• Kristina Mulligan

Dental Work

You might be thinking to yourself, “Wow, there’s a lot that parents of preemies have to be on top of!” and you’d be absolutely right. There are lots of medical issues, delays, growth milestones, and more that those with premature babies need to watch closely. What if I told you that some preemies have to make more trips to the dentist are more prone to dental issues?

I, personally, was so unprepared for this. When we were headed to Flynn’s first dentist appointment earlier this year, I even thought to myself, “Finally, we can be like normal people! Just the standard checkups for teeth every six months and we won’t have to worry!” Well, I was absolutely wrong. For us, it was recommended that we go four times a year, about once every three months.

Following the “typical” timeline, parents expect to see baby’s first tooth at about six months old. We didn’t see Flynn’s first teeth until he was 11 months old. Guess what? Turns out, in the preemie world, a 2-6 month delay of tooth eruption is pretty common. This generally doesn’t cause any problems, but is pretty alarming, especially to a parent that is already on high alert about reaching milestones.

Enamel hypoplasia means there is a lack of enamel on the outside of the teeth, which makes affected teeth more prone to cavities and decay. Premature infants have enamel hypoplasia four times more often than those born full-term, which is believed to be due to intubation, ventilation, and a lack of certain nutrients in the NICU. Tooth discoloration can also occur in preemies who had high bilirubin levels. We’ve already implemented a regimen, with the help of our dentist, where we apply and remove fluoride to each individual tooth daily to prevent damage to the mouth.

Another complication in preemies is a palatal groove, a narrow indentation in the roof of the mouth, also called the hard palate. This groove is caused by intubation in the NICU and can cause crowding or poor positioning of the teeth, sucking or speech problems, feeding issues, and/or hearing difficulties. Treatments for this may vary depending on the care team and child.

Needless to say, I was wrong about being let off the hook when it comes to the dentist... In our experience with oral aversions and sensory issues, navigating trips to the dentist can also be tricky in itself. Our OT and SLP have been extremely helpful with this, and it helps to have a patient dentist who is great in these situations.

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