August 11, 2006

Bright smiles for MGH patient

Like many 5-year-olds, MGH patient Craig Trites is a bundle of energy and enthusiasm. With his outgoing personality, talkative nature and cheerful
disposition, Craig endears himself to everyone he meets. However, beneath this sunny exterior hides something else — a chronic medical condition. Craig has severe focal segmental glomerulosclerosis, a disease that occurs when scar tissue forms on the areas of the kidney that filter waste products out of the body. The condition can lead to chronic renal failure.

While Craig's family has had to grapple with the many doctors' appointments and medical treatments that his condition brings, they also have had to face a more
surprising challenge — finding a dentist to care for Craig's teeth. The complexity of his disease has made it difficult for his family to find a pediatric dentist who would accept him as a patient. "I looked for a dentist everywhere, but no one would take him," says Craig's mom Christine.

No one, that is, except the MGH. For the past year, Craig has been a patient of pediatric dentist Shanta Richardson, DMD, of the MGH Dental Group. Providing him with the care he needs can be a challenge. Because of his disease, he is prone to infections and requires antibiotics prior to each appointment. His condition is treated with steroids, and before each dental procedure he must take an additional "stress dose" to help prevent further kidney damage. Craig also takes a daily aspirin, which he must be weaned off of one week before each appointment because it can cause excessive bleeding. Coordinating his care has been made easier by the fact that his nephrologist, Amita Sharma, MD, also practices at the MGH.

Because of the extensive medical care Craig has received, he often is fearful of dental treatments. "Craig is very anxious and cries when he has to receive dental care," says Richardson. "I've had to use several behavioral management techniques to help him relax during his appointments." Richardson tries to make each appointment as soothing and stress-free as possible for Craig. For example, she calls a tooth that needs to be pulled a "wiggle," making it sound less frightening to a young child.

Other children like Craig also can benefit from the services offered by the MGH Dental Group. The office is well-equipped to treat children who suffer from all types of medical conditions or complex dental diseases. Children who are unable to tolerate treatment on an outpatient basis also can receive care in an operating room under general anesthesia. In addition to pediatric dentistry, the MGH Dental Group provides dental care for adults and has specialists in orthodontics, periodontics and endodontics. For more information or to schedule an appointment, call (617) 726-1076.