multiple teeth extraction in PANDAS child

[colleenrn]

I was wondering if anyone has any advice. My PANDAS daughter (12) has to have 8 teeth extracted tomorrow. She has been on Zithromax 250mg since October (with a few breaks due to vomiting virus- she recently got an ear infection despite the Zithromax which worries me).

 

Yesterday I gave her Zith 250mg, but today plan on giving her 250mg twice. I am so worried that despite the Zithromax she will have a flare up of symptoms b/c she has to have so many pulled.

 

EAMOM,

I remember you saying that your daughter had the worst flareup after having a tooth extracted. Do you think it would be overkill to add a few days of Keflex?

 

Any suggestions would be appreciated! Thanks!

Colleen

[Caryn]

Colleen,

Has she been screened for Celiac? Why does she need 8 teeth pulled? Are there ongoing enamel problems, etc...? The reoccurring infections despite antibiotics also make me wonder if a screening might reveal something. Have you done all the leaky gut testing already?

 

http://www.celiac.nih.gov/DentalEnamel.aspx

 

In many cases kids with Celiac are actually first diagnosed by their DENTIST. That is how far behind pediatricians are on this.

 

Just my two cents.

 

Caryn

[colleenrn]

Caryn,

 

Thanks for your response. The 8 teeth being pulled are baby teeth. I just realized that I did not put that in my original post.

 

She had the allergy food testing (I think it was ELISA?) about 4 years ago and they tersted for about 600 things- she was only sensitive to four of those tested. Does that include celiac screening?

 

I have never tested her for leaky gut. How is that done?

Thanks,

Colleen

[dut]

At a recent dental check up, my dd's first baby tooth came out... not extracted just they helped her wiggle it and pull cos she had another right behind it waiting to come out but it still amounted to an open wound in her mouth. She had a symptom flare within 5 hours. Behaviours up and some tummy problems. Despite our peds assurances they weren't connected we still did a course of azith and overlapped it with her proph penicillin by a couple of days. 2 days or so into the azith all was well again. maybe it wasn't lonked but I didn't want to takw the chance.

[EAMom]

Hi Colleen,

 

yes, feb/march 08 PANDAS dd had major symptom explosions with extractions (also baby teeth, extracted for orthodontic reasons)...she was (likely) positive for strep at the time (but we didn't know it). Her throat culture (and perianal) were positive 2 weeks after the 2nd extraction. Her sister was also positive (strep carrier).

 

This winter we did 2 more extractions and were okay. We continued the 250mg Azith. (55 pounds) and also added on Amoxcillin 250mg 2x daily. The first time we did the amoxcillin for 1 week, the second time I think it was just a few days. We were just being paranoid. We did the Amoxicillin (vs.keflex) b/c that's what we had at home. WE didn't consult with any doc on this...just did it. Figured it wouldn't hurt, might help. We started the Amoxicillin the day before (or the morning of) the extraction.

 

I know dental cleanings can also be a problem. I would agree with DUT that it makes sense that falling out baby teeth could too. The ped. rheumatologist also said nose picking could also release strep into the bloodstream.

[colleenrn]

Thank you everyone for your responses. I never even thought about the potential for a flareup with losing baby teeth, BUT it makes perfect sense! I will watch my 3 younger children for potential flareups as they lose their teeth. My gut tells me to add the Keflex (which I have) even if it is just a short course. If she were having only 1 pulled, maybe I would think diferently, but 8 seems to really open her up to possible release of any strep that may be lingering.

 

Do any PANDAS families notice problems with getting teeth very late, and losing them very late? My two oldest children did not get their first tooth until 18 months. My 12 1/2 yo still has 8 baby teeth. My 8 yo has only lost 2 teeth. When they lose a baby tooth, it literally takes months for the adult tooth to come in. Just wondering if this has anything at all to do with PANDAS.

Thanks,

Colleen

[EAMom]

Hi Collen,

my pandas dd got her first teeth at about 9-10mo (if I remember correctly). She will be 9 in July and she has lost 4 teeth naturally and had 4 (canine teeth) pulled.

[bronxmom2]

Mine got his teeth super early (3 months-- he had a mouthful by 10 months) but they are very late coming out. His two top teeth hung on for months, ridiculous-looking, dangling, partly askew little pearls. I have wondered if his teeth suddenly turning weird was related to PANDAS.

[Caryn]

Colleen,

 

Celiac testing involves blood testing, genetic testing, and/or a biopsy to confirm diagnosis. Most docs don't do it as it is one of the most missed diagnoses there is, often going undiagnosed for an average of 8 years.

 

Anyway, found this link and thought it might be of interest:

 

http://www.celiacchicks.com/2008/11/oregon...ease-study.html

 

tooth discoloration, enamel problems, etc.... These are common signs.