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Blogs

THE NEXTDDS Student Ambassador Blogs

Special Smiles

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Throughout my childhood, I had always heard so much about the Special Olympics program, which allows athletes of all ages with special needs to participate in competitions and win prizes for their abilities. As I grew older, I had the honor of being invited to help staff the program and learn more about what this amazing event has to offer. Very few people know how much the Special Olympics program means for participants, not only for children with special needs, but also for their families. I was pleasantly surprised to learn that not only was it a sports collaboration, but also a health screening service in addition to the exciting events that families enjoyed.

 

            When I was in college, I was invited to join the Special Olympics Special Smiles team in the field of dentistry to help screen children with special needs for oral care and other services. It was there that I learned about the misconceptions about children with special needs, and how to effectively demonstrate oral health care and hygiene practices to prevent future discomfort or their need for future dental work.

            Many of the children exhibited fluorosis, caries, and had fractured teeth from sports injuries or congenital abnormalities. Parents explained their journeys to finding the right dentist, and the hardships they encountered as a family trying to find care for their children.

            When I volunteered at the Special Olympics Special Smiles event in New Jersey, I had the pleasure of working alongside a dentist who taught me the basics of clinical screenings before I began dental school. This was an excellent preliminary experience to learn all about dental terminology and various conditions associated with congenitally acquired disorders. Not only did I have the opportunity to learn about these conditions, but also how to manage and identify them in a clinical setting. Many of the Special Olympics Special Smiles program participants required mouth guards for their regular sporting activities, so we were able to provide them along with other preventive services, such as fluoridated toothpaste, floss, and toothbrushes. They could then prevent dental caries while enjoying their daily activities at a minimal risk.

            Another Special Olympics Special Smiles program was recently held in Miami, which similarly provided dental and oral healthcare aid for children with special needs. There, special needs children were also provided with non-intrusive dental exams to encourage oral hygiene and to ameliorate issues in the dentition. Although many participants were known to be regularly noncompliant with dental professionals, they were more relaxed in a friendly and inviting setting, which helped decondition them from previous fears of the dentist.

This is critical to help provide care for children and adults with special needs, as they will be more likely to become compliant in the future if dental phobias are eradicated. Using the “tell-show-do” method, many of the participants learned proper oral hygiene techniques, learned about prevention, and reduced their dental anxiety for a brighter and healthier future.

Treating Cracked Teeth

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As a third year in dental school, one of the most difficult tasks in clinic is gauging the longevity of certain teeth. This past week in our Endodontics class we learned about cracked teeth and the various prognoses for each type of crack that may result.

The first type of crack is the fractured cusp. Patients with this type of crack in a tooth generally present with pain upon release and this can be gauged with a tooth sleuth to determine which cusp is the one in question. To treat this type of crack, remove the cusp and restore the tooth. Root canal therapy is only necessary if the crack has affected the pulp but otherwise the overall prognosis of the tooth is good once it has been restored. The next type of crack is one that starts in the crown and cracks the tooth mesiodistally. To treat, the crack must be prepared until it is gone and a crown is likely to keep the tooth healthy. Again, root canal therapy may be indicated based on the extent of the crack. If a cracked tooth is untreated, it can lead to a split tooth in which the crack extends down to the root and can separate the tooth in segments. If the crack extends on to the root surface beyond a restorable area, extraction will then be necessary. A third type of crack is the vertical root fracture. This starts in the root as opposed to the crown and usually begins in a buccolingual direction. These teeth almost always have had a root canal treatment prior. The only way to treat these teeth is by extraction or removal of the fractured root (a root amputation or hemisection may also be indicated).

The best way to diagnose any of these types of cracks is first to use transillumination. This technique uses a light and shines it directly onto the tooth from the lingual in order to see if a crack exists in the coronal portion of the tooth. Taking a periapical radiograph is also very useful in diagnosis of cracked teeth. Another valuable tool is the periodontal probe. With cracked teeth, there will almost always be a deep pocket where the crack arises; thus, probe around the tooth in question and if you feel a deep pocket and the tooth was otherwise periodontally healthy, a crack may have resulted. As with any type of dental pain, the earlier you can treat it the better. Be sure to get these patients in as soon as possible before their problems progress because once a tooth is extracted, a patient’s dentition will never be the same again.