S4B-01 SESSION 4B: ORTHOGNATHIC / TREACHER-COLLINS DENTAL CARIES IN A CRANIOFACIAL POPULATION: ‘UNDERSTANDING THE RISK: PREVENTING THE PREVENTABLE’ WEST MIDLANDS SUPRA REGIONAL CRANIOFACIAL UNIT, UK

Abstract

Introduction: Abnormalities of oral and dental anatomy are noted in many craniofacial conditions. Children diagnosed with craniosynostosis may present with dental anomalies, skeletal abnormalities and cognitive defects. This puts them at a greater risk of developing dental caries. Dental caries is a largely preventable disease, however dental extractions are still a common reason for hospital admission in the UK. Having a healthy dentition will provide a more accurate base for later proposed orthognathic/ facial deformity surgery in the craniofacial patient. Aim: A prospective audit to assess craniofacial patients’ caries experience and associated risk factors at Birmingham Children’s Hospital. Objectives: 1.To assess the patients’ caries risk against UK guidelines; 2. To assess if the patients have access to a General Dental Practitioner (GDP) To assess the patients’ previous experience of dental treatment Methods: Questionnaires were disseminated prospectively over a 4-month period to patients who attended the craniofacial clinic at BCH. This comprised a series of questions to understand their risk of developing dental decay, access to dental professionals and any experience of dental treatment. Results: 40 patients completed the questionnaire, 16 had craniosynostosis related to a syndrome or multi-suture synostosis, the other 24 patients had single suture synostosis. Caries risk status: The caries risk for each patient was assessed based on their diet, availability of fluoride and dental caries experience. In the single suture cohort, 4 patients were regarded as being ‘low caries risk’ and the remaining 20 were ‘high caries risk’. In the syndromic/multi-suture craniosynostosis cohort, all children were regarded as being ‘high caries risk’ as a result of their medical condition and the other risk factors for caries. Access to routine dental care: In the syndromic/multi-suture synostosis cohort, 3 children did not have access to a dentist and 4 children did not have access in the single suture group. Patients’ previous dental experience: Of the study population, 10 had experienced dental fillings, 4 had previous extractions and 2 children had undergone a general anaesthetic for dental treatment. The 4 children who had undergone extractions were in the multi-suture craniosynostosis group. Conclusion: This patient reported questionnaire, demonstrated that the majority of our craniofacial patients sampled were at high risk of developing dental caries. To reduce this risk, there is a need for a preventative strategy and development of a robust pathway to support the young craniofacial patient population.