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?
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 orthodontists--the treatment of children that have difficulty in accepting the treatment and all that goes with--is 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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