Tooth Decay (and extraction)

My daughter’s teeth are badly decayed due to chronic reflux and the acid in the regurgitation. Her dentist is recommending that the teeth be pulled.

It is very common for children with CdLS to have a great number of dental problems. Reflux and the acid that enters the mouth can cause a serious breakdown of the enamel covering the teeth.

Once the protective layer of enamel has been altered, large dental cavities can destroy the teeth in a short period of time. Often it is extremely difficult to provide adequate oral hygiene for the children due to their protective and resistant actions, keeping us from gaining access to the mouth. Getting a toothbrush to the areas furthest back in the mouth can be a challenge. This is where the acid can have its most devastating affects. Therefore, in a situation where oral hygiene is difficult, the teeth chronically come in contact with strong stomach acids and we can expect dental cavities, leading to infections and abscesses.

It is not surprising that the dentist you are working with might have prescribed removal of some teeth. Many times the teeth are just not restorable. If there is not enough of the tooth left to place a filling or a crown, removal is the only answer. Treatment will probably have to take place in a hospital setting. Conscious sedation or general anesthesia may be necessary for your daughter in order that adequate cooperation can be attained to perform a safe dental operation.

Our top priority is always to save teeth and bring the oral condition back to a healthy and functional state. Extractions are our last resort, but certainly they often are the only treatment possible. Discuss your concerns with your dentist, ideally a pediatric dentist. If a second opinion would help in assuring that you are well informed, then I strongly recommend it. You might find that the treatment prescribed by your current dentist is the only way to go.

RM/TK 7-13-10