November 16, 2009
As previously mentioned, when Alex was born the internet was not the huge repository of information it is today. My information came from books, professionals and other parents. Now I google search and can find anything I need, and more. Amazing what has happened in 16 years!
One of the aspects of Alex's growth that I want to chat about is dental development. This has been one of the weirdest demonstrations of that chromosome that I have noticed to date. Teeth was not a hot topic in my research, so I really did not know much. It was a big surprise for us - but fascinating. Never a dull moment in Alex’s mouth.
I hesitate to quote anything that generalizes the characteristics of down syndrome across the entire down syndrome population. In my experience, all kids with down syndrome are different. They may have similar characteristics – but all are exhibited differently. So, when I google down syndrome and get thousands of links, I read everything with a grain of salt. However, in Alex's case the following information I found is accurate:
The orofacial and skeletal development associated with Down's Syndrome contribute to dental problems. It is important to be aware of the type of anatomical soft tissue and dental anomalies which are part of the typical developmental pattern of people with Down's Syndrome, which have influence on dental problems.
Dental anomalies are related to the tooth morphology in that there is:
Decreased root to crown ratio
Decreased tooth size
Hypodontia or partial anodontia
We have witnessed all four of the above characteristics playing out in Alex's mouth. A very strange phenomenon.
Alex’s baby teeth started growing in at about 12 months and in the strangest order. I do not even remember, but we were certainly entertained when saw one front tooth, then two back teeth, then a side tooth and on and on. By about four she had a mouth full of tiny, oddly shaped teeth. Our dentist did his research and told us this was nothing to be concerned about. We went with that plan until she was about eight.
Around this age we started to notice that Alex's adult teeth were coming in behind her baby teeth. Apparently the baby teeth were happy and did not want to leave. She was developing two sets of teeth - now this was a bit creepy. I figured at this point I should intervene and we went to the oral surgeon.
Alex had three separate stints with the tooth doctor - as we called him. She needed to have all her baby teeth removed. Can you imagine the tooth fairy coming when your child has ten teeth under the pillow? Well – she does. Maybe she miscounts a bit - but she does leave money.
Once Alex's mouth work was complete we took her to the orthodontist. I will never, ever compromise any medical or dental procedures because Alex has down syndrome. There are those who might say - or perhaps did say to me - "Why spend the money, it will not make a difference”. That is simply not true. Alex was born with my small mouth as were her brother and sister. They both needed braces, and Alex is no different.
Alex got her braces on last year. We had a great consult with the orthodontist who made a good number of observations and suggestions about Alex's teeth. They are smaller than normal, oddly spaced and some have ragged edges. I must interject, the two ragged teeth in the front could have something to do with the bicycle accident three years ago - stitches required. We agreed that once Alex was done with her orthodontia we would file and cap her teeth to create an even and beautiful smile – even more beautiful than her current smile.
Alex has not had any significant problems with her braces - except for one. She cannot get her fingers all the way to the back outside of her teeth to put on the rubber bands. As I understand it - without rubber bands the process will take longer -at $155/month we prefer to shorten the term. Somehow this got mentioned to the orthodontist – who promised to work on this.
My daughter likes to be independent and will not let me accompany her to the ortho. I drop her off and wait in my office for her to walk over. I applaud her self reliance, but it does mean I have to follow-up with a phone call to get a progress report. She does not seem to like to tell me all the details. She also tends to make the next appointment when it works for her – not me!
Last week Alex came in to my office beaming - “look Mom, I can do my own rubber bands". The orthodontist had inserted a hook on the inside of her mouth. This made it easier for Alex to get her fingers to the back inside of her mouth and hook on the rubber band. What a great and out of the box idea. We need thinkers like this in our lives.
So, I say, thanks once again, to all the people out there, who are watching out for my daughter. The new smile will be well deserved!