31 for 21: Dental Concerns (2)

When you have a child who is diagnosed with Down Syndrome, it is important to become informed about some of the potential health concerns that can happen.  This can seem overwhelming at first, especially when you need to start seeing different kinds of specialists.  However, many of the Down Syndrome organizations and medical facilities have healthcare guidelines that give approximate ages that certain evaluations should be completed.  This is typically followed by the pediatrician, but it's always good to be aware of these timelines. 

Many of these guidelines highlight dental concerns and it is recommended that the first dental visit be within 6 months of the first tooth eruption or by 1 year.  We were a bit off with these recommendations, partly because Colin's eruption of teeth did occur later than other typical children and happened in a slightly different order than is usually expected for babies.  It is also expected that children with Down Syndrome may have smaller than normal or slightly misshapen teeth.  I have always been aware of the fact that Colin's teeth do seem smaller and have pointier ends than most and his teeth have never seemed as white as other kids.   

More recently (past year), we have noticed some changes that have been taking place with Colin's teeth.  At first, it started to look like they were become slightly speckled but in the past 6 months, they are actually appearing a purplish color that gets darker over his molars (particularly the top of his mouth).  I have been doing some research to see if I can narrow down what may be causing this (before heading to the dentist) but I can't seem to find anything other than a high incidence of periodontal disease in people with Down Syndrome.  We were only at the dentist in June and a pretty thorough exam was done despite the fight that Colin put up when the hygienist and dentist were in his mouth.  Neither Chris nor I have ever had a cavity so I am honestly unsure of what that would look like, but I can't imagine that his teeth would be completely covered like that in cavities.  I started changing my searches to try and correlate anemia with dental issues but it still seems to tie back into periodontal disease.  When I try and search images of periodontal disease, I don't see anything that looks like Colin's appearance of his teeth (and I am finding some SCARY looking pictures when I try to do it this way).  Another correlation I am trying to make is whether or not reflux has played a role in wearing away the enamel of his teeth.  Could this possibly create discolored teeth?  I am concerned because I start thinking about a massive infection that is in his mouth (he can have pretty bad breath at times but is usually fixed by brushing his teeth).  We brush twice a day, he takes a multivitamin, and he really doesn't eat much in terms of sweets so I am hoping that this won't be a significant problem we will be facing.  

Another "sign" that is discussed about people with Down Syndrome is that they can have enlarged tongues or a normal tongue in a smaller sized jaw causing the tongue to appear bigger.  When Colin was a baby, this was something that Chris and I analyzed more closely.  I am not sure why this was such a big hang up for us, but in the early days of dealing with the diagnosis, we had a hard time with it if his tongue hung out of his mouth.  His tongue has mostly been hanging out of his mouth a small amount (usually it was just the tip that would be visible) and directly correlates to how tired he is.  In Colin's case, his tongue would be visible because of lower muscle tone in his mouth which has significantly improved as the years have gone by through different therapies and more simply, because of the need for better muscle control in speech production, chewing, etc.  The picture just above and below this paragraph show what we sometimes see of Colin's tongue when he is tired.  

For more information on dental issues in people with Down Syndrome, you can click on this link which will take you the National Down Syndrome Society website.