DDS Lister

Surgical interventions improve the quality of life of children with cerebral palsy, Hamad Medical Corporation’s consultant orthopaedic surgeon Dr Mohamed Shaarani said yesterday. “Surgery enables many wheelchair-bound children to be transferred to walkers and those who are crippled to get on to wheelchairs,” he explained to Gulf Times on the sidelines of the first cerebral palsy symposium in Qatar.

Children with cerebral palsy have spasticity (stiff or rigid muscles with exaggerated, deep tendon reflexes, for example, a knee-jerk reflex), which can interfere with walking, movement, or speech. “We elongate some muscles and cut some others to make them loose and allow movement and flexibility,” pointed out Dr Shaarani, also a consultant paediatric orthopaedic.

Between two to three years of age is the ideal time to show an affected child for the first time to a surgeon, he added.
In a presentation about dental problems in cerebral palsy, Primary Healthcare Department’s senior consultant Dr Mutaz Ahmed observed that incidence of dental decay is higher in this group, mainly due to poor oral hygiene.
“Dental caries, gum disease, malocclusion, enamel defects, increased incidence of dental trauma, drooling, and grinding of teeth are among the main problems,” he explained. The incidence of gum disease is three times more among those with cerebral palsy than in the general population. The affected group also have a higher rate of dental enamel defects. “The increased risk for dental trauma can be attributed to problems with balance and muscle weakness in legs,” Dr Ahmed pointed out.

Giving sedation, including general anaesthesia, is a very important option when doing dental procedures on an individual with cerebral palsy, as it may otherwise be difficult to control the patient.Highlighting the significance of maintaining proper dental hygiene in those with cerebral palsy the senior consultant suggested that parents should be instructed by dentists in this regard.
“Cerebral palsy patients should be seen by a dentist every six months,” Dr Ahmed recommended while observing that electric toothbrush can be very useful for them. Radiology, seizure disorders, growth and nutrition, medical management of spasticity, roles of physiotherapy, occupational therapy, orthotic, speech therapy and dietician, and education were the other topics of presentations at the symposium.

Source:

• Gulf Times

Nearly 30,000 children a year attend hospital to have teeth pulled or be treated for decay, research has shown.

Researchers who analysed hospital data said it was “worrying” that the number of under-17s hospitalised for dental treatment had been rising since 1997.

They found children from poor areas were twice as likely to need treatment as those from more affluent families.

Experts said the findings, published in the British Dental Journal, highlighted a major public health issue.

It has led to criticism of Labour’s policy relating to NHS dentists and calls by some for compulsory water fluoridation.

The data revealed there were 517,885 individual courses of dental treatment in NHS hospitals for children up to the age of 17 between 1997 and 2006.

The total number of children needing treatment was 470,113 and 80% of admissions involved extraction – in two-thirds of cases because of tooth decay.

It is a tragedy that social class remains such an accurate predictor of oral health
Peter Bateman
British Dental Association

The peak age for children needing teeth taken out was five.

“It is a tragedy that social class remains such an accurate predictor of oral health”

Prof David Moles, who led the study at Plymouth’s Peninsula Dental School, said yearly rises in hospital admissions had come despite rates of tooth decay and infection remaining steady.

The reasons for this would have to be identified “in order to cut the number of admissions, improve dental care for children and ultimately reduce the financial burden to the NHS”, he said.

Dr Paul Ashley, head of paediatric dentistry at University College London’s Eastman Dental Institute, was the second author of the study.

He said: “Two aspects of the study are particularly worrying – the rise in the number of general anaesthetics being given to children, and the widening gulf in dental health between social classes.”

He said general anaesthetics could be fatal to children.

Tooth decay is preventable through regular brushing and check-ups and Peter Bateman, chairman of the British Dental Association’s salaried dentists committee, said: “It is a tragedy that social class remains such an accurate predictor of oral health.

“Water fluoridation, as the long-standing scheme in the West Midlands illustrates, has great potential to address this divide.”

‘Lack of access’

Liberal Democrat health spokesman, Norman Lamb, criticised the “appalling lack of access” to NHS dentists and called for a “radical overhaul” of the system.

He told BBC Radio 5Live: “One of the possible causes [of poor child dental health] is that children are not going to the dentist enough.

“We hear constantly about problems in accessing NHS dentists. It really demonstrates a failure of government policy that the situation is getting worse, not better.”

Mr Lamb acknowledge that the research was based on figures pre-dating the 2006 introduction of new contracts for NHS dentists, which aimed to widen access.

But he said: “What we’ve seen since is the position getting even worse.”

A Department of Health spokesman said the study’s findings had been influenced by changes in 2001 to ensure anaesthesia was given in hospitals – rather than dental surgeries – for safety reasons.

“There has been no increase in tooth decay in the period covered, which pre-dates the new dental contract,” the spokesman said.

“Preventative oral healthcare has actually improved substantially thanks to the new dental contract.

“Recent statistics from the World Health Organisation show that our 12-year olds have the healthiest teeth in Europe.”

The government advised the NHS to consider introducing water fluoridation in some areas, where it was supported by communities, to address disparities in oral health, he added.

Source:

• BBC News