sourires solidaires clinic, led by DD Alami-Laroussi and her husband, maxillofacial surgeon Farid Amer-Ouali, Bournouss’ father will not have to pay anything.
Sometimes difficult treatments
But for now, Bournouss is screaming at the top of his lungs. She is under double local anesthesia, she doesn’t feel anything, but she is afraid. Her father is lying in the dentist’s chair, holding his daughter against him. The DD Alami-Laroussi urgently repairs two cavities, the worst, which cause the child the most pain.
“Breathe, my beautiful Bournouss. Don’t forget to breathe,” said the dentist, in a calm voice. Despite this soothing tone of voice, no one is really calm here: we must proceed as quickly as possible. The father grits his teeth when he hears his daughter scream and sees her rearing up, the dentist and dental hygienist must provide care in an extreme environment.
That’s the difficult side of the job, emergency patients. Not everyone likes to do this, but at some point you have to relieve the child’s pain.
Tasnim Alami-Laroussi, pediatric dentist
And then, the intervention ends. Bournouss stops crying. Two fewer “bad cavities”, so two gifts for the little one in the surprise machine. A ball and a small necklace. From entry to exit, at Sourires solidaires, everything is designed to facilitate dental treatments for children with special needs.
A waiting room designed for autistic children, whose senses are often overstimulated, with an adapted color spectrum, subdued lighting, round shapes. Small booklets designed by a psychoeducator, which show, step by step, with photos and pictograms, what will happen in the dentist’s chair. An occupational therapist and a speech therapist who work for the clinic several days a week. “Clown noses” with various scents that release laughing gas, a calming product for the anxious. Dentists who sometimes work for free to provide relief to clients who cannot afford dental care.
The point of all this? Treat the mouths of children or adolescents who are sometimes unable to get through a visit to a traditional dental clinic. These “special needs” children make up almost half of Sourires solidaires’ clientele. Nearly 80% are young children and nearly three-quarters are recommended by another dentist.
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“We have references from all over Quebec,” underlines the DD Alami-Laroussi. We didn’t expect that at all. The problem is much broader than what we anticipated when the clinic opened: the dentists are not at all equipped to receive this clientele. »
“We are changing the lives of children here,” says young dentist Catherine Daignault, who works at Sourires solidaires. We really have an impact on them. » Around twenty dentists and six hygienists, employees or volunteers, work at the clinic.
“For me, this clinic is unheard of. Go find an occupational therapist, two days a week, you have to do it! The equipment, the staff… it’s extraordinary,” says retired psychoeducator Nicole Morn, who voluntarily designed the educational center’s materials.
Dentist Arian Mir comes to the clinic as a volunteer every Friday. Some cases he saw there left an impression on him. “The little one was no longer eating, she was crying. She didn’t have a sun card. We should have anesthetized her… but she didn’t have a sun card. His mother begged us to treat her child. She was given some sedatives, but at that age she wasn’t cooperating at all. Physical restraint had to be done by the parents. We had to do the extraction while the child was crying. I extracted more than six teeth, finished, decayed, black teeth. »
Desperate parents
Take Eda, 11 years old. “This is the first time she’s had a dental exam since she was born! », exclaims his mother, Fevziye Oguzer. The young person has non-verbal autism. The mouth and face, for her, are hypersensitive areas. She never agreed to open her mouth at the dentist. Except at Sourires solidaires, where occupational therapist Geneviève Poirier received her in a very special treatment room.
Blinds drawn, extremely subdued atmosphere, a soothing projection of fish sailing on the walls. Young Eda is immediately attracted to this luminous fiber optic tube, which gives off a soft green light. She agrees to sit on the chair, where they put a heavy stuffed animal on her abdomen and earmuffs to limit the sounds.
Geneviève Poirier moves up and down the chair. The little one laughs. The occupational therapist shows him the steps that will be followed using small pictograms. And then the dentist arrives. The little one agrees to open her mouth. Eda has five cavities, three of which are on baby teeth that will soon fall out anyway. We will repair, within a few months, the two cavities on adult teeth, decrees the DD Alami-Laroussi.
The mother can’t believe it. “I didn’t expect it to do so well… I must say that the setup is extraordinary! »
When they arrive at Sourires solidaires, parents are often on the verge of despair. “Their child has been suffering from pain for two or three months. They are discouraged, underlines the DD Alami-Laroussi. Arriving in the waiting room of a traditional practice, their child screams, he moves, everyone looks at them. The rooms are often small. It’s very stressful for them. »
It’s not the dentists’ fault, but they are intimidated by these types of kids. So they tell the parents they have to go see a pediatric dentist, with a six-month wait. But we’re talking about a dental emergency!
The DD Tasnim Alami-Laroussi, pediatric dentist
Emmanuelle Lemaire experienced this way of the cross a few years ago. Her daughter Makayla, who just turned 10 and was diagnosed with autism at age 3, had visited many dental clinics in vain. “Everything that has to do with the mouth is difficult for her. Eating, spitting… so being played in the mouth, for her, it was very complicated. »
Until she met the Dr Amer-Ouali. It took three progressive taming sessions for the little one to agree to open her mouth. “And then, we made an attempt… and it worked! », recalls Mme The mayor.
“We worked on motor skills, sensation. And she ended up brushing her teeth at home, recalls the Dr Amer-Ouali. When the little one brushed her teeth for the first time, we saw the mother crying. »