sedation for teeth cleaning

[BeeRae22]

Dd desperately needs to have her teeth cleaned, since she freaked out and wouldn't let the dentist do it at her last appt which was months ago.

 

She is doing better now, but you still can't even MENTION the dentist to her without her having a panic attack. Just telling her that she needed to get it done soon send her off the edge

 

I made an appointment for a consultation with a ped dentist that can sedate her. I made the appt for the end of September, I wanted her to have time to adjust to school first before I break the news to her again.

 

I am nt kidding when I tell you that I think I may need to give her something just to get her to the consultation. Anyone else that's had this issue? Any advice?

[TeamTyrion]

I would try to avoid sedation as much as possible. A lot of people with methylation problems (many here suffer from) don't do well with the epinephrine that is often used with the gas. Also, there have been issues with nitrous oxide (laughing gas) too, although my understanding is that nitrous oxide isn't often used anymore. You may want to ask what specifically is used.

 

Nitrous oxide and methylation:

http://www.psychologytoday.com/blog/health-matters/201209/laughing-gas-nitrous-oxide-is-no-laughing-matter

[Mommy2MCL]

Also, Teeth can be big triggers for PANS kids. The bacteria that will go down into the bloodstream from a cleaning can cause a flare. Please be in touch with your doctor. An additional antibiotic should be added and care taken.

 

Loose teeth can cause flairs too.

[BeeRae22]

It's not going to be possible to avoid sedation, she's just not going to let them do it without it. I have let it go for almost a year because she was in such a bad place for so long, but she's doing really well now and it needs to be done. Not only have her teeth not been cleaned, but she more or less didn't eat for 8 months, which made her teeth even worse. She is only 8, and doesn't brush very well to start with, and won't let anyone get anywhere near her to help her with it

 

I will ask what's going to be used, and talk to her pans doc about it. She's currently on full doses of Zith, minocycline and Bactrim-- do you really think she'll need additional abx??

[pr40]

just want to suggest a different take: why clean teeth at all? esp since your child is going to change most of them. if she is on abx, given that strep is among the major causes of caries, her mouth may not be all that full of bacteria.

get her to rinse, if you must do something. but be careful for her not to swallow.

 

i am from the third world and my teeth were not cleaned until I was in my thirties.

[airial95]

We just went through this when finally getting our kids teeth cleaned/checked for the first time in almost 3 years. (They are both headed for braces, so we felt we couldn't keep putting it off!!!)

 

First off - I agree with the others about talking to your PANS doc/ped about the sedation/NO2. Our doctor used NO2 with no problems, but neither of my kids have MTFHR issues. But I still checked ahead with our doctor.

 

Same thing with upping the abx before the appointment, check with the doctor!!

 

Call the dentist ahead of time and discuss a couple of things with them:

First - that your child has PANDAS, describe it as rheumatic fever of the brain if they haven't heard of it. Based on that alone they will know what extra precautions to take (as they also have to take precautions for RF patients).

Second - explain to the dentist what happened last time, and that your daughter has anxiety. Our dentist asked me that up front when she found out my kids had PANDAS (she has 3 other PANDAS families in her practice!!). What she has done for other with anxiety is set up a series of appointments, the first one, just gets the kid through the door. Second, maybe they sit in the waiting room for a bit and the dentist/assistant comes out and chats with them. The next time, they go back and just look at the rooms, they continue this progression - all the way up to them watching a cleaning - to get them used to it. It obviously takes some time (they do it over a few days/weeks, and no - she doesn't charge for all of these visits!) But she has had success with it. Almost like mini ERP for going to the dentist (and she has said that she's needed to use it on lots of kids who are scared, not just PANDAS kids).

 

Lastly, we learned something from the dentist when we were there about long term abx and how they affect the teeth. Long term abx will not help prevent cavities, however, once cavities form, they will help "mask" them. When a cavity begins to get infected, bacteria causes pain and discomfort, and that's typically when we go to the dentist. This bacteria can be killed off by the abx, however the bacteria that actually CAUSES the cavities cannot. So, what happens is that the cavity continues to get worse and worse, but the person has no clue because the infection that would normally trigger our need to see a dentist isn't there because of the long term abx.

 

I probably didn't explain that too well, but I asked our pediatrician about it and he basically told us something similar (and also compared it to our need to use a topical abx in the nostrils because oral abx won't always get what's hiding in there).

 

 

As for the cleaning, it triggered about a 3-4 day rise in symptoms (tics for my son, nervousness for my daughter). They both had cavities that had to be dealt with (on the 13 year molars - still way too far from losing them for us to completely ignore). What was initially thought to only need a filling in my daughter ended up having to be root canaled/capped (because the cavity was much deeper than thought - she should've been in a TON of pain - but no signs of a problem). With the actual dental work, we had the same blip in symptoms, but they resolved again in a few days. We switched up abx a bit to cover the cleaning and dental work and used ibuprofen regularly to get us through.

[1010son]

I wasn't sure where to add this comment, but my son developed tics after getting 2 teeth filled. Turns out, they were BPA fillings! I'm having them removed to see if that removes the tics. He also has dark circles under his eyes which always tells me he is having an allergic reaction to something. His diet is strict and our naturopath believes it is the fillings because of the timing. He did also get NO2 (which I didn't realize was bad) and we are now supplementing with lots of vitamins. I'll post again to let you know if we see changes after fillings come out.