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Dentistry
Dentistry

Research activities

Introduction  |  Research Mandate  |  Current Studies  |  Future Studies


 

INTRODUCTION

The mouth is the window to general health, making dentistry play a strategic role in the improvement of health for children at SickKids.  

The Department of Dentistry at SickKids is the largest paediatric dental department in Canada, and involves two divisions - Paediatric Dentistry (including oral and maxillofacial surgery and prosthodontics) and Orthodontics.

 

RESEARCH MANDATE

Research within the Department of Dentistry has focused on the areas of dental trauma, primary pulp therapy and multidisciplinary interventions in cleft lip and palate and craniofacial patients.

The focus of dental trauma research has been the injured healthy child and adolescent. A prospective dental trauma database allowed for translational research that led to the development of evidence-based, treatment protocols for the management of dentoalveolar trauma. Furthermore, the initially controversial outcomes of these investigations have widely been accepted in the therapeutic guidelines of professional dental organizations around the world.

The outcomes of dentistry’s investigations in dental trauma and pulp therapy have been important contributions to the dental profession’s treatment of healthy children in the community setting. However, oral health is intrinsically linked to systemic health of the medically complex children treated at SickKids. Thus, integrated research between Dentistry and healthcare partners at SickKids is strategic for improvement of healthcare in children within the hospital, provincially, nationally and internationally. A strategic research plan was developed with the goal of improving outcomes for children with medical comorbidities through clinically focused investigations.

Current strategic areas of research include:

    1. Cardiology
    2. Oncology
    3. Craniofacial Anomalies
    4. Sleep Apnea
    5. Evaluative Dental Sciences

A LOOK AT SOME CURRENT STUDIES

Low Light Laser Therapy (LLLT) in treatment of Oral Mucositis (OM) in children receiving treatment for cancer

OM develops in 20-40 per cent of patients receiving conventional chemotherapy and 60-85 per cent of patient undergoing Hematopoetic Stem Cell Transplantation (HSCT1).

LLLT appears to reduce the incidence of OM in patients undergoing HSCT by over 50 per cent.

Future research should focus on identifying optimal characteristics of LLLT and feasibility in clinical setting.

Fluoride varnishes for the prevention of dental caries in Congenital Heart Disease (CHD) patients at the Hospital for Sick Children

A large number of carious lesions are identified immediately prior to planned cardiac surgery in children with CHD.  Children with CHD are more likely to receive sedation as a means to provide dental treatment and given they are already in a medically compromised state, they are at an increased risk for an anesthetic related cardiac arrest.

Purpose: This study will use fluoride varnishes on children diagnosed with CHD at first tooth eruption and continue to do so 2 times/year for 2 years in order to prevent caries and thus reduce dental OR visits in this population.

Longitudinal craniofacial growth in Pierre Robin Sequence (PRS) in comparison with Isolated Cleft Palate (ICP) and unaffected children

Purpose: To identify the morphological and growth differences between PRS, ICP and unaffected children using comprehensive cephalometric analysis at age 6, 12 and 18 years.

Dental morphology in Obese and non-obese children with and without obstructive sleep apnea

Purpose: To compare prevalence of dentofacial abnormalities in children with and without obstructive sleep apnea in cohorts of children with and without obesity and Down syndrome.

Rate of Repeat Dental General Anesthesia in a Tertiary Paediatric Center: A 10-year Retrospective Study

Purpose: To determine the annual incidence of patients coming for repeat GA for dental treatment over a 10 year study, and determining any associated trends (i.e. medical comorbidity, etc.).

 

FUTURE PROSPECTIVE STUDIES

The impact of palatal expanders on speech in the Cleft Lip and Palate population 

Currently there are no studies on the effect of palatal expanders on the cleft lip/palate population. 

This study will determine how the speech of patients with cleft lip and palate is disrupted by the cementation of a maxillary expander prior to receiving alveolar bone grafting.

Secondly, it will assess speech adaptability and compensation after maxillary expander cementation.

Lastly, we wish to determine if the placement of a palatal expander alters speech more when the patient has a fistula or narrow maxilla.

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