*MEET THE DENTIST!* Dr. Olson Smith

Meet Dr. Lauren Olson Smith from our Jeffersontown office!

Doctor's Full Name:

Lauren Olson Smith

Hometown:

Pewee Valley, KY

Undergraduate College:

The College of Santa Fe

Dental School:

University of Louisville School of Dentistry

Family:

Husband and 2 boys

Pets:

Black Lab and 2 Dachshunds 

Favorite Toothpaste: 

Sensodyne Pro Enamel 

Manual or Power Brush?

Manual

Favorite Food:

New york Style Pizza

Favorite Vacation Spot:

Hawaii

Favorite Hobbies:

Horseback riding, camping, hiking, quilting

Funniest/Most Memorable and/or Most Interesting Moment Experienced in Dentistry:

*Not one in particular! But it's interesting hearing stories from patients about life experiences, fascinating jobs or cool hobbies! 

*MEET THE DENTIST!* Dr. Tammra Catron

Meet Dr. Tammra Catron from our Jeffersontown office!

Doctor's Full Name:

Tammra S. Catron

Hometown:

Monticello, KY

Undergraduate College:

Georgetown College

Dental School:

University of Kentucky College of Dentistry

Dental Specialties:

Enjoy cosmetic dentistry, surgery and prosthetics (dentures)

Pets:

2 dogs - Elle Mae and Rainy Day 

Favorite Toothpaste:

Colgate

Manual or Power Brush?

Power

Favorite Food:

Pepperidge Farm Gold Fish

Favorite Vacation Spot:

Any beach, hiking out west, Lake Cumberland

Favorite Hobbies:

Anything outdoors & adventurous

Funniest/Most Memorable and/or Most Interesting Moment Experienced in Dentistry:

Seeing someone who hasn't smiled in years, with the happiest smile ever, after restoring their broken down teeth. 

Dental Care & Down's Syndrome

Proper dental care is just as important if not more important for a patient that has Down's Syndrome. We want to share a study with you called 

"Dental Care for the Patient with Down's Syndrome" by Elizabeth Pilcher.

Introduction

Approximately one out of every 800-1,100 births results in an extra chromosome of the twenty first group called Trisomy 21, or Down syndrome. Affecting over 250,000 people in the U.S. alone, this population has progressed tremendously over recent years to be able to function in the mainstream of society. Inclusive school, work and community settings are now becoming the norm for persons with Down syndrome. This has resulted in a higher level of functioning for most of these individuals with resulting increases in self-esteem and self-image. The demand for dental care in persons with Down syndrome is increasing with this inclusive trend. Most dental treatment for persons with Down syndrome can take place in a general dental office with relatively minor adaptations. In undergraduate dental training there is usually little or no exposure to treating patients with disabilities, and general practitioners may be hesitant to treat these patients with confidence. This paper will attempt to summarize the unique characteristics associated with Down syndrome that influence the dental care and treatment of this population.

Bits and pieces of what we found most important and easily understandable from the full study:

•  Children with Down syndrome often have chronic upper respiratory infections. These contribute to mouth breathing with its associated effects of dry mouth and fissuring of the tongue and lips. 
• A reduced degree of muscle tone is generally found in Down syndrome. This affects the musculature of the head and oral cavity as well as the large skeletal muscles. The reduced muscle tone in the lips and cheeks contribute to an imbalance of forces on the teeth with the force of the tongue being a greater influence. This contributes to the open bite often seen in Down syndrome. Additionally, reduced muscle tone causes less efficient chewing and natural cleansing of the teeth. More food may remain on the teeth after eating due to this inefficient chewing. 
• Persons with Down syndrome vary widely as to their degree of intellectual impairment. Most have IQs in the mild to moderate range and are able to be treated in a normal setting. There is often a relatively severe delay in language development. The patient with Down syndrome will probably understand more than their apparent level of verbal skills. The assistance of the patient's family or caregiver will be necessary in conveying to the dentist and staff what level of communication should be used with the patient. It may take a little extra appointment time to explain procedures to the patient with Down syndrome, but once a level of trust is achieved they are likely to be very co-operative patients. 

 Orofacial Structures

• Often underdeveloped which means the bridge of the nose, bones of the midface and maxilla are relatively smaller in size. This can cause an open-bite 
• Mouth breathing is very high due to a small nasal airway. The tongue may protrude and appear to be too large.  
• With age, both the tongue and the lips in people with Down syndrome tend to develop cracks and fissures. This is a result of chronic mouth breathing. Fissuring of the tongue can become severe and be a contributing factor in bad breath. Patients should be instructed to brush their tongue when they brush their teeth. 
• Another result of chronic mouth breathing may be a decrease in saliva with a dry mouth. This reduces the natural cleansing that occurs in the oral cavity and may contribute to the development of caries. Irritation at the corners of the mouth may also be a result of mouth breathing.
• The eruption of teeth in persons with Down syndrome is usually delayed and may occur in an unusual order  
• The delay in eruption may be as long as two to three years. Although independence in feeding and the introduction of adult food is encouraged in the toddler with Down syndrome, the diet may need to be altered because not enough teeth have erupted to safely chew some foods. 

Dental Disease

• Historically the incidence of dental decay in persons with Down syndrome has been reported to be extremely low. Recent studies however have shown that while the incidence is lower, it is not as rare as once thought and it certainly should not be taken for granted that "these patients won't get decay"
• Today, children with Down syndrome should be educated in proper oral hygiene, and receive the benefits of both systemic and topical fluoride.  
• Sealants are also recommended 
• Early, severe periodontal disease is often seen with onset in the mid to late teen years. 

• Some studies report an incidence of periodontal disease to be between 90 and 96% in adults with Down syndrome. This is thought to be related to a lowered host response due to the compromised immune system in Down syndrome  
• Patients with early signs of periodontal disease may need to be seen as often as every three months for scaling and root planing and may also benefit from the use of  a special mouth rinse and possibly systemic antibiotic therapy.
• Good home care is essential in the management of periodontal disease of this type. This may be difficult to achieve with the intellectual impairment and decreased manual dexterity seen in Down syndrome. Flossing may be very hard for these patients and instruction in the use of a floss holder may be helpful. New mechanical tooth brushing and flossing aids on the market may also be of help. It is important to be sure that the patient's family or caregiver is educated in proper home care as well. Parents need to realise the importance of proper daily home care because the child with Down syndrome may be resistant to tooth brushing. Additionally, the age at which a child with Down syndrome can be expected to take care of his/her own teeth may be much later than that of normal children.

Treatment Objectives

• Should be the same as that of normal patients. 
• Treatment plans may need to be adapted as necessary due to each individual's condition, but the overall goal should be to provide as comprehensive treatment as possible.  
• Areas of dental care such as cosmetic dentistry, orthodontics, and reconstructive oral surgery should not be ruled out simply because the patient has Down syndrome. With the numbers of persons with Down syndrome working and living out in the community, there may be many who desire and can handle some of the more extensive dental treatment options available today.

Behavior Management

• Good behavior in the dental office is learned. In a population with delayed learning, this can be a challenge for the dentist and staff. Dental treatment for children with Down syndrome may not be sought out at an early age. There may be more pressing medical problems, financial considerations or parents may want to wait until the child seems mature enough to handle a visit to the dentist.
• Determining the level of communication is very important in developing a co-operative relationship with your patient with Down syndrome. 
• It is important that the dentist communicate directly with the patient whenever possible in order to build a level of trust.
• Most patients with Down syndrome can handle routine dental care with just a little more time and attention given during the appointment.
• Scheduling appointments early in the day is beneficial as both patient and operator are more rested. First appointments should be for orientation only, and subsequent appointments may require a little more time than what is usually allowed. The patient's medical history should be obtained prior to the first appointment. This allows for medical consultation if necessary before any treatment begins.

Summary

Dental care for the patient with Down syndrome can be achieved in the general practitioner's office in most instances with minor adaptations. Although this population has some unique dental care needs, few patients require special facilities in order to receive dental treatment. Adequate dental health care for persons with developmental disabilities is a major unmet health need. It is hoped that the information contained in this review will encourage general practitioners to be willing to provide comprehensive dental care to their patients with Down syndrome.

Source & Full Study

*MEET THE DENTIST!* Dr. Bryan Fox

Meet Dr. Fox from our Jefferson Mall office! 

Doctor's Full Name: 

C. Bryan Fox

Hometown:

Henderson, Ky. 

Undergraduate College:

Murray State University 

Dental School:

University of Louisville School of Dentistry 

Dental Specialties: 

I enjoy all areas of dentistry. I have extensive post graduate education on Cosmetic Dentistry, Laser Dentistry, Oral Surgery, Endodontics, and Implant placement. 

Family:

I have been married to the love of my life Ryan for over 10 years. We have two beautiful daughters, Dylan and Pepper. They definitely keep us on our toes! 

Pets:

Our first non-human child is our 11 year old mini-schnauzer named Marley. We wish our real kids were as good as her! =) We also have a beautiful brainless ragdoll cat named Alexandra Sarah Fox (of course my girls named her!)

Favorite Toothpaste:

Whatever is on sale! LOL

Manual or Power Brush?

Power without a doubt! 

Favorite Food:

There aren't too many foods that I don't like. It's hard to narrow it down! 

Favorite Vacation Spot:

Give me a beach and my family and I'm a happy man. 

Favorite Hobbies:

I am a semi-professional musician. I love to sing, play guitar, and especially song-write. I have also lately been enjoying recording in my studio. I also love to read.

Funniest/Most Memorable and/or Most Interesting Moment Experienced in Dentistry:

Every time I am able to make someone feel good about themselves it is memorable for me. I also love being able to ease someone's past fears of dentistry and have them comfortable with our office getting work down. I work in such a rewarding field... I am so thankful.