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prevention International magazine for oral health No. 1, 2018

| systemic diseases Patients with cystic fibrosis often have an accumulation of viruses, fungi and bacteria in their airways, which can in turn lead to pneumonia. These patients are under con- stant drug therapy. As dentists, we should comply with special hygiene regulations. We should be aware that the particulate matter that normally develops during dental treatment is to be avoided. One danger, for example, is lung infections, which can be triggered by bacteria like Pseudomonas aeruginosa. This risk can be prevented by using an external water supply. What measures do you recommend to reduce the risk of bacteraemia for these risk groups? We are currently conducting an intervention study in collaboration with the paediatric nephrology division at the University of Cologne. In addition to treating gingivitis through intensive prophylaxis, the goal of the clinical trial is to determine the bacterial risk after toothbrushing. For bacteria identification, blood cultures and oral microbi- omes are examined. We want to examine the influence of a patient-centred intensive prophylaxis programme and improved oral hygiene on the change in the oral microbi- ome. We hope in the long term to improve oral hygiene through regular check-ups and instructions, and to im- plement an interdisciplinary prevention programme for children with chronic kidney disease. Furthermore, we hope to achieve a substantial im- provement in oral health with targeted tooth cleaning and intensive prophylaxis, and to eliminate the daily bacterae- mia risk in children at risk, as well as carious lesions and gingivitis. This includes a regular recall system for these high-risk patients adapted to their individual needs. What are your recommendations for parents? I would like children to look forward to their dental ap- pointment with me. Through a very intensive relationship with the children and their relatives, I replace the cliché of an uncomfortable and angst-ridden dental visit with trust in dental treatment. We should give today’s generation of children a new perception about dentists. Of course, for many parents who have a child with a systemic dis- ease, oral hygiene is not their top priority. However, all the results of my clinical trials to date have shown that oral health has only a positive effect on the overall health of children with systemic disease, but besides that, the quality of life and self-confidence of my young patients are enormously strengthened. What is your appeal to your peers in practice? It is enormously important to take children in dental treatment in hand, accompany, explain and find a way to bring dentistry goals in line with the systemic disease. We must achieve oral health in children as quickly as pos- sible and maintain it for the long term through individual prevention programmes. The treatment of children with systemic disease should always take place in consulta- tion with the treating paediatrician. Every practice staff member should contribute to paediatric dentistry being perceived by parents as a specialist field in interdisci- plinary cooperation with paediatricians and serving the well-being of their children. 30 prevention 1 2018

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