GUILAS, Hans Christian L.

DMD-4G

I decided to choose this topic on “What Should be Done for Dental

Care in Down’s Syndrome Children?” because living in the Philippines,
which is considered third world country, it’s very desolating to see
children with such condition of mental challenges and Down’s
syndrome that it seems they didn’t have suffice admittance to undergo
dental treatment and further health care needs in general. They are
often neglected in the society due to incapacity to think or
incompetency that mediocre people used to dwindle them down and
sometimes the negative part is mocking them because it happens in
real life. As an undergraduate this is a good topic that is underrated and
is a very sensitive topic and should undergo a process of serious
discussion for improvement on how we see things.

It was noted in this journal that children with Down’s syndrome have
similarities with a healthy child but by some means there are also
different approach on how to manage them during a dental treatment
that differs from a healthy child. I think it’s also challenging to manage
such children because they are unpredictable and often have tantrums
and difficult to determine if they are responding on pain, discomfort
etc. Like for instance the patient is still considered a child when he or
she is below the age of 18 but a patient with Down’s syndrome might
as well have this innocent mindset even biologically the patient is
considered adult and has a capacity to bear a child. This will put you in
a test if you love the craft as well as how dedicated you are so in
applying the discipline and principles in Paediatric Dentistry in the
future practice.

Just a quick story to tell, last semester in our Community Dentistry 1

we went to a public school as a part of our fieldwork wherein our
patients are predominantly deaf and mute patients and I was assigned
to do Oral Prophylaxis to all the patient who will be accommodated in
the mission, before that day I watched different video tutorials of basic
sign languages so I can communicate with them to avoid having a hard
time as well. Happily I was able to interpret myself and kinda feel a
proficient clinician a little bit because I fulfill my part and I didn’t suffer
major communication barrier that might probably hinders me to
perform the treatment the day itself specifically to those children with
no guardian companion. For me, that was the day I was lighten up that I
need to go more on a deeper aspect of understanding certain kind of
patients with disabilities and to be honest I have superficial idea about
this sensitive topic. Personally, I also think that broadening my
knowledge about Pediatric Dentistry and Management is a
fundamental discipline need to develop even if I passed the board
exams already. Everytime I handle patient specially pediatric patient, I
need to be well equipped.

There are various kind of Down’s Syndrome (Crouzon’s, Trisomy 21,

Translocation etc.) as what I learned on Genetics and there are
contributing factors why these conditions happened during maternity
such as genes or chromosomes of the parents and it can also be
hereditary or due to trauma during pregnancy. Also it was discussed
here the most common oral manifestation as seen in Down’s syndrome
paediatric patient. As being mentioned these are some manifestation
being observed on cluster of pediatric patient with down syndrome:

Periodontal disease, xerostomia, infection such as fissured lips which

is a predisposing factor of candidiasis, sleep apnea, caries, maloclussion
anomaly etc. It is good to know these oral manifestation because for
me its insensitive to ask a parent questions like “ Is your child normal? ”
or “ Who among in your family have the same condition? ” which will
create an impact that is not good to their mental health and
considerably another sensitive topic to dive in. As being mentioned
again in this study compared to other people with mental disabilities,
patients with Down’s usually have fairly good intelligence and can learn
and execute the dentist recommendations, but unfortunately, there is a
problem with the communication, and this may force the dentist to
make a mistake in his decision. In this journal there is a description how
to instruct a child with Down’s syndrome such as: Demonstrating the
proper way of brushing in a creative way as much as possible and
mouth rinsing. Things like that for instance a general practitioner
should be aware of. Its true that sometimes Im having a hard time
managing a pediatric patient but I am very open for possibilities and
topics like this because one day If im fully stable I want to share my
good deeds as a dentist for those anyone who can’t afford to go on a
private dentist. Topics like patient with mental disabilities need to be
talk further so we can puzzle out our ideas and maybe change the
world in to a beautiful place wherein a basic people in our society won’t
create a barricade on people with such condition and who knows?
Maybe more moral support to raise for them 