Pediatric Dentistry · patient case question
Which of the following treatment options is CONTRAINDICATED as first-line management at this patient's age?
Patient case: Soft, dry skin in a 5-year-old
Patient: Male, 5 years old
Chief Complaint: Mother: “He barely has any teeth and he cannot tolerate hot weather.”
Background: Full-term birth, normal cognitive development. Mother reports he almost never sweats and runs a fever in the summer. No medications.
Vital Signs: BP 96/60 mmHg · HR 96 bpm · T 98.9°F
Findings: Skin is soft, dry and smooth. Sparse fine scalp hair. Multiple missing primary teeth with knife-edge ridges; the teeth present are conical.
Show answer and explanation
Correct answer: B. Dental implants
- A. A removable overdenture (or a partial denture) is the actual standard of care for a young child with ectodermal dysplasia. It restores function and esthetics, supports speech development, and is simply relined or remade as the child grows.
- B. CORRECT. Implants placed in a 5-year-old behave like ankylosed teeth: the surrounding alveolus continues to grow while the fixture does not, so the implant becomes progressively infra-occluded and can distort the alveolar ridge. Implants are deferred until skeletal growth is complete, usually the late teens. The one narrow exception discussed in the literature is the anterior mandible in severe anodontia, and even that is done with caution and specialist planning.
- C. Preventive counselling matters greatly here, and so does the medical side: the child cannot thermoregulate, so heat avoidance advice is part of the dental visit.
- D. Interceptive orthodontics has a legitimate role — maintaining or redistributing space for the teeth that are present and preparing the arch for later prosthetic work.
Note: The recall recorded only three options — implants, orthodontics, orthognathic surgery — with no key. None of those three is truly the first line for a 5-year-old; the answer is a removable prosthesis. The stem has been reversed to ask what is CONTRAINDICATED, which is the defensible version of the question.
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