FYI - teeth decalcification

General discussion regarding Kawasaki disease
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quiverfull
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FYI - teeth decalcification

Post by quiverfull » Thu Apr 30, 2009 2:57 pm

This is not related to KD, but I know a lot of our KD kids have been sick a lot with other illness like my son. He was complaining of his tooth hurting for a couple of days, so I looked in his mouth and saw a hole in his back molar. He is only 4, so I was very shocked. I took him to the dentist and their first question was "Has he been sick a lot?" I just laughed and said you have no idea!! I told them he was always sick with sinus infections, pneumonia, allergies and had KD last summer. She said it is very common for children who are on a lot of antibiotics as young children to have their teeth come in with very little enamel on them because of decalcification from the antibiotics. I had never heard of this before. They said to make sure he drinks public water as much as possible (we are on well water) and uses fluoride toothpaste. They said it is quite possible all his permanent teeth may come in like that too. So I thought I would pass along the info for all the other kids like mine who are sick all the time and take a lot of antibiotics.

Momcat
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Re: FYI - teeth decalcification

Post by Momcat » Thu Apr 30, 2009 7:19 pm

Actually I think it has more to do with the high fevers as a child, not the antibiotics. As the enamel is being laid down something happens during the high fevers that disrupts the enamel formation. I am a dental hygienist and when I see certain teeth--often with specific eruption patterns, like first molars--that have lines or odd colors all at the same areas in all 4 quads you can tell that something happened to the tooth before it erupted. The patient can often have dental problems in those teeth. My question to parents or to the patient is usually, were you sick with a high fever when you were really little? Most of the time when you see that pattern the answer is YES. Scarlet Fever, Rheumatic Fever, KD, etc.....high fevers do it. Not always, but it is obvious to those of us who see it a lot. I don't think the antibiotics have anything to do with it, but asking about antibiotics might give the dental staff an indication that the child was sick a lot and probably had high fevers. We used to see a lot of tetracycline staining in enamel, but it isn't used in kids like it used to be. It really discolored enamel, but didn't weaken it.
Sandy

quiverfull
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Re: FYI - teeth decalcification

Post by quiverfull » Fri May 01, 2009 11:20 am

So is it likely that more of his teeth will come in like this? And is there anything I can do for the pain? It bothers him. They told me they couldn't do anything until he gets older and they can cap it. I have never heard of any relation between illnesses and teeth before. Thanks for the info!

Momcat
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Re: FYI - teeth decalcification

Post by Momcat » Fri May 01, 2009 12:27 pm

Get yourself a new dentist if he is in pain. That is absolutely untrue that there is nothing they can do for it if he is in pain. No one should suffer from dental pain and the dentist should be addressing it immediately. He may have a tooth that is decayed or maybe more than likely if it is because the enamel is compromised, the tooth might be cracked or broken. The way you can tell this is from the pain----if it only hurts when he bites on it. If a tooth is cracked, you can take a little stick (like on a q-tip) and have a patient bite down on it (in an office we can do this with each cusp on a molar) and if he has pain immediately when he opens, it is more than likely cracked. The tooth would need a crown. On kids they often use stainless steel crowns until they are adults and can get a porcelain or gold crown. They can do pulpectomy (removal of the blood supply and nerves of the tooth if he is little and depending on what tooth it is and how developed it is). When does he complain about the pain? If it is hot, cold and biting sensitive, along with pain that throbs or bothers him out of nowhere, then it might be infected, then you are talking more aggressive treatment like a root canal-depending on the age of the person. Is it sweet sensitive? That would be a cavity most likely. Did they see anything on the x-ray? In our state you can get a copy of your x-rays, or your x-rays and take them with you to another dentist. A pediatric dentist might be the best, but they will be a lot more expensive with treatment. A person that has pain is an emergency patient in dental offices so you should be able to get in immediately. Even as a LAST resort the tooth could be pulled. However, this does sound like a permanent tooth and if it is a first molar, also called a 6 year molar, it is an important tooth to keep and maintain in the dentition. I may have missed something here, not sure. Let me know if you have more questions. I've worked in dental offices for over 30 years and have just about seen it all. You will know if it was caused by fevers if the other first molar ( I am assuming which tooth it is ) come in with changes in the enamel or not. Sometimes there are things that can cause problems with teeth before they erupt. It is impossible to diagnose without seeing it and I am not qualified to do that anyway, so these are just suggestions. Probably the most important clues would be in the symptoms and in the x-ray - although cracks usually are not seen on x-rays. Hope some of this helps!
Sandy

quiverfull
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Re: FYI - teeth decalcification

Post by quiverfull » Fri May 01, 2009 6:43 pm

He usually complains when he is eating, but not all the time. They did tell me he will have that molar until he is twelve. I can actually see a hole in the front side of it. They did say it was not a cavity though. I will try to find a pediatric dentist. I can't imagine having to live with tooth pain for as long as they are suggesting! They said they couldn't cap it until he was older. So I will definitely try somewhere else. Thanks!

quiverfull
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Re: FYI - teeth decalcification

Post by quiverfull » Fri May 01, 2009 7:01 pm

As I was writing this, Jay is sitting on the couch and said My tooth hurts. It really hurts today. So I will for sure go to another dentist!

Momcat
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Re: FYI - teeth decalcification

Post by Momcat » Fri May 01, 2009 8:06 pm

Sounds like a baby tooth.....they can fix it or pull it......let me know how it goes and I am sorry you went to someone who wouldn't address the pain--that is just crazy.
Sandy

Al-n-Charl
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Re: FYI - teeth decalcification

Post by Al-n-Charl » Sun May 03, 2009 4:47 pm

Good to know that fever affects teeth! I was concerned that Bobby's teeth could be damaged because his molars are discolored...I thought it was the asprin regemin or all the meds he got while hospitalized for KD. He hasn't had any cleanings yet (will only be 3 in August) and is definitely not ready to see the dentist yet. (The hygenist had extra time after Julia's cleaning and tried to get Bobby to let her see his teeth...no way!)

At least I know it's nothing major unless he complains of pain.

Thanks!
Charlene

Gemmasmom
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Re: FYI - teeth decalcification

Post by Gemmasmom » Sun May 03, 2009 9:24 pm

I am heading to my third pediatric dentist tomorrow for my 18 month old. She had a very aggressive KD which was diagnosed last August and had high fevers, lots of suspension meds each day, long-term steroids, and was a frequent breast-feeder due to the need of extra comfort for all her hospital stays. I took her to the dentist when she was one last fall because I was worried about a little bleeding due to Lovenox and other blood thinners she was on. The dentist told me that everything was fine and to come back in six months. I brushed her teeth each night (but she would breastfeed throughout the night). When I returned a couple of weeks ago - I WAS IN SHOCK! He told me she had early childhood caries (tooth decay) and had at least 3-5 cavities. This would require dental treatment under anesthesia that he was not equipped to do in his office and I would have to find a dentist who had rights at Texas Children's Hospital for her dental work. I was upset beyond belief! I felt like this was something I could had prevented if I would have been better educated or if he would have taken the time to understand her complex medical history and daily routine. I then went and saw another dentist who suggested 4 root canals and crowns on 5 of her teeth! I am now headed to the best dentist in Houston I can find and will see what his recommendation is tomorrow. For other parents out there who have not taken their child to a dentist yet - do it! Explain that they have suffered from an inflammatory/autoimmune disease - directly correlated with tooth decay and ask if there are extra measures you can take as a parent to protect their teeth.

Now in addition to her nightly meds and Lovenox shot, we brush, apply a mineral paste, a flouride treatment, and floss. She is just 18 months old! I am now facing two upcoming procedures involving anesthesia in the next two months - dental treatment and a coronary caterization. Dental problems was the last thing we needed on our plate.

Momcat
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Re: FYI - teeth decalcification

Post by Momcat » Sun May 03, 2009 10:59 pm

Just to say one more thing about this problem, it happens when the teeth are forming under the gumline. Paige was 6 years old when she got KD and had those high fevers for so long. So, even though her teeth hadn't erupted yet, most of the enamel was already formed on the crowns of her teeth under the gums-even the 12 year molars had enough enamel formed that I wasn't too worried. Enamel forms early, so these little kids may not have problems with the primary teeth unless they had problems in that first year of life (which I guess a lot are with KD huh?), but the secondary ones might have some problems.....it just depends on when everything was disrupted. It isn't anything that always happens either, but it could very likely happen with the fevers from KD. X-rays won't show it.
I would make sure kids get fluoride if it isn't in the water--if it is incorporated into the enamel when it is forming it forms a super strong bond and that is so much better than any topical fluoride provides later on. My 2 cents from watching kids vs cavities for all these years! I can guess that most adults with few or no cavities either grew up in areas that had fluoridated water or in the midwest where it was in the well water. Uh oh--was that a hygienist lecture? Sorry!! : )

Gemmasmom--I just read your post before I posted this....what a bummer! I can tell you that kids should NOT have anything in their mouths at night, be it a bottle of milk, juice....whatever. Nothing but water. You can't bath the teeth with anything that will stimulate the production of acids in the mouth and if there is food or anything in there besides water the body will produce acids. Acids etch the teeth and certain bacteria cause cavities in those etched areas. Nursing bottle mouth is preventable and I am surprised at how many parents let their kids have bottles at night. Perhaps this also happens with letting a baby nurse all night, it sounds like maybe that is what happened. The meds in sugary suspensions are not great either. If kids HAVE to have something like this then brushing or rinsing is recommended immediately afterward.

Please know that I am not saying that KD causes decay and I am not saying that kids will have decalicified enamel or enamel hypoplasia because they had KD. There is no direct relationship of KD to decay. I am just saying that high fevers can disrupt enamel formation and that is all.......it may weaken enamel or stain it or cause it to become malformed or it may not. KD has nothing to do with it. If enamel is weakened because of fevers, it still doesn't mean it will decay. I hope I have explained this well enough...
Sandy

miami
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Re: FYI - teeth decalcification

Post by miami » Wed May 13, 2009 1:58 pm

Now I'm mortified...my son is 2.5 and can't sit still to save his life. Should I take him to the dentist now?
He got KD at 7 weeks old, so I'm worried he might have this issue?
He brushes twice a day, doesn't go to bed with anything, and his pediatrician has never noticed anything.
Should I take him to a pediatric dentist?

quiverfull
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Re: FYI - teeth decalcification

Post by quiverfull » Thu May 14, 2009 8:26 pm

Sandy, thought I would let you know Jay got his tooth capped today at the pediatric dentist. He did such a good job!! That is the one positive thing from having KD. He is not scared of any doctors now! What else can they do to him that hasn't been done? What brave kids we have! I was disappointed that they told me his other molars were as bad as that one, and two of his front teeth also. The regular dentist told me everything looked good. But as long as they don't bother him, they should be OK. Will have to wait and see what is permanent teeth look like. Thanks for all your help! -Patty

Mecca24
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Re: FYI - teeth decalcification

Post by Mecca24 » Fri Mar 30, 2018 3:32 am

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