Teeth enamel

[Rebjane]

My daughter's teeth are discolored in front especially. Dentist said it was the way the enamel was laid down. Gave her some stuff to rub on her teeth at night to redistribute the enamel...I think it's a combination of things, too many antibiotics, inhaled meds, just having CF in general....My daughter just cares cause she doesn't like her teeth Anyone have any advice? Thinking of researching a pediatric dentist to look at her...Anyone done this?

 

[Ratatosk]

We had issues earlier with ds and discoloration as a baby. The cf vitamin drops and chewables really discolored them. He liked sucking on the chewables like candy -- he now has softgels. And ds isn't the greatest brusher, though he's getting better. We get cleanings 4 times a year to help with the plaque and staining and got a high end electric toothbrush. I can ask a friend of mine whose daughter has cf and is a hygienist, too. If she's self conscious, would be good to do research, get a second opinion to see if it can be fixed.

 

[kosdancer]

This is pretty common with strong antibiotic use. Are these the permanent teeth? If they are baby teeth the dentist probably won't do anything. For my permanent teeth with staining we did bonding. It matches my other teeth well, has been on for at least 10 years and seems to be staying put. The dentist's original plan was to put bonding on temporarily because we knew that I'd be getting braces and that when we took off the braces the bonding would likely come with it, then I would get veneers. But my orthodontist took my brackets off really carefully so the bonding stayed, so that would be the route I'd recommend for permanent teeth!

 

[Rebjane]

Thanks. The discoloration is on adult teeth, but she still has baby teeth too. She also needs to see an orthodontist to make she does not need braces. The dentist office mentioned something about doing composite bonding but not sure with if she needs braces? I guess they said her enamel is pitted, not smooth but her teeth are strong.

She is close to entering her teenage years (12.5) and I don't want it to affect her self esteem...

I also don't want her teeth to weaken from the bonding?

 

[Gammaw]

Not only do antibiotics and vitamins affect coloration, but the acidic saliva and reflux in general can cause premature wearing/thinning of the enamel and allow the yellow dentin underneath to become more prominent. I take our 10 year old to the pediatric dentists at our CF Centers Pediatric Hospital. They have treated his teeth and are prepared to do whatever he needs. We had dental surgery at one point to rid him of large cavities and missing enamel. They put silver crowns on his baby teeth which are coming out as his adult teeth come in. I would definitely recommend you start with a pediatric dentist who is familiar with CF. I had a pediatric dentist once years ago who didn't understand the CF mouth and kept blaming us for not brushing his teeth or leaving him with drinks at bedtime. He infuriated me with his disbelief and ignorance. Make sure they have an understanding of the CF mouth!

 

[Rebjane]

Gammaw, Thank you. My guess is the closest pediatric dentist that would understand CF would be about 300 miles away( which is fine).. I am just not sure how to go about finding him/her. The yellow dentin is what I think we are seeing. I tried to explain that her saliva is not "normal" Plus the meds, nutrition etc. Fortunately she does not have cavities... I can ask our CF clinic who they would recommend. At first they tried to tell me it was from too much fluoride.

 

[Gammaw]

There is a site maintained by the American Association of Pediatric Dentists, with a locator function. http://www.aapd.org/mobile/finddentist/
that might help, especially if you follow up with calls and ask for referrals from your CF Clinic. I like that idea.
There were only two pediatric dentists in our town and I assumed they would be good with parents and children. But I clearly picked the wrong one. Horrible. He was accusatory, beligerant, and supercilious. He even seemed to find parents a barely necessary annoyance. We've all met them - the doc who thinks you should never ask questions because they take it as a challenge to their intelligence and authority, rather than be an informed and participatory patient. Was I surprised. I pulled my then 4 year old out and went straight to the Dental Clinic at the children's hospital that houses our CF Center. Amazing difference. They see so many children with life threatening illnesses and are also a teaching hospital, so there was always some wise older experienced dentist/professor around the corner. They do a nice job. Even tho it takes me awhile to get there. They've seen everything. It was such a relief to find them.
I would talk to them long and hard about the bonding. I'm no dentist, but I heard once (obviously not very reliable info!) that bonding can be difficult to maintain in an acidic mouth. It tends to separate more easily. That was some years ago and it may be different. But I suspect there are other solutions as well.
Blessings!

 

[Gammaw]

Here's another link to the certifying board. They also have a locator function.
https://www.abpd.org/Diplomate-Roster.aspx
I suggest you start here. I do remember now that a dentist could apparently call themselves a "pediatric dentist" simply because they treat children. But that didn't mean they were board certified, which I suggest is what you want.
You will find one. Happy Hunting!

 

[The Dot]

Gammaw, Thank you. My guess is the closest pediatric dentist that would understand CF would be about 300 miles away( which is fine).. I am just not sure how to go about finding him/her. The yellow dentin is what I think we are seeing. I tried to explain that her saliva is not "normal" Plus the meds, nutrition etc. Fortunately she does not have cavities... I can ask our CF clinic who they would recommend. At first they tried to tell me it was from too much fluoride.

I am a Respiratory Therapist/not a CF patient, but I have Sjogren's and was exposed to Tetracycline as a baby which permanently stained my permanent teeth. When they started doing bonding, I was the first one in my dentist's chair for the procedure! Originally, the composite bonding fell off of my teeth from time to time. Also, with composite, you need a dentist who is a good artist because your teeth are only going to look as good as he can "paint" them. When they did not fall off, my composites generally lasted about 8 years. The cost increased from $35/tooth to $350/tooth over the years! So, the last time I had them done with porcelain. The porcelain gives me picture perfect teeth, but the color matches my unstained teeth, so they look natural. These would have cost $1000/tooth, but I went outside the big city to a small town dentist. And, I signed up for one of those $20/month discount programs. This brought the cost down to about $600/tooth. (Traditional dental insurance does not cover this - it is considered cosmetic.) I only have the top front 6 teeth done, and the porcelain has been on for over ten years without a hitch! They do file your enamel back so that the bonding or porcelain will attach well, but then the tooth is actually stronger for the bonding and/or porcelain. Before this procedure, they used to put caps on people who had staining as bad as mine was, but I did not want to go that route. God Bless!

 

[windex125]

Speaking from experience, please look into anything that will help. I am a 60 year old woman and that has been my worst nightmare, believe it or not? not the infections, the picc lines, the port, the bleeding, the stool backup, it was the yellow teeth. From using tetercycline for many years as a child, I was a teeth grinder as a child, so I can't even tell you how bad those got and we did not go to a dentist, we could not afford it. When my adult teeth came in the grinding stopped??? don't know why?. but the color was light yellow I got made fun of for years. I started attending a dentist as a young teenager as I was using my baby sitting money to pay. I still hv those fillings in my mouth they are 40 yrs old and I hv not had a a cavity in more than 40 years, so I know I havestrong teeth, big deal... It took a big toll on my self esteem My problem is I hv a under bite my bottom teeth hit against my top so bonding was out then veneers came about sometime in the 80"s I think same problem, and thousands of dollars.... I've been to more than 15 or more dentists for oponions. Then the zoom whitening came out and I've done it abt 4x it lasts a few weeks but when you put the gel in the trays your gums / my gums are so sensitive it felt like they were being burned. Just this week I looked into something called snap on smile. It looks like a complete set of beautiful white dentures, and they snap on to yr exsisting teeth $3500 approx. I don't hv that kind of money, and at this late age I won't do it. I don't know I'm looking for a miracle I guess it's just in 2015 you think it would be easy to obtain a nice smile. But when I went for the consultation she said the same thing you hv a under bite... you problably shd of had yr jaw re wired in yr 20's still ignoring the fact that I told her or tried to expalin abt CF ??? So I'll buy those whitening strips for now never used them before and see how they work, at least I'll only be throwing away $50.00 instead of big money. So the ending to this long graged out story. If at all possible, try to get your children the help they need for a white smile it really does make a difference, and other children are still mean no matter what year we are in. Hope I didn't bore you all. Pat/60

 

[The Dot]

Speaking from experience, please look into anything that will help. I am a 60 year old woman and that has been my worst nightmare, believe it or not? not the infections, the picc lines, the port, the bleeding, the stool backup, it was the yellow teeth. From using tetercycline for many years as a child, I was a teeth grinder as a child, so I can't even tell you how bad those got and we did not go to a dentist, we could not afford it. When my adult teeth came in the grinding stopped??? don't know why?. but the color was light yellow I got made fun of for years. I started attending a dentist as a young teenager as I was using my baby sitting money to pay. I still hv those fillings in my mouth they are 40 yrs old and I hv not had a a cavity in more than 40 years, so I know I havestrong teeth, big deal... It took a big toll on my self esteem My problem is I hv a under bite my bottom teeth hit against my top so bonding was out then veneers came about sometime in the 80"s I think same problem, and thousands of dollars.... I've been to more than 15 or more dentists for oponions. Then the zoom whitening came out and I've done it abt 4x it lasts a few weeks but when you put the gel in the trays your gums / my gums are so sensitive it felt like they were being burned. Just this week I looked into something called snap on smile. It looks like a complete set of beautiful white dentures, and they snap on to yr exsisting teeth $3500 approx. I don't hv that kind of money, and at this late age I won't do it. I don't know I'm looking for a miracle I guess it's just in 2015 you think it would be easy to obtain a nice smile. But when I went for the consultation she said the same thing you hv a under bite... you problably shd of had yr jaw re wired in yr 20's still ignoring the fact that I told her or tried to expalin abt CF ??? So I'll buy those whitening strips for now never used them before and see how they work, at least I'll only be throwing away $50.00 instead of big money. So the ending to this long graged out story. If at all possible, try to get your children the help they need for a white smile it really does make a difference, and other children are still mean no matter what year we are in. Hope I didn't bore you all. Pat/60

I started to get the comments from the children I was teaching at church - - - when I was a young adult! Growing up, I had an underbite and had to wear a palate splitter and braces and nobody ever made fun (except when I talked with a lisp for a few weeks with the palate splitter). Please, do not waste your money on the whiteners. If you have Tetracycline staining, it goes completely through the tooth. I am told that because it is not a surface stain, it cannot be removed (unless there is something totally new on the market that your dentist has told you about...?)

 

[Ratatosk]

Response from my friend whose a hygienist and whose dd has cf.

DRY tooth brushing first, with an elec. toothbrush ( helps the most with stain!) With the combo of all the meds these kids do AND breathing through their mouths etc. I have DD dry Brush and use an RX fluoride in the AM and Pm and Brush after every treatment!!!
YES we do have things like MI paste that can help with the enamel BUT sometimes the discoloration was caused by antibiotic use or fevers while the teeth were forming!
My best information is to DRY brush first and Fluoride after you brush.
Prescription Flourides are
PREVIDENT
CARI- FREE
GEL-KAM
MI PASTE

 

[windex125]

The Dot ... thanks for yr feedback, believe me I am not a vain woman. But imagine never smiling showing yr teeth your whole life sad... I kinda smirk with a closed mouth it never looks right in pictures, and now being a older adult it just feels so more noticeable. Had I had that jaw surgery in my 20's they break the jaw move it back and yr wired for 7 weeks, sounds great. I shd of considered it...when I was healthy things wld be different, think of Jay Leno but not to that extreme, I had to end with a joke it's what keeps my sadness in ck. Not only the teeth life in general...Thanks Pat/60

 

[Gammaw]

Windex, consider fixing your teeth if there's any way you can, despite your age. You're alive and kicking. It would make you feel good. And you darn well deserve it. Age has nothing to do with it. And one day......40 years or so from now.......you can go out SMILING!

 

[Rebjane]

The dry brushing we will try. I had never heard of that before, my son who had braces for a long time said the orthodontist recommended doing that. Our Cf doc has not personally seen issues with teeth but said he has heard of it from some CF patients. He also said mouth breathing can cause problems. My daughter can not sleep and breath through her nose, she always mouth breathes at night. So, I plan on making an appointment with a pediatric dentist and go from there.