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Medical Forum / General / Dentistry / October 2005

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Pediatric gingivitis/crowns

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Richard - 19 Oct 2005 08:36 GMT
I have a 4 year old son who had several teeth removed and some crowned at
the age of 2 years old due to hypocalcaemia (secondary to
hyperparathyroidism). Everything has been fine up to about six months ago
when his dentist (specialist in pediatric dentistry) noticed inflamed areas
around his front crowns. It appears to be gingivitis. We have been brushing
his teeth with a medium to soft brush, but I'm afraid we're making no
progress. The gums are very red, now in fact I see his gums growing OVER the
TOP of the crowns! The more brushing we do, the more they bleed, the more
they seem irritated. Now on top of this, my son eats very little to nothing
by mouth - due to other unrelated problems, he eats strictly by g-tube
feedings. This just doesn't make sense. We're catching it from the dentist
who insists we're not brushing his teeth, but in fact we are. What other
reasons would there be for gums to grow over the top of crowns? These are
not crowns in the normal sense.. they are like plastic covers that are glued
on top of stainless steel crowns. The front canine teeth (the only front
teeth remaining) have a white plastic coating over the steel to make them
look like enamel. It is here where the gums are growing over. Could this be
causing the problem? We're going to try a different brush and maybe
Listerine... but I swear, I don't think this is from bad hygiene. If that
fails I'll take him to a new dentist. Any other ideas? I really don't like
this because he does have a heart valve problem.
Joel M. Eichen - 19 Oct 2005 09:45 GMT
>I have a 4 year old son who had several teeth removed and some crowned at
>the age of 2 years old due to hypocalcaemia (secondary to
[quoted text clipped - 3 lines]
>his teeth with a medium to soft brush, but I'm afraid we're making no
>progress.

Bah humbug. New dentist time.

Joel

> The gums are very red, now in fact I see his gums growing OVER the
>TOP of the crowns! The more brushing we do, the more they bleed, the more
[quoted text clipped - 11 lines]
>fails I'll take him to a new dentist. Any other ideas? I really don't like
>this because he does have a heart valve problem.
Steven Bornfeld - 19 Oct 2005 14:17 GMT
> I have a 4 year old son who had several teeth removed and some crowned at
> the age of 2 years old due to hypocalcaemia (secondary to
[quoted text clipped - 17 lines]
> fails I'll take him to a new dentist. Any other ideas? I really don't like
> this because he does have a heart valve problem.

    If the crowns are at the gumline some inflammation is pretty much
unavoidable.  Also, if your son is congested and a mouth breather, this
will tend to inflame the gums and make them overgrow.
    You should ask the pediatric dentist to show you how to brush your
son's teeth.  I wouldn't be too concerned at this point with
inflammation at the gumline.  If your pediatrician feels this is a risk
with regard to the heart, then the pediatrician and pediatric dentist
should get together to solve this problem.  You shouldn't be made to
feel like the bad guy.

Steve

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W_B - 19 Oct 2005 16:05 GMT
>    If the crowns are at the gumline some inflammation is pretty much
>unavoidable.  Also, if your son is congested and a mouth breather, this
[quoted text clipped - 7 lines]
>
>Steve

This child is being fed by a G-tube, has heart valve problems,
and chance that this is dilantin hyperplasia ?
There seem to be some genetic issues here, but what about
epilepsy ?
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Mark & Steven Bornfeld - 19 Oct 2005 16:46 GMT
>>    If the crowns are at the gumline some inflammation is pretty much
>>unavoidable.  Also, if your son is congested and a mouth breather, this
[quoted text clipped - 17 lines]
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com

Good point.

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Richard - 19 Oct 2005 23:23 GMT
> > If the crowns are at the gumline some inflammation is pretty much
> >unavoidable.  Also, if your son is congested and a mouth breather, this
[quoted text clipped - 12 lines]
> There seem to be some genetic issues here, but what about
> epilepsy ?

What about epilepsy? He has DiGeorge syndrome. No epilepsy, however due to
the hyperparathyroidism he did in fact have seizures early on ... ionized
calcium was very low. We give him calcium and vitamin D daily to keep his
ionized calcium at 5 to prevent this. What are you thinking about epilepsy?

Thanks,
Richard

> W_B
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com
Mark & Steven Bornfeld - 20 Oct 2005 00:44 GMT
>>On Wed, 19 Oct 2005 13:17:15 GMT, Steven Bornfeld
>
[quoted text clipped - 24 lines]
> Thanks,
> Richard

    Some anticonvulsants (notably hydantoin sodium) cause overgrowth of the
gums.
    Not related to convulsions, calcium channel blockers also can cause
gingival overgrowth.

Steve

>>W_B
>>Take out the G'RBAGE
>>wubbabubbazG@RBAGEyahoo.com

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

W_B - 20 Oct 2005 15:02 GMT
>> This child is being fed by a G-tube, has heart valve problems,
>> and chance that this is dilantin hyperplasia ?
[quoted text clipped - 8 lines]
>Thanks,
>Richard

Dilantin Hyperplasia.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Richard - 21 Oct 2005 00:24 GMT
> >> This child is being fed by a G-tube, has heart valve problems,
> >> and chance that this is dilantin hyperplasia ?
[quoted text clipped - 10 lines]
>
> Dilantin Hyperplasia.

Thanks. Dilantin wasn't specific then Steve said "some anticonvulsants"...
but no, he's no on any seizure meds. Used to be 2 years ago. Now he's only
on Synthroid, vit D, and calcium. Nothing else. I seem to be making this
worse with the way I'm brushing his teeth or maybe its the brush. Should I
try a soft brush? Is Listerine helpful?? It seems to be painful.

Thanks,
Richard

> --
>
> W_B
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com
 
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