Clinical services

  • Dental care for patients with developmental disabilities

    The Department of Dentistry is staffed by specialist consultants, a senior registrar, postgraduate students and support staff who are all highly trained in the dental management of patients with developmental disabilities such as cerebral palsy, Down syndrome, autism and intellectual disability, who meet our  eligibility criteria.

    The dental staff have received graduate level training and have considerable experience in the use of a range of behaviour management techniques that can be used successfully in patients with developmental disabilities. Such techniques include, but are not limited to:  tell-show-do, nitrous oxide analgesia (laughing gas), conscious sedation and general anaesthesia.

    At the first visit, a paediatric dentist will:

    • gather detailed information regarding the patient's medical and dental history
    • assess the ability of the patient to cooperate with oral hygiene practices and dental procedures
    • perform a comprehensive oral examination
    • formulate treatment plan options that consider the special needs of the patient and ensure the best possible outcome
    • schedule further appointment(s) for the provision of care

    Other specialised clinics are offered at the Royal Children's Hospital that cater to specific problems encountered in children with developmental disabilities:

    Dental care for patients who are medically compromised

    The Department of Dentistry is staffed by specialist consultants, a senior registrar, postgraduate students and support staff who are highly trained and have considerable experience in the dental management of patients who are medically compromised.

    For some medically compromised patients, poor oral health threatens their medical condition or their general health. An example of such a situation is a patient who develops a dental abscess while in an immuno-compromised state following bone marrow transplantation. Because the patient is immuno-compromised, the dental infection could lead to a more generalized infection and become a life-threatening event. In other situations the patient's medical condition can adversely affect their oral health. An example would be a patient on chemotherapy who develops painful mouth ulcers. Another consideration for patients who are medically compromised is that their condition may necessitate an alteration to the normal delivery of dental care. An example would be administering blood factors before extracting teeth in patients with bleeding disorders.

    The Department of Dentistry provides the following services for patients who are medically compromised:

    • in-patient consultation
    • oral rehabilitation under general anaesthesia on an outpatient or in-patient basis
    • pre-procedural screening and treatment prior to surgical procedures; eg. an oral screening is part of routine pre-organ transplant programmes
    • out-patient preventive and treatment services

    At the first visit, a paediatric dentist will:

    • gather detailed information regarding the patient's medical and dental history
    • perform a comprehensive oral examination
    • formulate treatment plan options after consultation with the patient's medical team that consider the special needs of the patient and ensure the best possible outcome
    • schedule further appointment(s) for the provision of care

    For further information regarding dental care for patients who are medically compromised:

    Emergency dental care

    The Department of Dentistry provides a 24-hour emergency service for children presenting with acute problems and dento-facial injuries requiring hospitalisation.
    Unless the patient meets certain eligibility criteria, management will be limited to the presenting problem only and no long term or routine care will be provided by the department.

    To access this service

    • During office hours - 03 9345 5344
    • After hours - 03 9345 5522 - and ask to page dentist on cal

    For more information regarding the management of dental infections and dental trauma:

    Specialist dental services

    The Department of Dentistry is staffed by a full range of specialist dental consultants who provide comprehensive dental services for those patients who meet certain eligibility criteria. The following specialty services are available:

    Endodontics

    Endodontics is a branch of dentistry concerned with diseases and injuries to the dental pulp, root and peri-radicular tissues.

    Oral medicine and dental genetics

    Oral Medicine amd Dental genetics are? branches of dentistry concerned with acquired and inherited disorders and diseases of the orofacial region.

    Orthodontics

    Orthodontics is a branch of dentistry, which specialises in the diagnosis, prevention and treatment of problems in the alignment of teeth and jaws.

    Orthodontic treatment involves the design and use of corrective appliances (such as braces, plates, headgears and functional appliances) to bring the teeth and jaws into proper alignment.

    Periodontics

    Periodontics is a branch of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes.

    Prosthodontics

    Prosthodontics is a branch of dentistry that deals with the replacement of missing teeth and related mouth or jaw structures with artificial devices.

    Oral and maxillofacial surgery

    Oral and Maxillofacial Surgery is a surgical specialty which treats conditions, defects, injuries and aesthetic aspects of the mouth, teeth, jaws, and face. Oral and maxillofacial surgeons care for patients who have problem wisdom teeth, tumours and cysts of the jaws, facial pain, misaligned jaws, accident victims suffering facial injuries, as well as provide reconstructive and dental implant surgery.  The Department of Dentistry works closely with the Royal Children's Hospital Department of Plastic and Maxillofacial Surgery to provide oral surgical services for patients.

    Cleft lip and palate and craniofacial anomalies

    The Department of Dentistry has a number of specialist consultants who are members of the multidisciplinary team that provides ongoing assessment and management of the complex, long term needs of patients with cleft lip and palate and various craniofacial anomalies. The dental needs of patients with facial deformities often begin early in life. Our specialist consultants evaluate each patient individually and then meet with the other members of the multidisciplinary team to formulate a treatment plan that will facilitate the best possible outcome.

    The dental team may be called upon from infancy for patients with cleft lip and palate. They may need to fabricate appliances to enhance the alignment of the jaws prior to lip repair. As the patient grows older, the orthodontist may need to correct the position of some teeth prior to alveolar bone grafting in adolescence. And then during the teenage years, definitive orthodontic care is often necessary. For some patients, a combination of orthodontics and surgery will be require to achieve the best alignment of the jaws. Throughout the patient's childhood, adolescence and early adulthood, the Department of Dentistry provides preventive and restorative dental care as needed.

    The Commonwealth Government Medicare system assists in the cost of dental care for individuals with clefts of the lip/palate and certain other nominated conditions under the Cleft Lip and Palate Scheme. Patients remain eligible for commencement of treatment through to 18 years, and may continue to be managed until 22 years, or to the completion of a current course of treatment. Only certain items of treatment are actually covered by the scheme eg. examinations and orthodontic treatment. Routine dental treatment including all aspects of restorative dentistry; fillings, crowns, bridges etc. are not covered by the scheme.

    For more information

    • Visit your local Medicare office or
    • Call Medicare on 13 2011 or 1300 652 492 or
    • Contact Medicare Cleft Lip and Palate Scheme Support and Interpretation Section
      PO Box 9822  Perth  WA  6001

    For further information on Cleft and Craniofacial Services at the Royal Children's Hospital

    For further information on cleft lip and palate and craniofacial anomalies in general

    Hypodontia clinic

    The Department of Dentistry is staffed by a team of specialist consultants including a paediatric dentist, an orthodontist and a prosthodontist who provide consultation and management of patients with missing teeth.