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ISSN: 2637-6636

Interventions in Pediatric Dentistry: Open Access Journal

Short communication(ISSN: 2637-6636)

Improving Infant and Toddler Health is a Team Effort: The Need for the Medical Profession and Dentists to Work Together to Improve Infant Overall Health and Development? Volume 6 - Issue 3

Lawrence Kotlow DDS*

    Private practice in Pediatric Dentistry, USA

Received:July 19, 2021   Published: July 26, 2021

*Corresponding author: Lawrence Kotlow, Private practice in Pediatric Dentistry, New York, USA

DOI: 10.32474/IPDOAJ.2021.06.000238

Abstract PDF

Short Communication

In 1972 I completed my dental school training and the new high technology we were learning centered around learning to do sit down dentistry. The science of light energy was in its infancy, we were just beginning to use light to set up composite fillings and prosthetic dentistry was the real art for making perfect crowns and dentures. Little was taught about how the professions of dentistry and medicine would begin a slow journey to work together for our pediatric patients care. During my pediatric residency at the Children’s Hospital in Cincinnati, Ohio, I was introduced to the idea that the medical and dental residents could work hand and hand together to help our pediatric patients [1-8]. The Chief Medical and Dental residents would often confer with each other when patients with diabetes, hemophilia, trauma burns, congenital birth defects, facial swellings, and unexplained pain were admitted to the hospital. After completing my two-year residency, I returned to my hometown and was shocked and dismayed on how little coordination of care between the two professions was occurring. Pediatric patients were rarely if ever warned about sleeping with bottles filled with sugary liquids. Fluoride was not prescribed with knowledge on updated dosages. We were taught that the tongue was a simple muscle containing taste buds. Breastfeeding and restricted tethered oral tissues were not a consideration nor taught in either profession’s educational programs. The norm was to use a bottle and formula. It seemed more like physicians and dentists were competing rather than working together to achieve healthy growth and development of our patients [8-14]. As the years passed by, I began to understand the importance of understanding the relationship between a healthy oral environment and the rest of our pediatric patient’s overall growth and development. As we learn more about how our oral cavity is a mirror of our patient’s general systemic health, the need for both professions to understand we are merging ever closer and closer when treating our patients together rather than as two separate professions. I have been fortunate to be able to speak to healthcare professional all over the world, yet the one question that is universally asked is “How do we get the medical community to work with us?” The time has come for the Medical Profession to accept that Dentistry as its ally and is important to work together in caring for our patients and understanding the how the oral structures are in important part in the overall growth and development of our pediatric patients.

Treating patient’s symptoms and not the identifying the cause of many medical problems originating in the oral cavity should not be the accepted standard of care. When an infant presents with a variety of medically related symptoms, such as air induced reflux, apnea, failure to thrive, excessive gas, breastfeeding difficulties, maternal bonding, the oral structures need to be considered as part of the differential diagnosis [15,16]. Instead of treating the symptoms, the primary care provider and many medical specialty providers prefer to treat using drugs, hospital admissions, invasive GI procedures. Most importantly both professions need to learn to examine infant’s correctly in the examiners lap, not on the mother’s lap to correctly diagnose and identify the existence of RTOTS. (Restrictive oral tissues). Today’s technology involves using dental lasers for almost all dental procedures. There is no longer any reason for healthy for infants and toddlers be subjected to going to the operating room and having general anesthesia to have RTOTS revised. Proper pre and post revision care can have in many cases an immediate positive result in the bonding of infants and mothers, opening airways, improving infant breastfeeding. What we need desperately is for the educational institutions and post graduate programs to graduate informed medical and dental practitioners who are not fed the old school beliefs when they join older established dental and medical practices.

References

  1. Donna TG (2008) Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and sucking mechanism as imaged by ultrasound. Pediatrics 122(1): 188-194.
  2. Yu-Shu Huang, Stacey Quo, J Andrew Berkowski, Christian Guilleminault, Huang et al. (2015) Short Lingual Frenulum and Obstructive Sleep Apnea in Children. Int J Pediatr Res 1: 1
  3. Dominic Holland (2014) Structural Growth Trajectories and Rates of Change in the First 3 Months of Infant Brain. JAMA Neurol 71(10): 1266-1274.
  4. (2020) Peracid, Nexium or Prilosec USFDA has not approved these drugs for children under age one. Studies show they are not effective.
  5. Bixler EO (2009) Sleep disordered breathing in children in the general population sample; prevalence & risk factors. Sleep 32(6): 731-736.
  6. Kotlow L (2011) Infant reflux and Aerophagia associated with the maxillary lip-tie and ankyloglossia. Clin Lact 2(4): 25–29.
  7. Kotlow (2016) Breastfeeding and Tethered Oral Tissues: Air Induced Reflux and Obstructive Sleep Apnea EC Paediatrics pp. 356-365.
  8. Martinelli R, Marchesan I, Gusmao R (2020) Effect of lingual frenectomy. On tongue and lip rest position: A nonrandomized clinical trial. Int Arch Ororhinolaryngal.
  9. Guilleminault C, Huseni S, Lo L (2016) A frequent phenotype for paediatric sleep apnoea: short lingual frenulum. ERJ Open Res 2(3): 00043-2016.
  10. Kotlow l (2019) Tethered oral tissues as a differential diagnostic took in infants and toddlers presenting with obstructive sleep apnea and air induce reflux.  Australian Medical Jr 12(5): 131-137.
  11. Karen Bonuck, Katherine Freeman, Ronald D Chervin, Linzhi Xu (2012) Sleep-Disordered Breathing in a Population-Based Cohort: Behavioral Outcomes at 4- and 7-Years American Academy of Pediatrics.  Pediatrics 129(4): e857–e865.
  12. Padmanabhan V, Kavitha PR, Hedge AM (2010) Sleep disordered breathing in children-A review and the role of the pediatric dentist. J. Clin Ped Dent 35(1): 15-21.  
  13. Chervin RD, Archbold KH, Dillon JE (2002) Inattention, hyperactivity, and symptoms of sleep-disordered breathing. Pediatrics 109: 449–456.  
  14. Huang YS, Quo S, Berkowski JA (2015) Short lingual frenulum and obstructive sleep apnea in children. Int J Pediatr Res 1: 1.
  15. Siegel S (2016) Aerophagia induced reflux in breastfeeding infants with ankyloglossia and shortened maxillary labial frenula (tongue and lip tie). Int J Clin Pediatr North Am 5(1): 6-8.
  16. Hand P Olivi G (2020) Short lingual frenum in infants, children and Adolescents>Part 1 Breastfeeding and Gastroesophageal reflux disease improvement after tethered oral tissue release. Eur J Pead Dent 21(4): 309-317.
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