2.10 yr old with bleeding tooth - Doctors or Dentist!??

[PurpleLostPrincess]

DD2 has had a throat infection so most of last week was spent with high temperatures and trying to keep her fluids up. She's had antibiotics for 3 days now and has started to improve thank goodness!

Yesterday she kept telling me she had something in her mouth, and it seemed to be preventing her from eating and drinking. I inspected her teeth and mouth but couldn't find anything. Then, she woke at 3.30am (very unlike her, even when ill); telling me again that she has something in her mouth - still couldn't find anything.

Today, she seemed much better. I had to go out with a friend so she stayed home with DH. Apparently she had been munching all day long which was a relief to hear. Towards the evening she got more and more distressed, again saying she had something in her mouth. So we inspected it again, and I'm sure there was a bit of gum inbetween her molar and a new back tooth that has fully come through. I could see some food in there too, so I suggested we go and brush her teeth. I started (gently) brushing, but all of a sudden she was screaming and there was blood everywhere! I'm really not squeamish at all, and it always looks worse when there's water involved, so I'm not panicking, but I am concerned. I've tried to look again and it appears to be coming out of the middle of her back tooth...

I'm more concerned about the fact that it is causing her pain, and that it is preventing her from eating and drinking. She woke up about half an hour ago complaining of a sore mouth, but then refused her bottle...

Should I get her to a doctor or a dentist? I don't like seeing her in constant pain, she's had enough of that in her lifetime already!

I think I would ring the dentist 1st thing in the morning and get her in for them to look at, if the dentist says she needs to see the gp then you can get an appt for her the same day because of her age (afaik) no matter what time you ring them. Hence why dentist 1st.

Can she take calpol / nurofen?

It could just be where her tooth is pushing through a bit further, but obviously you need to get her checked, hope she's feeling better soon.

Thank you, I'll give them a ring first thing... she is already on nurofen regularly to keep her temperature down and her throat was hurting too. Might give her some calpol too, she is definitely in lots of pain

She is slightly improved this morning, but only ate half a banana for breakfast. Have rung the dentist and they have booked her in for Thursday, but said if Calpol isn't working, to ring back and be seen sooner.

She's been ok-ish for today according to DH, but has spent the evening whinging that her mouth is sore. Have investigated and all her gums are red and swollen! Think I'll ring the dentist first thing, have never heard of this! Anybody else?

Actually, I'm wondering if it's a reaction to the antibiotics she is on - eurythramycin or something (not her usual amoxcycillin)...?

It sounds like gingivitis. Antibiotics can do funny things and I will look up side effects of erythromycin for you.......

I have looked it up and this is a rare side effect of erythromicin:

www.merck.com/mmhe/sec18/ch203/ch203e.html

tbh its quite scary and I would get in touch with a GP asap. Its probably just an extension of the inflammation in her throat but it is quite that her gums are red and swollen, and unusual. Im sure its something straightforward though. This is the source and should be on your patient leaflet (if kids get one!)

www.medicines.org.uk/EMC/medicine/20128/SPC/Erythrocin+500+Tablets/#CLINICAL_PRECAUTIONS

(patient information leaflet that the doctor can access - if that makes sense) The one the patient gets is simpler!

4.8 Undesirable effects
Occasional side effects such as nausea, abdominal discomfort, vomiting and diarrhoea may be experienced. Reversible hearing loss associated with doses of erythromycin usually greater than 4g per day has been reported. Allergic reactions are rare and mild, although anaphylaxis has occurred. Skin reactions ranging from mild eruptions to erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis have rarely been reported. There are no reports implicating erythromycin products with abnormal tooth development, and only rare reports of damage to the blood, kidneys or central nervous system.

Cardiac arrhythmias have been very rarely reported in patients receiving erythromycin therapy. There have been isolated reports of chest pain, dizziness and palpitations, however, a cause and effect relationship has not been established.

Symptoms of hepatitis, hepatic dysfunction and/or abnormal liver function test results may occur.

Printed it out for you as having trouble with my links (

Oh my - thank you so much for going to all that trouble!! I won't be giving her any antibiotics in the morning, that's for sure - she had heart surgery when she was tiny, and although she is 'heart healthy' now, I daren't risk anything untoward . She is also a VACTERL baby and although her kidneys were given the all clear, this medicine looks rather worrying for her, yikes!!!

OK, so my plan of action is to ring the GP first thing in the morning and see if they can either change her antibiotics, or if she can just come off them completely...

How scary!

Thank you again so much

I've put in a request for a call from NHS Direct but the more I think about it, the more I reckon I'll just ring the out of hours doctor for advice. She's sleeping now so there's not much they can do, but I'd like to think a professional is giving me permission to stop treatment of something. IME, NHS Direct tend to refer me to the GP anyway because of DD2's history!

They have advised me to watch her through the night and get her a rapid access appointment first thing in the morning...

What would I do without mn!!!!

I work for NHS Direct so I think you are doing the right thing ringing OOH. It is a very rare side effect, but just because its rare doesnt mean it doesnt happen to somebody sometime! You just cant be too careful with little ones. Certainly also have a word with your GP who prescribed the med. tomorrow morning, someone who knows DDs full history is the best person to advise.

NHS direct wont advise either way regarding stopping the medication - only a doctor or the prescriber can do that, so not much use to you. They usually have a pharmacist to discuss med calls with but he's likely say refer back to prescriber. ! (He'd also only check the same databases as me.

Dont be too offput by the side effects - every medicine you get including penicillin has an horrendous list. Its just the gum stuff is unusual and certainly needs looking at. It is also listed in the proper patient leaflet which you should have got (steven johnson syndrome)

Im sure your GP was playing safe with the abx in view of DDs heart op. but I would speak to them tomorrow for sure.

We crossed posted. (me waffling on) I am glad your info was similar to mine. Its info you need. Good luck !

What a day!!! My feet haven't touched the ground all day, phew!

Thankfully, we saw our family GP - bless him, the booking in screen said there were 3 patients in front of us but we were called straight in! He really is a great GP...

Anyway, he is convinced it is gingivitis (sp?) and gave her amoxycillin as her throat is still inflamed and has pussy spots on it. He checked her all over for any rashes etc but couldn't find anything (neither could we) and ruled out kawasaki and SJS, he was very thorough and discussed the different symptoms that he would expect to see. He's been our GP from when I was pg with her and has always taken extra time what with all her problems - I think he's got a soft spot for her (in a nice way!).

So, she has her amoxycillin, and when I checked her mouth earlier, the redness had gone down a bit, probably from not having that horrible other ab!

Thank you again for all the advice, mn really is the best place!!

x PLP x