Mouth Tic

[MMC]

We feared when DS14 got braces this week, it would bring back his sucking mouth tic, and it sure did. He sucks the sides of his cheeks in and pinches them between his teeth, he can't stop doing it. He had this tic about a year ago, but it was one of the few tics that subsided after plasmapheresis last summer. Well...it sure came back the day he got braces. His cheeks are swollen out, looks like he has mumps. Could not go to school today, can barely eat or drink. We are really worried he might end up in the hospital. The orthodontist will see him today to place silicone guards on the braces, but I don't think that will help much. Told my wife, just get the braces taken off for now. But he just wants to keep the braces and be a normal teenager. We don't know what to do.

[dcmom]

Do you think the braces are causing a pandas flare up- or did the braces trigger the tic in more of a "habit" way? (my kids have ocd, no tics, so I don't know much about them).

 

If the braces have caused a pandas flare, I would consider a steroid burst (if you have had positive results from steroids before), followed up by a week of advil and a short term increase in abx- to help calm things down.

 

My dd12 got braces this year, I was very nervous- it hasn't caused any issues, thankfully.

[ChrissyD]

Maybe you could try Motrin to start with?

[Kathy4Him]

I remember when my son got braces...before pandas...his mouth hurt for about 1-2 weeks and it was hard to eat solid foods. Hopefully you will see a difference in a week or so. In the meantime, I would give him something for pain.

[Broo100]

When I told my son's orthodontist that my son had Pandas he recommended that he NOT get braces. Braces cause an inflammation to allow the teeth to correct in place. If you use motrin or any other Antiinflammatories you would be fighting against this needed inflammation and could end up with braces for years with no teeth correction.

[Missmom]

When I told my son's orthodontist that my son had Pandas he recommended that he NOT get braces. Braces cause an inflammation to allow the teeth to correct in place. If you use motrin or any other Antiinflammatories you would be fighting against this needed inflammation and could end up with braces for years with no teeth correction.

I am just really shocked you found an orthodontist who knows anything about pandas... Maybe he could educate some pediatricians....

[Broo100]

No. He had never heard of it before. He asked me if my so. Had ano conditions or was in any medications and I told him that he needed to be on constant Antiinflammatories and that is when he told me he should not get braces then. He is an NYU teacher too. He had never heard of pandas but was very curious.

[MMC]

Update...we had to remove the braces. DS just couldn't tolerate them. He really wanted to keep them, but we explained he can get them later when he is better. The orthodontist was understanding and will refund our down payment. His mouth tic would not stop no matter what we tried and he missed three days of school, lost some weight (is already under weight), and has a huge ulcer in his cheek that needs to heal now. It is not from the braces rubbing his cheek, it is from his biting mouth tic that the braces caused. He still has the tic some, but is overall out of stress and can sleep better. We did start a 5 day steroid burst, but he only took two doses before we had to yank the braces...we all just couldn't take it any longer. I don't think that short burst would have done the trick. We noticed his other normal tics, which are about 10 different ones, increased greatly with the braces. So, it seems the inflammation the braces caused (if you had braces, just remember how they felt when they were first installed and when they got tightened - it hurts)...caused an overal increase in inflammation that caused a big flair in PANDAS symptoms. I am thinking the inflammation in his mouth was so close to the head / brain, it created more than usual inflammation in the basal ganglia. Our dauther who also has PANDAS, did not experience this issue when she had braces, but her PANDAS is on the mild side. So...braces may not always cause an issue, but be aware they can, at least it did with us.