Have you got Ehlers Danlos Syndrome?
We have several patients who do and one of them has asked me to write about Ehlers Danlos Syndrome (EDS), as she said that there was very little information about EDS and dental treatment.
While most people with EDS don’t have lots of mouth problems it can affect teeth, gums and jaw joints due to the connective tissue problems.
Attending the dentist/hygienist regularly is a must for EDS patients to keep treatments short in length and to catch problems early. Often patients can easily be treated at the surgery for routine maintenance. However, we can also arrange for appropriate referrals for further complex treatments.
Things that may be a problem for EDS patients
- Some patients with heart valve defects may need antibiotic cover for some dental treatments. Advice should be sought from your doctor or specialist on this matter making it safe for us to treat you.
- Patients with haemorrhagic types of EDS may suffer from post extraction bleeding when they have a tooth out. Advice from your doctor or specialist will help us to decide the best way forward for treatment.
- Sometimes local anaesthetics don’t work as well for EDS patients, if this happens to you we can refer you to a specialist team, normally at the hospital.
- Patients may have hypermobility in their jaw joint and care should be taken not to yawn or open too wide. Several short appointments are better than long ones, for dental treatment, to prevent joint damage.
- Mouth ulcers are more common in EDS patients due to the skin inside their mouths being thin and fragile. Caution should be taken with ill-fitting dentures and rough or sharp teeth. Gentle dental treatment is a must to prevent damaging delicate skin.
- Any ulcer that has been present for more than two weeks should be seen by a dentist.
- Orthodontics (braces) may have to be monitored closely as teeth tend to move faster in EDS patients. After teeth are in the right position they have to be held for some time by an appliance or fixed by a small wire cemented to the back of the teeth. This is to stop them from moving back to where they came from! EDS orthodontic patients can suffer with ulcers from the wires on braces, but orthodontists often give patients a sticky wax to put over any sharp edges.
- The enamel on EDS patients’ teeth is often not formed properly (hypoplastic) and some teeth can be smaller or a funny shape.
- Many patients will notice an early increase in gum disease with puffy and bleeding gums, leading to early tooth loss. This is due to the gums being more delicate allowing the plaque poisons to damage them more easily. It has been suggested that this is more noticeable in classical and vascular EDS.
Advice for maintaining teeth and gums.
Dental decay and gum disease are caused by plaque germs producing acids and poisons, when they eat sugar. So good diet and home care is essential to the EDS patient.
Teeth should be cleaned twice a day including in between care i.e. floss, little brushes. Electric toothbrushes are a helping hand to remove plaque and with the small head stops people from opening too wide. Closing down to brush helps to protect the jaw joint from over extending in hypermobility cases. When gums get very thin and sore soft manual toothbrushes are kinder but teeth and gums must be cleaned to prevent plaque from building up.
Avoid sugary food and drink
It is very difficult to avoid sugar in today’s world but reducing in between meal snacking, sticky sweets and sugary drinks will help. If your tooth cleaning is good this will also reduce the impact of sugars.
Fluoride in toothpastes and mouthwashes will help protect the surface of the enamel. Ask for advice on the best products for your age and susceptibility to decay.
The best way that EDS patients are treated is with understanding, empathy and good communication with patients, families and dental professionals. If you would like a free coffee and a chat to talk about how we can help you with your EDS and dental treatment just call us on 01323 325397.