Is there anything special we should do or Not do when PANS child gets tooth extracted?

[HopeinHIM]

DS11 has a defected 12 yr molar and we are having it pulled next week. They are going to sedate him. Should we forfeit the steroid pills they give post op for swelling? He has been on anti b for 1 yr and worried about the whole thing. He has been thru so much and this is making him more anxious. Just wondering if we should just opt for Novocain bc I read somewhere that Pandas/Pans kids can get funny with anesthesia. Thanks!

[qannie47]

_{I would go with the steroid if they are offering it. Also, our doc suggests an increase of abx prior a tooth extraction. My son had anesthesia and had no unusual reaction. I never heard that one, but that does not mean it does not happen....}

[Michel12]

I dont want this to effect any decision making but I have PAns and when I got the nitrous oxide for my wisdom teeth extraction I had a major flare up afterwards.

[nicklemama]

I would give the steroid. It will tamp down any autoimmine reaction. My son is given clindamycin for 10 days. Two or three days ahead of any dental appointment and then the rest after the appointment. This is in addition to the abx he's already on.

[sf_mom]

I would also gargle with diluted 35% food grade hydrogen peroxide a couple days before and for at least a week after. There is plenty of information on line as to how to dilute. It will help with the healing process and prevent bacteria from mouth entering blood stream.

[airial95]

Antibiotics before and after the procedure for sure. If you haven't discussed PANDAS/PANS with your dentist already, I would. Our dentist automatically puts in the protocols for rheumatic fever patients when she sees our kids. (When my daughter had to have an emergency extraction done last week she insisted on a conference call with the pediatrician to discuss abx protocol to not interfere with what we are doing PANDAS-wise). I would also consider adding anti-inflammatories for a few days after to control inflammation that may occur from the release of bacteria.

 

As for anesthesia, my PANDAS do fine with it, however, I know that if you have the MTHFR mutation (neither of mine do) there may be reactions to that. Others may be able to guide you better on that one.