Pediatric Dentistry · patient case question
What is the most appropriate next step in this child's management?
Patient case: A father who says his son has no teeth
demo: 6-year-old male, accompanied by his father
chief: The father is worried that his son still has almost no teeth.
history: Born at term. The father reports the boy overheats badly in summer and has to be cooled with wet towels; he rarely seems to sweat. He has never been seen by a specialist.
meds: None.
findings: Sparse fine scalp hair, prominent periorbital wrinkling with darkening around the eyes, frontal bossing, a depressed nasal bridge and everted lips. The skin is dry and scaly. Only two conical teeth are present in each arch.
Show answer and explanation
Correct answer: C. Refer for coordinated multidisciplinary care including paediatrics and genetics
- A. Implants are contraindicated in a growing child. Placed before jaw growth completes, they behave like ankylosed teeth and end up in infraocclusion as the alveolus develops around them.
- B. Passive observation misses the thermoregulatory risk and delays the speech, nutrition and psychosocial benefits of early prosthetic care. Overdentures can be provided from around age three.
- C. Correct. The dental findings are one part of a systemic condition. The most urgent issue is thermoregulation, since a child who cannot sweat is at genuine risk of hyperthermia. Paediatrics, genetics, dermatology and dentistry need to coordinate, and prosthetic rehabilitation is staged within that framework.
- D. The conical teeth are valuable. They are retained as overdenture abutments to preserve alveolar bone and improve retention and proprioception.
Note: Removable overdentures are the usual first prosthesis, remade periodically as the child grows. Implants wait until growth is complete, roughly 17 to 18 years in males.
Practice Pediatric Dentistry questions Pediatric Dentistry study notes