KUWAIT: 621 million children, around the world, suffer from untreated tooth decay. This International Happiness Day, help protect your children’s teeth as problems with teeth and jaws can have a serious impact on general health, well-being and self- esteem. Dental disease can affect a child’s ability to eat and socialize properly. For the Maxillofacial and Dental Department at Great Ormond Street Hospital for Children (GOSH) in London, seeing children from the Middle East with tooth decay is becoming a rising occurrence. In Kuwait, only 26.4 percent of 12 year olds are cavity free, with almost two thirds of 15-17 year olds in Dubai having tooth cavities and 80 percent of 12-15 year olds suffering from gum problems. Tooth decay can lead to pain, infection, difficulty eating and loss of sleep, often resulting in the extraction of teeth, which can deeply affect children, especially if they are young.
For children with medical problems, the consequences of tooth decay can be very serious. 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. Children who are anxious or very young, requiring extensive treatment, often need this to be provided under general anaesthesia, which may carry risks for the medically compromised.
Early diagnosis and management of dental disease is important for all children, but even more so for those with a wide range of medical problems. Dental disease is preventable and these children should have access to dental care, especially preventive regimens, from infancy. Fizzy drinks and sweets, as well as food that are naturally high in sugar have been linked to dental erosion and severe tooth decay, so maintaining a healthy, balanced diet is also important. With a proper oral hygiene routine in place, accompanied by regular check-ups from a qualified dentist, and a sensible diet, children can avoid dental disease and protect their teeth for life.
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.
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.
Great Ormond Street Hospital (GOSH) for children is one of the world’s leading centres for treating sick children, with the widest range of specialists under one roof in the UK.
With the UCL Institute of Child Health, GOSH is the largest centre for paediatric research outside the US, and play a key role in training children’s health specialists for the future.
In 2014-15, the international unit of Great Ormond Street Hospital treated over 5000 children from all over the world.