Kate, E Trieschman
| Kate, E Trieschman |
Kate E Trieschman
Maria, F Velasco, Alina, N O'Brien
Division of Pediatric Dentistry, Preventative and Restorative Sciences, University of Pennsylvania School of Dental Medicine
Introduction
The Pediatric Dentistry Honors Program aims to increase exposure to all aspects of pediatric dentistry. Comprehensive care was delivered to patients including management of patients with oral mucosal conditions, congenitally missing teeth, and restorations of teeth fractured due to trauma, in addition to caries control and space management. Biweekly participation in the pediatric dental resident seminar was required. Observation of resident cases both in the pediatric clinic and under general anesthesia was completed. Three clinical cases are highlighted in this poster.
Methods
Patient A presented for recall examination. Panoramic radiograph revealed congenitally missing teeth #21, 28, and the patient’s mother reported family history of missing teeth. Based on CAMBRA and AAPD guidelines on caries risk assessment, patient was determined to be high caries risk. Therefore, placed sealants on primary first molars #L, S which were caries free but had deep occlusal grooves. Anticipatory guidance was provided regarding importance of maintaining primary teeth for retention into adulthood. Patient B presented for caries control and follow up of asymptomatic smooth, red/white lesions on the floor of the mouth that were found incidentally at patient’s recall appointment. Consultation with the Department of Oral Medicine confirmed that patient presented with atypical presentation of benign migratory glossitis. Anticipatory guidance provided regarding benign nature of the lesions, importance of periodically monitoring the lesions, and to follow up with a dental professional if lesions ever become symptomatic. Patient C presented with MILF coronal fracture of #9 due to trauma. A trauma evaluation as detailed in the AAPD guidelines was performed. Patient was asymptomatic, periapical radiograph and clinical examination revealed the fracture was limited to enamel and dentin in the incisal ½ of the crown. #9 was successfully restored with composite, and anticipatory guidance was provided to regarding possibility of restoration fracturing, prevention of additional trauma, or development of pulpal pathology due to the history of trauma.
Results
In addition to the cases described above, preventative treatments such as prophylaxis, fluoride varnish, and sealants were performed in addition to restorative procedures including extractions, stainless steel crowns, composite resin restorations and silver diamine fluoride. Many procedures were performed utilizing nitrous oxide due to patient anxiety. A total of 17 patients were treated.
Conclusion
Participation in the Pediatric Dentistry Honors Program allowed me to develop skills as a clinician necessary for treating the pediatric patient. Most significantly, and as emphasized by the cases presented, anticipatory guidance is critical to establish trust with patients and guardians, empowering guardians to become actively involved in their child’s unique oral health needs.