Dental management of cystic fibrosis
There are reports of decreased caries prevalence attributable not only to the long term
use of antibiotics and pancreatic enzyme supplements but also to increased salivary
buffering. Nevertheless, these children suffer from delayed dental development; more
commonly have enamel opacities and are more prone to calculus. Moreover, they
need to have a very high calorific intake and may have frequent refined carbohydrate
snacks. As such, children with cystic fibrosis are an important priority group for
dental health education and care. General anaesthetics should be avoided in view of
the pulmonary involvement. A significant proportion of affected children also have
cirrhosis of the liver, with resultant clotting defects and a liability to haemorrhage
following surgical procedures. Children with cystic fibrosis sometimes still may be
prescribed tetracycline to prevent chest infections, as a result of the development of
multiple antibiotic sensitivities, even though it causes intrinsic dental staining (1103HFig.
16.7).
1104H
F
ig. 16.6 This boy has cystic fibrosis and shows a 'barrel chest' deformity due to
respiratory infections. Coincidentally, he also has a deformity of the clavicles.
(Courtesy of Wolfe Publishing.)