Dental Flares

[LaurenK]

How long do they last and what did you do about them?

[peglem]

I treat them like any other flare (flair?-I'm never sure)- in our case, that's usually abx and prednisone. But we also have ongoing treatment of IVIG and zith.

[nicklemama]

I treat w/ treatment dose abx for a week. I recently read right here about XClear, a mouthwash containing xylitol. Since DS has a tooth coming in, I decided I'd give it a try. He's still on abx and doing better now, but I will continue the XClear (also called Spry rinse) as long as the tooth is still working its way out. I figure it can't hurt and it will help his teeth. I also bought the Spry gum and nasal wash. DS loves the gum and says the nasal wash feels great.

[Kimflow]

What is a "dental flare". We are new to the PANDAS world.

 

I noticed that 7 weeks after another perfect visit to the dentist, he now has a black spot that has appeared on the side of his back molar.

How could this be? Never a cavity in 9 years!

 

I swear this has something to do the zithromycin that we just had him on....it is almost like a huge pit has been made in the side of his tooth.

 

Anyone have any experience with this?

 

Thanks,Kim

[norcalmom]

We've had no issues with teeth or cavitites - on high dose of various antibitoics for pandas and Lyme for 3 years now. From what this article says, antibitoics are actually good for you teeth and gum...

 

Dental flares are "mini" exacerbations - a flare in symptoms, usually somewhat less than a full blow exacerbation and usually much shorter (for us, about 70% and a week long vs - 100% and 6 weeks long) - when your child has a tooth coming in (or other inflamation or mouth problems). Some even get it from a cleaning. It took me a long time to realize DS was having this happen - because sometimes you don't know when a tooth is about to fall out and there isn't much irritation in there. We are done with most of that - DS just turned 13, so we haven't had any teeth fall out in over a year, but now have 12 year molars erupting, and a new gum issue that we've been dealing with.

 

When you take care of his tooth - I'd advise some antibiotics for a couple days before and after, as well as a couple days of anti-inflamatories. Do your own research on the antibiotics if you are uncomfortable, but anyone with hart issues has to take antibiotics before teeth cleaning or any work in your mouth. I think pandas kids should take same precausions. (if they aren't already on a high dose antibiotic). A few days isn't going to damage their teeth.

 

There does seem to be a higher incident of teeth problems in pandas kids. It could be that what is going on in the mouth is triggering pandas in your child. You know how gum disease is somehow linked to heart problems? It seems that infections and inflamation in the mouth (tooth coming in, herpes, absess etc.) for some reason produce a very strong immune / cykotine reaction. This reaction must somehow be linked with the inappropriate autoantibodies that result in cardiomyopathy (in syndenhams chorea, rheumatic fever), and pandas - there are also strains of strep bacteria (not the strep throat kind neccessarily) that are in your mouth, but perhaps they produce similar autoantibodies.

 

Excellent article below.

 

http://health.nytime...itis/print.html

 

On another note- I'm off to buy some Spry gum and L-lysine for DS - who has gum irritation (which is either from herpes virus on the gums, and or using "total"care toothpaste - the tartar control and the whitening can really irritate gums). Thanks for the X-clear/pry tip nicklemama!