what do you do about the teeth?

[EmilyK]

DS refuses to brush his teeth and can't stop picking at them - rips his fingernail between them. I've purchased vast varieties of tooth paste and brushes and mouthwash. He has a strong aversion to anything strong tasting including cinnamon and minty things. He has an rx mouthwash but it's minty and he won't use that either. Rewards haven't helped so far. He knows all about tooth monsters and cavities but that doesn't spur any improvement. Not even just brushing with water or using a giant qtip like swab. I did find one bubblegum flavored xylitol gum. He uses that. But he stil picks at them like crazy and tells me "has to do it" when we're on him to get his fingers out of his mouth. Seems to be a new compulsion. Yesterday he complained of doing it at night when he wakes up too. Poor kid. What else could I try to help him get past it?

[Mayzoo]

I used a product called "Thum" (My link) to help kiddo stop biting her nails during her worst flare. She had never bit her nails before, nor since. It is a clear liquid you would put on the fingers he uses (or all of them) and it tastes bitter. Since he seems to want to stop, maybe he would allow its usage.

 

As for the teeth, we have always brushed kiddos for her first (despite her being 10 now), then let her brush afterwards. She does not do a good job alone, and I feel it is too important to just let her do alone (no cavities yet). When she decided she no longer wanted her teeth brushed at all during her bad flare, I told her I would not read a book at bedtime if she did not allow me to brush her teeth. When she refused, I would just say "okay then, no reading tonight" without making a huge deal about it. It took about a week, but she reluctantly started letting me brush them again. Kiddo is verbally and developmentally delayed, so she could not tell me why she did not want them brushed, but I suspect it may actually have hurt at that time, so I was all the more gentle then.

 

Good luck.

Edited September 7, 2012 by Mayzoo

[Missmom]

Have you thought about trying baking soda. When I was a kid my mom would sometimes make me brush with baking soda because she felt it cleaned better than most toothpastes. I personally never liked it but it did clean well.

[norcalmom]

my son picks his gums too. It is UNCLEAR weather he picks them because of an OCD habit - or if there is some sensation due to infection or inflamation that makes him want to pick them. Low Nerutrophils can result in gum infections (common among those with certain diseases like AIDS).

 

I like the idea of putting something on his fingers like Mayzoo suggested - we haven't tried that. Because no matter the reason for picking- open wounds in your mouth will cause a low level pandas flair for most kids. Strep, and other bacteria are high in the mouth, and its in your head..and for some reason researchers have found that mouth wounds illicit much more cytokines to be produced.

 

HE could also have some sensations becasue he has molars or other teeth coming in. My son started this when his first 12 yr molar was errupting. It can take months and months for them all to come in.

 

So for us - our periodontist did not think that my some could cause the type of inflammation along his gum lines buy just picking - he thought he had an infection of some other kind, and was picking because of the sensation. We did the mouth wash - didn't help. Did a deep cleaning - and DS LOVED it and found it very "relaxing". Must have had a very good hygienist! His teeth were clean...our regualr dentist, and the periodontics said his teeth were looking good. And the hygienist that did the deep clean found only a very small amount of plaque. Their theory is that you have to keep it really - REALLY clean, so the bacteria causing the infection are almost non-existent.

 

DS also had to go on penicillin. And off his other antibiotics to do it - for 10 days. It helped. He had one part that was clearly infected (that he had probably been digging at).

 

Its still a mystery. He still does it on occasion. We have been using the gum numbing cream (lydocaine for the mouth?) that the periodontist uses. He gave us a jar so that DS would keep his finger out of his mouth while healing. IT works for us - and he will ask for it on occassion - or if I see him pick we will put some in there. Orajel will work too - be not nearly as well.

 

Just to complicate things more - stress can cause gum infections to flair! And - you can get herpes (cold sore version) inside your mouth on your gums. Although, for DS this was not what it was because his inflamation was only along the gum/tooth line.

 

SO - for us - I still don't know what is causing it. OCD picking, or some type of cytokine relation to his molars or systemic immune thing. BUT - I was glad I took him in - because he DID have an infection from it!

[MassMom1414]

I know that a few people have talked about coconut oil helping as a supplement saw this and thought maybe it could help? I know the article doesn't say that anything is proven but if it could get him to brush it could be better than not brushing at all. Neither of my kids will use anything to strongly flavored we have found success with the Toms of Maine strawberry. We have also used some of that yucky tasting stuff on my daughters nails to keep them out of her mouth and it seems to ave worked.

 

http://www.boston.com/lifestyle/health/2012/09/04/coconut-oil-could-battle-tooth-decay/CG0NUJmQvNOgWzuvRi4IMO/story.html

[1tiredmama]

Oh, Emily, I feel for you! My ds just starting brushing without an argument or a fit 4 months ago, and he's 18!!! Like you, I tried everything. He hated even the smallest amount of foam, and I never did find an acceptable flavor. Wouldn't do mouthwashes or flouride rinse. For the first (maybe) 8 years, I brushed his teeth. Then, I argued and or threatened a negative consequence for the next decade.

 

Here's the weird thing: One night, he SUDDENLY came to the realization that he should brush his teeth to avoid cavities, just like that! Not one argument in 4 months! No more yelling, "This is disgusting!" while he brushes. I don't even need to remind him. And, he requested a flouride rinse, which he actually uses!!!

 

He was one month from getting his PANDAS dx. However, ds had, at this point, been taking an antibiotic for acne for 8 months. I credit a lot of milestones to his acne treatment.

 

I guess what I'm saying is, you may not find an answer to the toothbrushing issue outside of having his PANDAS appropriately addressed. In the meantime, it may continue to be a battle. BUT, there is hope!

[EmilyK]

I never thought to try baking soda, which I use myself, cause I figured he's just hate the taste - however, he probably would appreciate the super clean feel of it. Won't hurt to ask! He doesn't fight the dentist, so far. So I think he likes the super deep clean feeling and they use bubblegum or strawberry. I don't know why he didn't like Uncle Tom's strawberry toothpate other than maybe the texture and foam. I saw a recipe for baking soda, coconut oil, stevia toothpaste. They added lemon and peppermint, but maybe we could find some other flavor to add that he would go for. He hates almond. He loves real strawberries, so maybe I could get that in there somehow.

He won't let me brush for him but once in a blue moon he'll let me floss. I too suspect some treatment once we see Dr. B on Tuesday will be the biggest help of anything. Given his age, we have plenty of tooth loss and new tooth growth going on which I'm sure began it all. I keep looking for cankersores and things, but no signs of that or of red gums.

Thanks for all the ideas!