» Dental Treatment Protocol

Dental problems can include small jaw development, poor oral hygiene, crowded teeth, small teeth, periodontal disease, and the erosion of teeth caused by stomach acids from reflux. Children diagnosed with CdLS require early dental evaluation, treatment, planning and preventative home care. The oral structures are greatly affected with this syndrome. Growth and development concerns of the jaws and teeth must be assessed at a young age in order that therapeutic measures can be instituted.

Clefting of the palate is common in patients with CdLS. This condition would necessitate pediatric dental involvement shortly after birth. Feeding obturators and surgical stents may be of great assistance to the craniofacial surgeons. The early introduction to dental care allows for baseline documentation of the oral soft and hard tissues. Clefts should be repaired as early as possible. Not only does this repair improve the ability to eat and reduce the likelihood of ear infections leading to hearing loss; it also enhances the speaking process.

Oral hygiene practices can be taught to tocaretakers, thus, preventing infant bottle cavities and other common dental problems. Routine six-month check-ups can assist in monitoring changes, detecting pathology and reinforcing appropriate home care. Orthodontic evaluation should take place by the 7th year.

Pediatric dental specialists are trained in the specific dental requirements and treatment of children, especially in the area of children with special health care needs. The American Academy of Pediatric Dentistry recommends regular professional attention beginning with patient oral evaluation and parental counseling no later than 12 months of age with a pediatric dentist.

Pediatric dentistry educators and practitioners throughout the country are advocating a preventative approach, which has been termed the ìno-cavity planî. In addition to water fluoridation, optimal systemic supplemental and topical fluoride, the daily use of appropriate amounts of a fluoride dentifrice and the placement of pit and fissure sealant, the no-cavity approach utilizes nutritional counseling, strict home oral hygiene care, the maintenance of existing restorations and biannual professional cleanings.

When indicated, using conscious sedation and performing a number of tasks at one time may optimize dental care as well as care for other medical conditions for certain individuals. Individuals who are unable to communicate pain or discomfort and who are uncooroperative in the dental office may need to be sedated in order to provide quality care. Remember, whenever an individual has anesthesia for dental care, consider other procedures that could be done concurrently (endoscopy, ENT exam, eye exam etc).