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http://dx.doi.org/10.5933/JKAPD.2017.44.2.228

Dental Management of Pediatric Hydrocephalus  

Kim, Mijun (Department of Pediatric Dentistry, Oral Science Research Center, College of Dentistry, Gangneung-Wonju National University)
Park, Howon (Department of Pediatric Dentistry, Oral Science Research Center, College of Dentistry, Gangneung-Wonju National University)
Lee, Juhyun (Department of Pediatric Dentistry, Oral Science Research Center, College of Dentistry, Gangneung-Wonju National University)
Seo, Hyunwoo (Department of Pediatric Dentistry, Oral Science Research Center, College of Dentistry, Gangneung-Wonju National University)
Publication Information
Journal of the korean academy of Pediatric Dentistry / v.44, no.2, 2017 , pp. 228-234 More about this Journal
Abstract
Hydrocephalus is a condition in which the volume of cerebrospinal fluid in the cerebral ventricles is abnormally elevated. Hydrocephalus patients may show macrocephaly and delayed development. Ventriculoperitoneal shunt is the most commonly used treatment but ventriculoatrial shunt is another treatment option. This report discusses the dental management process employed for a 7-year, 6-month old patient with ventriculoperitoneal shunt-treated hydrocephalus. This patient showed dental caries on the deciduous molars, facial swelling, macrocephaly and delayed development. Pulpectomy was performed on the deciduous molars under nitrous oxide sedation and mild protective stabilization. This patient did not appear to have any specific complications until the latest follow-up and was scheduled for the management of overall oral hygiene, development of permanent teeth, and craniofacial asymmetry through periodic follow-up. During dental treatment of shunt-treated patients, care should be taken to avoid applying excessive force to the catheter running along the patient's neck to prevent the displacement of the catheter. A referral to a neurosurgeon is recommended for patients with ventriculoatrial shunts for prophylactic antibiotics. As hydrocephalus patients grow, they may show craniofacial asymmetry or differences in the calcification of the permanent teeth, and require periodic oral and craniofacial assessment.
Keywords
Hydrocephalus; Dental practice management; Antibiotic prophylaxis;
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1 Pirttiniemi P, Poikela A, Huggare J, Lopponen T : Dental maturation in children with shunt-treated hydrocephalus. Cleft Palate Craniofac J, 41:651-654, 2004.   DOI
2 Cartwright CC, Wallace DC : Nursing Care of the Pediatric Neurosurgery Patient. Springer-Verlag Berlin Heidelberg, 444, 2013.
3 Fernell E, Hagberg G, Hagberg B : Infantile hydrocephalus in preterm, low-birth-weight infants--a nationwide Swedish cohort study 1979-1988. Acta Paediatr, 82:45-48, 1993.   DOI
4 Pirttiniemi PM, Huggare JA, Kantomaa TJ, Serlo WS : Craniofacial asymmetries in shunt-treated hydrocephalic children. Cleft Palate Craniofac J, 28:369-372, 1991.   DOI
5 Huggare JA, Kantomaa TJ, Ronning OV, Serlo WS : Basicranial changes in shunt-treated hydrocephalic children--a two-year report. Cleft Palate J, 25:308-312, 1988.
6 The Korean society for pediatric neurosurgery : Text book of Pediatric Neurosurgery. Dr's book, Seoul, 2011.
7 Forsberg H, Quick-Nilsson I, Gustavson KH, Jagell S : Dental health and dental care in severely mentally retarded chil dren. Swed Dent J, 9:15-28, 1985.
8 de Morais Gallarreta FW, Bernardotti FP, de Freitas AC, et al. : Characteristics of individuals with hydrocephalus and their dental care needs. Spec Care Dentist, 30:72-76, 2010.   DOI
9 Dachs RJ, Innes GM : Intravenous ketamine sedation of pediatric patients in the emergency department. Ann Emerg Med, 29:146-150, 1997.   DOI
10 de Carvalho RW, Pereira CU, Santos EA, do Egito Vasconcelos BC : Retrograde migration of a ventriculoperitoneal shunt to the neck after dental treatment. J Dent Child (Chic), 80:47-49, 2013.
11 Do patients with hydrocephalus shunts need antibiotic prophylaxis before undergoing dental procedures? Available from URL: https://www.sps.nhs.uk/articles/do-patients-withhydrocephalus-shunts-need-antibiotic-prophylaxis-beforeundergoing-dental-procedures-2/ (Assessed on September 30, 2016)
12 American Academy of P, American Academy of Pediatric D, Cote CJ, et al. : Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update. Paediatr Anaesth, 18:9-10, 2008.
13 Helpin ML, Rosenberg HM, Sayany Z, Sanford RA : Antibiotic prophylaxis in dental patients with ventriculo-peritoneal shunts: a pilot study. ASDC J Dent Child, 65:244-247, 1998.
14 Moazzam AA, Nehrer E, Da Silva SL, et al. : The association between dental health and procedures and developing shunt infections in pediatric patients. J Neurosurg Pediatr, 14:508-513, 2014.   DOI
15 Acs G, Cozzi E : Antibiotic prophylaxis for patients with hydrocephalus shunts: a survey of pediatric dentistry and neurosurgery program directors. Pediatr Dent, 14:246-250, 1992.