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Missing Teeth


Pregunta

Male, 11 years old, went to the orthodontist and had impressions taken. He has six missing permanent teeth and the dentists are trying to figure out a route of replacing those teeth. What is recommended? Could this be related at all to CDLS?

Respuesta de nuestros expertos

This family is experiencing exactly what we would expect regarding this child's permanent dentition. We often see missing teeth and, sometimes, extra teeth in CdLS. There are many children with various syndromes and those with no specific developmental abnormalities that have missing permanent teeth. Orthodontists have seen this situation many times and search for a solution and plan for treatment. Obtaining a panoramic x-ray and cephalometric x-ray will help determine what teeth are present and missing. These x-rays will also show what space is available to work with in bringing the teeth into a functional and esthetically pleasing position

The only limiting factor related to the possibility of treatment for this child is his ability to offer adequate cooperation for treatment. If it is impossible to obtain the various x-rays and impressions for orthodontic study models (molds) then it might be very difficult to place braces or retainers in the mouth. The presence of braces and retainers also compromises oral hygiene and this might jeopardize the health of the existing teeth if improved dedication and acceptance of oral hygiene does not take place

The treatment of children with missing teeth is not a tremendous challenge to orthodontiststhe treatment of children that have difficulty in accepting the treatment and all that goes withis a challenge. Not all orthodontists are equipped to offer the added time and expertise required. Search out, with the help of your local pediatric dentist, the orthodontist in the area that enjoys our special needs children and is dedicated to their betterment

RM/ TK 7-13-10

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Recomendación (es)

Dificultades de alimentación y problemas dentales

R12
En cada paciente con SCdL que tenga dificultades graves y prolongadas para alimentarse, la evaluación multidisciplinar (profesionales sanitarios de varias disciplinas) debería considerarse la colocación (temporal) de una gastrostomía (abertura quirúrgica al estómago a través del abdomen) como un complemento a la alimentación oral.
R13
En pacientes con SCdL que sufren infecciones respiratorias repetidas, debe descartarse la existencia de reflujo gastroesofágico y/o la aspiración de jugo gástrico o alimentos a los pulmones.
R14
Debe examinarse detalladamente el paladar. En caso de síntomas sugerentes de fisura palatina (submucosa), está indicado remitir al paciente a un especialista.
R15
La exploración y limpieza de los dientes debe realizarse con regularidad; podría ser necesario un examen o tratamiento ortodóncico más exhaustivo bajo anestesia.

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