UDL in Practice · Universal Design for Learning (UDL)

UDL visits the dentist

In addition to all the other pieces happening in September 2020 in my life, I also had a dental cleaning scheduled, the first time I had set foot inside a medical-type facility since we went out under COVID in March. Unlike my other regular appointments, such as blood draws, there is no way to avoid opening my mouth during a dental cleaning (um, obviously), so my anxiety was pretty high.

As in, pretty high on top of my usual anxiety. You see, every single one of my baby teeth had to be pulled because they never fell out and the adult teeth grew in over them. Do you how many baby teeth we have? A lot. Over the course of having them all extracted, plus adult dental issues, I ended my up with extreme dental trauma (and the acquisition of a number of small china tea cups and saucers, my consolation prizes for not biting the dentist).

As an adult, I went through a phase of being wheeled in from the car to the dentist’s waiting room in a wheelchair because the due anti-anxiety meds I took for cleanings were so strong I could not walk. Or sit up straight, for that matter. While this was highly entertaining for the office staff, especially since my social filter went out the window with the meds, I paid the price when it came time to apply for life insurance and other adult realities. I decided I needed to find a different approach; the first thing that helped was learning more about my teeth.

“Abnormally long roots”

I learned from one dental assistant that I have abnormally long roots–they touch my sinuses. When I learned this, my first thought was “IT IS NOT MY FAULT. IT WAS NEVER MY FAULT.” All the years of my well-meaning grandfathers tying string to my teeth and closing doors, bringing out pliers, offering me apples, telling me I should wiggle the tooth more often….it turns out, it was never actually my fault. As an adult, when I had to have some teeth extracted, the roots were so long that the dentist took pictures to send to other dentists as a learning tool. And then he had to break my tooth with a hammer in order to remove the pieces because, although the tooth was rotten, it was still too long to pull out. All those years….and there was never anything I could have done to generate a different conclusion.

Think about a parallel situation in a school setting. I call parents at the start of the school year to introduce myself and to learn about their children and I hear parents say, over and over again, “my child is self-conscious about his/her disability and doesn’t want to stand out.” In some ways, this will never change–welcome to adolescence! But I think we should be aware of how easy it is for us to believe we own the blame for things that we cannot change.

Having a voice

As I began to speak up for myself at the dentist, I began to challenge the assumptions, mine and those of the dental practice, of what is essential in the definition and understanding of “going to the dentist.” The word “essential” is not on the UDL Guidelines or the UDL Progression Rubric, but if UDL is standards-based (which it is), then it is “essential” in the sense that the content standards are designed to indicate the essence of the content we must teach.

At the dentist, do they have to brush my teeth with that nasty gritty stuff that gets caught between my teeth? I also have long contacts, which means my teeth touch almost all the way from top to bottom on the sides, making it very easy for things, like gritty toothpaste, to get caught–is it essential to use this toothpaste? Turns out the answer is no. Do they have to floss my teeth? With the long contacts, they push too hard and the floss ends up cutting my gums. Is it essential to have my teeth flossed at the dentist? Again, no. If they aren’t filling my mouth with that gritty stuff, do they need to rinse my mouth and then suck out the water and suck up my tongue? You guessed it–again, no. If they can tell from a visual check that there is a bit of gum recession and they know to check it again and the solution to it is one I can’t engage with, do they need to continue measuring the amount of recession by sticking that sharp thing into my gums? If you guessed no, you see the pattern.

It turns out that a visit to the dentist for a cleaning, at its most essential, just needs to be scraping the plaque off. Add a visual screen for cancer (no sharp objects included) and some updating of records. Done. Anything beyond that is extra. Yes, I have my x-rays and other care done regularly, including replacing fillings as needed, but I have worked with the dental office to pare the dental cleanings down to the essential. No anti-anxiety medication, no wheelchair, no heated neck wrap (that was never my idea), no elevator music, no suction tube thing, no metal scraping on my three-surface filling. Just the minimal cleaning. When we apply the principles of UDL–identifying barriers and looking for ways around them and/or to remove them–we find ourselves at the most essential, the most core. I’m always amazed at how much more I can do, even in the presence of anxiety, knowing that I don’t have to be in that situation for very long, knowing that most of the triggers have been removed. What would this look like in a school setting?

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