Expert team provide dental help for sick children
GOSH treats children from around the world with very complex and rare conditions, and the dental team at GOSH form part of the unique multidisciplinary team that treats and cares for these children. Miss Mason, a Consultant in Paediatric Dentistry at Great Ormond Street Hospital for Children (GOSH) in London provides the sick patients in her care with the best dental care possible.
Many of Miss Mason’s patients are very sick children whose teeth may have been affected by their treatment or condition. Here Miss Mason explains why oral care is especially important for sick children. “For children with medical problems, the consequences of tooth decay can be very serious.” Miss Mason says, “Dental infection can lead to endocarditis in children with congenital heart disease, or widespread life-threatening infection in children with poor immunity, either due to disease or medication. If children cannot eat due to dental pain, this can lead to weight loss and failure to thrive and have serious consequences for those with metabolic disorders. For these reasons, prevention of dental disease is particularly crucial for children with medical problems.”
Sara, a 7 year old girl from Oman with congenital heart disease, was referred to Miss Carol Mason, Consultant in Paediatric Dentistry at GOSH, for a dental assessment. Sara’s primary physicians were concerned about the risk of endocarditis and she was experiencing a lot of pain from her teeth. She was very anxious regarding any dental treatment and presented with extensive decay in all of her deciduous molars and smaller cavities in her permanent molars. Following a full discussion with her physicians, all the necessary dental treatment was provided under one episode of general anaesthesia - cleaning, fillings, application of fluoride varnish, protective fissure sealants, and removal of all eight grossly decayed and infected deciduous molars. “She made a good recovery and a few hours later she was very happy that her painful teeth had gone!” Carol explains after the operation, “Sara is now following a preventive regimen – limiting sugar containing foods and drinks to mealtimes only, brushing her teeth twice daily with adult toothpaste (containing 1450ppm fluoride), and regular visits to her dentist every 4 months for application of fluoride varnish. Hopefully, no further dental disease will occur and treatment will not be required.”
Miss Carol Mason is a GDC registered specialist in Paediatric Dentistry and is a member of the British Society of Paediatric Dentistry and the British Dental Association. In addition to dealing with dental disease, as a Paediatric Dentistry Consultant, Carol and her fellow consultants also see children with a wide range of dental anomalies for diagnosis and management. These include defects of enamel and dentine (amelogenesis imperfecta, dentinogenesis imperfecta), missing teeth (hypodontia), extra teeth (supernumeraries) and teeth of abnormal shape and size. Many of these children require a multi-disciplinary approach with the other consultants in the team.
All about GOSH
The Maxillofacial and Dental Department at GOSH cares for patients from the UK and overseas with a wide variety of medical and dental problems. A multi-disciplinary approach is often required, encompassing the specialties within the Department – Maxillofacial Surgeons, Orthodontists, Paediatric Dentists and Restorative Dentists and also medical and surgical colleagues from the rest of the hospital. The ethos of the Paediatric Dentistry Service at GOSH is to not only diagnose and manage any dental disease but to also prevent further occurrence by implementing preventive strategies, tailored to the individual.