I've added a new link in the sidebar about dental problems in preemies. Noah deals with the following dental issues:
1. Intrinsic staining: this is a nice way of saying that his teeth are mostly green with a bit of yellow closest to the roots, and there's nothing we can do about it. The most probable theory is that this was caused by his liver issues in the NICU, although another likely theory is that it was caused by a medication.
2. Enamel hypoplasia: this means that Noah doesn't have enough enamel on his teeth, which can cause all sorts of problems. The biggest concern is cavities and so far we've avoided that. Noah does currently have a chipped tooth, though, and there isn't enough enamel on the tooth to adhere a filling or crown to, even if they did make crowns in green (which surprisingly, they don't).
3. Oral aversion: this isn't technically a dental problem, but brushing Noah's teeth can lead to vomiting, and that seems like a problem to me.
4. Severe GERD: again, this is not technically a dental problem. But when Noah's reflux isn't under control he vomits a lot, and that's not at all good for your teeth.
5. Tooth crowding: I'm not at all sure that this is preemie related but Noah's mouth is too small for his teeth. The teeth that are in there right now are super tight and while his gums are swollen enough to make his dentist think his 6 year molars are on their way soon, there isn't enough room for them to come it.
Over all our plan is to spend the next few years encouraging dental hygeine and hope that some of Noah's baby teeth last long enough for his adult teeth to come in. Depending on what kind of shape the adult teeth are in, we'll make a more long term plan that might include caps, crowns, braces, or even dentures. For now I'm just worried about making him grow so he has room for those 6 year molars.