Dentistry For Children: Down's Syndrome and The Dentist

Dentistry For Children: Down's Syndrome and The Dentist: "Down's Syndrome children can often have a very positive and rewarding experience with the dentist. Most pedodontists and their staff ha..."

Down's Syndrome and The Dentist

Down's Syndrome children can often have a very positive and rewarding experience with the dentist. Most pedodontists and their staff have completed additional training and are comfortable in dealing with those children who have special needs. However, the treatment of Down's Syndrome patients can be very difficult for the patient, parent and dentist. The manner in which treatment is accomplished will depend upon how cooperative the patient is.
An initial evaluation will include having the patient seated in a dental chair alone. If that is possible, then an oral examination is done using only fingers. If this is accomplished, a dental examination using dental instruments will take place. A prophylaxis of teeth is the next step, followed by dental radiographs.
It is possible that the patient will not be cooperative; in which case a papoose wrap is used to immobilize the patient. Parents, dental assistants or the dentist trying to physically hold a patient down can be dangerous and possible bone fractures can occur. A papoose wrap will give an even pressure restraint, a mouthprop may also be needed if a patient will not open, or keep open, their mouth. The mouth prop keeps the patient from biting on an instrument and hurting themselves.
Oral pre-medication for sedation purposes may also be needed. The best way a parent can be confident of the different treatments is to consult their dentist and understand the appropriate treatment. The worse possibility is not to visit a dentist.
There can be many other questions that pertain to a Down's Syndrome patient, but these are some generalities. The best advice for any parent of a Down's Syndrome child is to practice proper oral hygiene and see the dentist regularly.
We are dedicated to providing quality dental care to all of our patients regardless of their physical or mental capabilities. I been trained in comprehensive dental education specific to children and those patients with special needs, and have been treating these patients since 1979 and have instilled in my staff the same confidence and techniques in caring for the special child, which will insure you have a positive experience.

Cell Phone Helps Us Make Quick Decision!

New technology is awesome and can help us in ways we never think of. Recently, one of our savvy mom's snapped a quick picture with her cell phone of her son's mouth injury. The injury involved one of his permanent teeth and occurred after regular business hours on a Sunday afternoon. Mom called our office and was prompted on how to reach me for after hour emergencies. Due to the quick thinking of this mom, she was able to "text" the picture to my cell phone, I then was able to assess the injury, set the mom's mind at ease, and make a decision as to whether it was necessary for them to be seen in the office immediately. This Family lived a great distance from the office, so this was a great tool for us to make a decision. Parents, please check out our web site where you will find detailed information regarding: What to do for "Knocked Out" Permenant Teeth, Fractured Teeth, Lip and Gum Lacerations as well as answers to many Frequently Asked Questions. Please also note that you may call our office anytime twenty four hours a day, seven days a week and myself or another Pedodontist will be on call for such emeregencies. It is not uncommon for us to meet patients in our office for emergencies during the evening hours or on weekends.

Mouth Ulcers.... Where do they come from?

Recurrent ulcers in the mouth occur in approximately 20-40% of the US Population.
Individuals who have a decreased thickness in the lining of the mouth are more prone to these ulcers. The duration of these ulcers generally last between 7-10 days. These ulcers can occur as single or multiple lesions and do not occur on the lips or gums directly around the teeth. The most common reasons ulcers appear is from trauma or from food irritants.
Trauma such as an external hit or blow or a pencil or toothbrush scraping the in inside of the mouth can cause an ulcer. Certain foods such as chocolate, tomatoes, citrus, peanuts,coffee and strawberries just to name a few, can be irritating to the oral mucosa (inside lining of the mouth). Sodium Laurel Sulfate(SLS) a highly effective surfactant used in many cleaning products requiring the removal of residues is found in toothpaste in lower concentrations. Studies have suggested that SLS in toothpaste caused recurrent aphthous ulcers, commonly referred to as canker sores. The preliminary study "showed a statistically significant decrease in the number of ulcers from 14.3 after using the SLS containing dentifrice to 5.1 ulcers after brushing with SLS free dentifrice". So if you are experiencing recurrent mouth ulcers, try using an SLS free toothpaste such as "Biotene. For the occasional ulcer, try products such as Orabase or Colgate Total and Canker Cover to control pain. A common holistic approach often recommended by Dr. Caldwell is to use honey applied to the area several times a day.

Dental Educational Program a Success!

Another successful year for Tillie the Tooth!

The dental educators from our office educated over 4000 students in Fort Bend County public and private schools this past year. With a hands-on approach and many visual aides, the students interact as they learn about good oral hygiene habits and nutrition. Tillie is a large animated Molar who presents with food and plaque on her that the students volunteer to brush off. Others are chosen to help with flossing. Nutritional snacks are discussed all in a fun and humorous way. At the end, the students are given toothbrushes and handouts to take home.

This program has been presented in area schools by Debbie Snelling, RDH and Anne Pencak RDA since 1989.

Sports Safety and Mouth

We see many injuries during this time of the year that are related to contact sports, especially in those sports that do not require the players to wear mouth guards, such as baseball and basketball. It is estimated by dentists that up to 40% of dental injuries occur while playing sports. Wearing a mouth guard is the best way to prevent many of these injuries and a trip to the dentist or emergency room. Boil and Fit mouth guards are available at sporting goods stores and many new styles are available that are a much better fit than previously. Another option is to have a custom sports mouth guard made in our office. I recently spoke to our local Little League Board of Directors who agreed with my concerns of our youth's safety. Their suggestion to me was to bring the topic up with the National Board of the Little League Association. This is a topic that I am very passionate about. I am committed to spreading the word about the use of mouth guards in contact sports other than football and hockey. A mouth guard can go for miles in keeping your child's smile!

Dental Xrays for Children

I am frequently asked about the necessity of Dental Xrays for children. I often tell parents who are concerned about the radiation that the exposure is less than they would recieve if they flew in an airplane. The American Academy of Pediatric Dentistry as well as the ADA have endorsed guidelines for prescribing radiographs in Children. First and foremost, the reasons for dental xrays is for the ability to detect dental decay. Taking bitewing xrays at the first dental visit is recommened if the proximal surfaces (sides) cannot be probed or seen. The frequency of Xrays depends on the child's risk for decay. I take Bitewing Xrays (cavity detecting) once a year, unless the child has recurrent decay, then I retake the Bitewings at the six month checkup. Most decay starts on the interproximal surfaces of the teeth and without detection and treatment these lesions can quickly grow in size effecting the pulp and creating the need for pulp therapy and more extensive restorations. Xrays are also needed to measure growth and development as well as rule out any abnormalities so that they can be treated early on. Detection of supernumary teeth or missing teeth early in life gives us the ability to develop a treatment plan and possibly avoid extensive or unnessary treatment later. For example, if we detect a permanent tooth is missing in a child early on, every effort is made to keep the primary tooth in place as long as possible, avoiding more expensive or complex treatment at a later date.

Approximately fifty percent of my patients develop decay between their primary teeth, so detecting decay early while it is small will be much easier and less expensive to treat overall.