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Full-mouth Rehabilitation of a Ventriculoperitoneal Shunt-treated Hydrocephalic Pediatric Patient: A Case Report
Anish Poonia1, Mm Dempsy Chengappa1, Rajat Mitra1
1Department of Pedodontics and Preventive Dentistry, Army Dental Centre, Research and Referral, New Delhi, India.
Insights
Pediatric dentists face challenges managing dental caries in children with hydrocephalus treated with ventriculoperitoneal shunts. Full-mouth rehabilitation under general anesthesia is a viable approach for these complex cases.
Area of Science:
- Pediatric Dentistry
- Neurosurgery
- Pediatric Anesthesiology
Background:
- Hydrocephalus, characterized by cerebrospinal fluid accumulation and increased intracranial pressure, is commonly treated with ventriculoperitoneal shunts (VPS).
- Children with VPS may exhibit delayed development, behavioral disturbances, and dental issues like increased caries prevalence.
Observation:
- Pediatric dentists encounter specific challenges in managing dental health for children with VPS.
- Behavioral disturbances often necessitate sedation or general anesthesia for dental procedures.
- Care must be taken to avoid excessive force on the VPS catheter during dental treatment.
Findings:
- This case report details the full-mouth rehabilitation of a pediatric patient with severe early childhood caries and a history of VPS-treated hydrocephalus.
- The rehabilitation was successfully performed under general anesthesia, addressing significant dental needs.
Implications:
- Invasive dental procedures in shunt-treated patients warrant neurosurgical consultation for prophylactic antibiotic assessment.
- Comprehensive dental care, including full-mouth rehabilitation under general anesthesia, is crucial for pediatric patients with hydrocephalus and severe caries.
- Multidisciplinary collaboration between pediatric dentists, neurosurgeons, and anesthesiologists is essential for optimal patient outcomes.
Abstract:
Hydrocephalus is characterized by accumulation of cerebrospinal fluid in the lateral ventricles of the brain, which results in progressive ventricular dilatation and an increased intracranial pressure. A ventriculoperitoneal shunt (VPS) is the most common treatment for hydrocephalus. Delayed development, behavioral disturbance, chronological changes in the eruption of their teeth, changes in the occlusion, greater accumulation of plaque, and increased caries prevalence are some of the clinical manifestations in these patients, which are encountered by a pediatric dentist. Behavioral disturbance in these patients makes sedation or general anesthesia the most feasible behavior management technique. During dental treatment of shunt-treated patients, care should be taken to avoid applying excessive force on the catheter. A referral to a neurosurgeon is recommended for patients with shunts undergoing invasive dental procedures for assessment of the need for prophylactic antibiotics. The present case report discusses full-mouth rehabilitation of a pediatric patient under general anesthesia who presented with severe early childhood caries and a medical history of ventriculoperitoneal shunt-treated hydrocephalus. How to cite this article: Poonia A, Chengappa MMD, Mitra R, et al. Full-mouth Rehabilitation of a Ventriculoperitoneal Shunt-treated Hydrocephalic Pediatric Patient: A Case Report. Int J Clin Pediatr Dent 2020;13(1):103-106.
