New here -- kiddo dental question

[LisaInGeorgia]

Hi all,

I posted an intro on the main board, but this is the subforum I'm really here for as a parent of a child with Crohn's Disease

My 8 year old daughter was dx with Crohn's almost 6 years ago. Overall she has done well, and is maintaining with Pentasa and 6mp (plus Miralax). She was diagnosed as failure to thrive two years ago, and as a result now has a MIC-KEY for nighttime feedings that she is doing very well with.

When we took her for her routine dental exam a month or so ago, she had a LOT of build-up (calculus) on the back of her lower front teeth. I was horrified, because she brushes her teeth 2x daily then I have a go at them as well. The dentist said it was no big deal, that some people's just tend to develop plaque/calculus quicker. However, this is new for HER; her teeth have always been fantastic with no need for "scraping" during exams.

So now, despite stepping up the brushing vigilence even more, I noticed that she has visible build-up on these teeth again already! Of course I consulted "Doctor Google", and came across an NIH article or two stating a strong relationship between periodontal disease and active Crohn's Disease.

Sorry to write a book here.......has anyone else dealt with this type of dental issue? I plan to call the dentist and GI both tomorrow, but also wanted to get some BTDT feedback if possible!

Thanks,
Lisa

 

[Patricia56]

Welcome to the board Lisa.

Haven't had the dental issues personally but have heard of it often on boards. I don't have any answers for you. If I recall correctly, getting into solid remission was the only help and even then it didn't always guarantee a complete resolution of the dental issues.

I have to say that my first thought when you said she had failure to thrive despite being on 6-MP was that she had active disease and probably needed to step up to a biologic.

Hopefully the GI will be helpful.

 

[LisaInGeorgia]

Hi Patricia! I remember you from another pediatric IBD board....I can't read there anymore because of the wonky colors, sadly.

The word they've always used to describe DD is "atypical". She has had signs of active disease before but her labs have been dead normal, that kind of thing. It's been tough to even go by what she says and how she feels, because CD is "normal" for her.

We went back and forth on the FTT/remission/active disease issue for a long time. Her appetite was non-existent (had been for a long time), and she could not take in enough calories to support herself. Once she started getting calories via enteral feedings, she started catching up some on growth (height and weight) and is staying on "her" curve with it now. Would there be other indicators to look for regarding active disease (besides scoping, which she had in that same timeframe)?

lisa

 

[LisaInGeorgia]

I clicked the "remission" link after hitting "send"....reading more on the Wiki about different catagories of remission.....thanks for sharing that

 

[Sascot]

Hi and welcome. That is great that your daughter is doing well. I've not read up much about dental problems with Crohn's, but I have to say my son also has a lot of bother keeping his teeth "clean". Although he brushes twice a day as well, he still gets alot of yellow build up of plaque. Our dentist has always told us as well that some kids just get plaque build up quicker - something to do with the ph balance in the mouth. However after he was diagnosed with Crohn's I do wonder if it has anything to do with it. Haven't done much about it apart from getting an electric toothbrush for him.

 

[LisaInGeorgia]

Hi Sascot....I think we'll add an electric toothbrush to the mix as well!

 

[DustyKat]

Hi LisaInGeorgia and :welcome:

I'm so sorry to hear about your daughter, bless her...:hug:

If you put teeth into the search option located on the blue tool bar at the top of the page quite a number of threads will come up that discuss dental issues and Crohn's. Much of the discussion is about cavities and gum disease but your question piqued my interest because it was something I had not thought about in quite some time in regard to my son.

I have two children, adults now, with Crohn's. Neither have had issues with cavities, no fillings or extractions. My son was diagnosed very quickly, within two weeks and with next to no symptoms, it was no doubt a legacy of my daughter's tortured journey to a diagnosis. Now the year he was diagnosed we had changed dentists so there was a longer lapse between check ups, when he went the dentist spent an inordinate amount of time scrapping his teeth. He had had the odd scrapping in the past whilst they did the examination but nothing like this and the dentist commented that although his teeth and gums were fine he couldn't believe the amount of plaque present in a boy that age, he was 16 at the time. The appointment was in June and he was diagnosed in November.

My son had surgery in April last year and has been solidly in remission since that time. He has always been vigilant with his oral hygiene so nothing had or has changed on that front but the problem has not been present since.

Dusty. xxx

 

[Farmwife]

Interesting, I know my Grace gets terrible plack build up. Just never thought as to why?

Oh, hi and welcome!

 

[LisaInGeorgia]

Thanks Dusty and Farmwife!

Since DD was diagnosed, I've always known that IBD can attack anywhere from mouth to anus; however, I've thought of mouth issues as having more to do with ulcers. It sounds like these other problems are pretty darned common...

 

[crohnsinct]

Hmmm...electric toothbrush suggested for my Chronie as well but not my other two. Not sure if this fits the many kids with IBD get build up or just many kids get build up theory.

 

[David]

Hi Lisa,

Regarding your daughter's teeth, I've got two pieces of reading for you:

1. Vitamin K2
2. Toothpaste

I hope it helps in some way.

 

[David]

Oops, I forgot to ask, have you had her vitamin D level tested? If so, what was it and when was it tested?

 

[LisaInGeorgia]

Wow, those are interesting! I'm more than happy to look at making toothpaste changes to see if it helps at all. We use raw milk from pastured cows, and make kefir out of it too, but DD hardly touches either one (in fairness, she barely touches food at all).

The suddenness of the change mystifies me. It will be interesting to see what doc and dentist say.

 

[crohnsinct]

Fascinating about the diet and K2. We switched to grass fed products a bit ago. Can't wait to see if it makes a difference at the next dental check up. Maybe not enough K2 (doesn't do milk, butter and maybe only beef 1-2 times a week) in what she is eating but at least it is something.....

At an IBD symposium I was at recently they also mentioned hygiene habits in developed nations and the high IBD rates and low rates in undeveloped nations with poor hygiene (although they do have a host of other problems). They said when people were moved to developed nations with better hygiene habits IBD incidence went up (assuming diets stayed the same). Hmmm. The research could go on and on I am sure.

 

[LisaInGeorgia]

I don't think it has been checked lately; over the summer she was hospitalized with mono, and there were tons of labs run at that time. Will find out!

 

[Jenn]

Welcome! My son has not had that problem, but has had a couple cavities over my healthy son. We use electric toothbrushes here, they are so much easier. He's 2 years delayed from growth failure while undiagnosed and his permanent teeth are coming in delayed too.

 

[LisaInGeorgia]

DD's dental "growth" is delayed as well....she just turned 8 and has only lost 2 teeth so far (her 6 year molars are just now coming in, too).