Pediatric Case Study the Patient

Pediatric Case Study

The patient chosen for this case study is a child who sucks his thumb. The patient was chosen because there are two major general reasons why the child would be sucking his thumb, that being mental issues or dental issues, and either is worthy of study. The immediate dental need for this child is to make sure there is not a dental reason why he is sucking his thumb.

The child is five years old, so perhaps a bit too old to be expected to be sucking his thumb but certainly old enough to be having dental issues that would lead to such a happenstance were dental issues the cause. The child has not had a negative history dental-wise thus far, with teeth coming in normally and at the regular intervals. There have been no jaw or tooth injuries of any note, so that is not a concern.

Mental issues that could be causing the child to suck his thumb include the results of abuse, the inability to break child-like habits that are more emblematic of two to three-year-olds or younger and mental illnesses such as depression and mental defects/developmental issue. However, thumb-sucking is usually a function of breaking habits before they go on too long.

As for lifestyle choices, the child drinks a lot of sugary drinks including juice and soda, so there is quite a good chance that a cavity is what is in play here. X-rays were done to address that. Another issue that came up is that the child is not brushing and flossing as much as he should be and the apparently cause for this is lack of enough reinforcement from the parents, driving home the need to brush and floss at least twice a day and certainly after any major meal.

The x-rays and radiographs reveal a cavity. The point of the cavity happens to correspond with the place where the child was placing his thumb. There was a concern that the thumb-sucking was based on a mental issue but the parents insist he had stopped sucking his thumb a while back and only recently started doing it again. It is expected that the thumb-sucking will stop immediately now that the cavity will be addressed.

Recommendations for the child and his parents are two-fold. First, the consumption of sugary drinks is probably not going to stop but it should at least be moderated and less common-place as the amount of decay that will occur will be a lot less if this is done. If the parents or child are unable to unwilling to comply with this, they should up the amount of times, to at least three times, that brushing and rinsing occurs in a day. The acid and sugar sitting on the teeth will advance the process. The less amount of time that this is the case, the better and thus will save the teeth for longer periods of time.

A few general observations are called for now. Trying to get through to a child is one thing, but if the dentist himself/herself is the only person instilling good habits and protocols, the child will likely not stick with the good habits. It is imperative that the parent set the guidelines and it is equally important that the child sees the parent practicing what they preach. If the parent is simply giving lip service but is not doing what he/she tells the child to do, it will almost certainly not stick (at least not as well) as it would if the parent is doing what they are asking the child to do. This is not unlike most good habits.

The parents should also make it a point to show proper technique and monitor the child discreetly as they do their brushing and flossing to make sure that the child is doing it correctly and for the proper interval of time. The monitoring should not be over-bearing or micro-managing as the child will likely get frustrated. However, it must be done because it will set the stage for good (or bad) habits in the years to come for the child.