10:58am Friday 18 August 2017

Show me your teeth

Oral health leads to overall health, say SickKids dentists

Beep – beep – beep goes the alarm clock. For many Canadians, the day begins with a basic hygiene routine involving a shower and a toothbrush. While maintaining oral hygiene may seem like common sense, tooth decay remains one of the most common infectious diseases, affecting nearly 80 per cent of Canadians by the time they reach the age of 17. Dental decay is progressive; it can start as a sore tooth and become a severe and potentially life-threatening infection. SickKids dentists are reminding Canadians that oral health is tightly linked to overall health, especially in children.

Dentistry plays an important role at SickKids

A visit to the dentist is not usually associated with a trip to the hospital; however, dentistry plays an important role in the treatment of medically complex patients. From cardiac to cancer patients, children with cognitive challenges to craniofacial differences, the Department of Dentistry at SickKids provides approximately 15,000 patient visits a year, of which 95 per cent have underlying health issues. The other five per cent are healthy children with dental injuries or facial infections who are referred back to their community dentist after treatment.   

Twelve-year-old James is an example of the type of patient that dentists at SickKids see on a regular basis. James deals with reflux, muscle weakness, balance problems, nausea and sleep apnea on a daily basis. At age three he was diagnosed with Chiari Malformation, a structural defect in the cerebellum (the part of the brain that controls balance). On top of this, James was born with a small jaw and as a result has severe crowding in his mouth.

“Many healthy people can experience dental issues without serious consequences, but in medically complex and fragile patients a dental infection can lead to major complications,” says Dr. Peter Judd, Dentist-in-Chief and Project Investigator at SickKids.   

Because of the overcrowding in James’ mouth, he requires orthodontic work involving several adult tooth extractions. While the average patient can have this done at a community clinic, James must see a dentist at SickKids due to his other medical issues that could cause complications.   

The SickKids Department of Dentistry’s team-based approach enables dentists to work with other medical teams in the hospital to manage the health of patients with complex medical issues by preventing potential oral health problems and intervening when necessary.

The dentists also work closely and frequently with patients with a variety of special needs, including autism, Down syndrome and developmental delays. One of the goals with these patients is to build confidence in a dentistry setting. “Lying down on the dentist’s chair with strangers hovering over your face can be a very stressful and threatening experience for many children – especially those with special needs,” says Judd. “Investing the time in a child to develop a long-term comfort with the dentist can prevent future problems and can lead to overall health in adulthood.”

SickKids Dentistry provincial leader in wait-time management

Over the past five years, the SickKids Department of Dentistry has worked to reduce surgical wait times and has become a provincial leader in wait-time management by cutting the waiting list from 680 to 200 patients, with 90 per cent of patients treated within the appropriate time frame for their condition. “With the support of the Ministry of Health and Long-Term Care, we have been able to reduce the numbers of children waiting for dental care. We have met our targets year after year by making an effort to use the resources available as efficiently as possible,” says Dr. Michael Casas, Director of Clinics in the Department of Dentistry and Project Investigator at SickKids.

The SickKids team successfully reduced surgical wait times through a variety of strategies, including scheduling appointments according to the next available dental surgeon and developing a software system to manage patients based on the severity of the condition. They also worked aggressively to minimize cancellations by educating parents about how to properly prepare their child for surgery (i.e. fasting).

“These efforts have led to more kids being treated and in the right order, based on the most acute need,” says Casas, who presented SickKids’ approach to wait-time reduction at the April 1 Canadian Dental Association conference in Ottawa about early childhood cavities.  

About The Hospital for Sick Children
The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally.  Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system.  SickKids is proud of its vision of Healthier Children. A Better World.™ For more information, please visit www.sickkids.ca.

For more information, please contact:

Suzanne Gold
Communications Specialist – Media Relations
Communications and Public Affairs
The Hospital for Sick Children
Phone: 416-813-7654 ext. 2059
Fax: 416-813-5328
email: suzanne.gold@sickkids.ca

Caitlin McNamee-Lamb
Communications Specialist
Communications and Public Affairs
The Hospital for Sick Children
Phone: 416-813-7654 ext. 1436
Fax: 416-813-5328
email: caitlin.mcnamee-lamb@sickkids.ca


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