Lindsay Hunter

Laband syndrome : report of two cases, review of the literature, and identification of additional manifestations

Twenty-six persons with Laband syndrome have been reported in the literature to date. We report two further unrelated cases and suggest that a skeletal anterior open bite and symmetric soft tissue swelling of the vault of the palate be added to the variable features associated with the syndrome. There is clear evidence in the literature of autosomal dominant inheritance but our analysis indicates that in some cases recessive transmission is likely.

Oral and dental problems associated with pregnancy

Even today, many women are convinced that pregnancy causes tooth loss (‘a tooth for every child’) or that calcium can be withdrawn from the maternal dentition to supply foetal requirements, thereby resulting in ‘soft teeth’. We must therefore emphasise that the relationship between tooth decay and pregnancy is not well defined, but it appears that pregnancy per se does not directly contribute to the decay process. It is more likely that any increase in tooth decay during pregnancy can be attributable to diet and poor oral hygiene. Furthermore, calcium is present in the teeth in a stable crystalline form, and, as such, is not available to supply a calcium demand. However, calcium is readily mobilised from bone to supply these demands.

Dental treatment during pregnancy

From the dentist’s point of view, the pregnant patient poses a unique set of management considerations resulting from the requirement to provide therapeutic care for the mother without adversely affecting the developing foetus. In order to ensure that potentially harmful elements of treatment are avoided, particularly during the critical first trimester, it is necessary for the dentist to be aware that a woman is or may be pregnant. Therefore, any woman who knows or believes that she is pregnant, or is actively trying to conceive, should always ensure that she has given her dentist this information. However, it should be emphasised that dental care during pregnancy is generally safe.

Diseases and disorders of the teeth and supporting structures

Tooth decay is more properly referred to as dental caries. It results from a complex interaction between oral bacteria, tooth substance, and the chemicals in our food and drink. The exact cause is still unproved but the acidogenic theory of the aetiology of dental caries is widely accepted. This proposes that oral bacteria (such as streptococci, lactobacilli and actinomycetes) produce acids from refined carbohydrate present in food and drink. The acids then attack the surface of the teeth, leading to decay.

Prevention 1: diet

The aim of this chapter is to suggest ways in which dental disease in childhood can be prevented by dietary means. While emphasising the necessity to reduce consumption of sugars and sugary foods, the authors are conscious that any advice given in this context should be consistent with general dietary advice aimed at producing a healthy individual.

Miscellaneous abnormalities of the teeth and oral soft tissues of preschool children

Teeth commence eruption at around six months of age. By the time an infant starts to learn to walk all of the incisor teeth in both jaws have usually erupted. Not surprisingly these new teeth are vulnerable to injuries as a consequence of learning to walk and run, and playing games with other children. Even when a child is confined to a push-chair or buggy, the teeth may be at risk. The authors not infrequently are asked to treat patients who have fallen out of a buggy injuring the teeth. These accidents are often attributed to loose paving stones or pot-holes in supermarket car park surfaces. While we do not wish to place undue emphasis on non-accidental injury, it should always be borne in mine that, in combination with other injuries, trauma to deciduous teeth may point to this aetiology.

Oral and dental problems of sick children

Sick children are further disadvantaged if they suffer from oral and dental disease, most of which is preventable. The sick child’s family is also subjected to additional unnecessary burdens and disruptions to routine when as the result of neglecting oral health, dental treatment requires admission to hospital and possibly the administration of general anaesthesia to extract decayed teeth.

Oral self-care in pregnancy and lactation

Pregnant and lactating women can avoid oral or dental problems by ensuring that they control their intake of dietary sugars, maintain an optimum level of oral hygiene, and visit their dentist regularly.

An introduction to oral anatomy

Like many professions, dentistry has its own language which can be unintelligible to the outsider. This introductory chapter is intended to provide the reader with a basic understanding of oral anatomy and its associated terminology.

Why care for the deciduous dentition

It is still common for the authors to encounter parents and professional colleagues who regard deciduous teeth as dispensable. This short chapter sets out to refute this remarkable attitude on biological grounds. In sociological terms we have not been able to identify another organ, system or tissue which some parents regard as so unimportant to their child’s welfare that when diseased they are content to consent to a professional surgically removing that part from the child. Yet this is precisely what happens to many children who undergo general anaesthesia (which still carries a small risk of brain damage or death) for the removal of decayed deciduous teeth. For the child, the result of this unpleasant procedure is loss of chewing ability and disfigurement. It must be a reflection of society’s attitude to children that deciduous teeth are regarded by many, including some health professionals, as dispensable. Unfortunately we may never know what the children themselves think about it.