Special Needs Children

Special Needs Children

At Pandit Clinic, we welcome children with special needs with open arms and treat them with gentleness and positivity.

Dentistry for Special NeedsChildren

Pandit Clinic is a medical practice that is kind and compassionate to all its patients, especially with special needs children. Our clinic does not make any distinction between special needs children and others. We welcome them with open arms and treat them with gentleness and positivity. 

We understand the hurdles parents face when raising children who are physically or mentally challenged. Our Pediatric Dentist Dr Pratibha Kukreja Pandit is calm, kind and understanding. Her sole focus when treating special needs children is to make the process as comfortable and as painless as possible. 

Dr Pratibha kukreja Pandit Pediatric and Special Needs Dentist
Dr Pratibha Kukreja Pandit - BDS, MDS (Pediatric Dentist)

Dr. Pratibha is trained at the prestigious Chang Gung Memorial Hospital, Taiwan, in advanced areas including Dental Rehabilitation of children with special health care needs and Nasoalveolar molding and dental rehabilitation of cleft lip and cleft palate.

Why Choose Us For Your Special Needs Child?

THE TEAM

Consultant specialists in all fields of dentistry

The Team: Our team consists of dental professionals, physicians, maxillofacial surgeons and pediatric anaesthetist for a comprehensive in-house experience for all pediatric dental needs. We also have consultant specialists in all fields of dentistry for interdisciplinary management of our cases.

THE STAFF

Courteous, polite, empathic and highly experienced

The Staff:The clinical and non-clinical staff at Pandit Clinic is associated with the clinic since its inception. They are courteous, polite, empathic and highly experienced in the field.

THE CLINIC

Located in the heart of the city, accessible by elevator and is also wheelchair accessible.

The Clinic: Pandit Clinic is located in the heart of the city. It is in the close vicinity of major hospitals like Joshi hospital, Ratna hospital, Poona hospital and KEM hospital. Levelled on two floors in sprawling 4000 square feet area, the clinic is accessible by elevator and is also wheelchair accessible. Ample amount of parking and parking assistance is available on request.

THE OPERATING ROOM

Very well equipped, follow strict protocols for sterilization and disinfection

The Operating Room: Our operating room is very well equipped with state-of-the-art equipment and monitors for procedures under general anaesthesia, inhalation and intravenous sedation. Strict protocols for sterilization and disinfection are followed at our operating room.

PATIENT ROOMS

Patient rooms for recovery and comfort

Patient Rooms: The clinic houses two patient rooms for recovery, one private and one semi-private room. The rest rooms are specially designed for patient comfort.
Pediatrics-Consultation-Room-pandit-clinic

State-of-the art equipments at our Pediatric Dentistry and Special Needs centre

Dr. Pratibha Kukreja Pandit - pediatric and special needs centre

Dr. Pratibha Kukreja Pandit – Preventive and Special Needs Pediatric Dentist

Cleft lip and Palate

Pandit Clinic has been a centre for specialized cleft lip and palate surgery ever since its inception 38 years ago. Dr Shrirang Pandit is a pioneer cleft surgeon in India and has about 7000 successful cleft surgeries to his credit. 

In 2017, Dr Vikram Pandit, Oral and Maxillofacial surgeon, completed his fellowship in Cleft and Craniofacial surgery from the world renowned Chang Gung Memorial Hospital in Taiwan for super speciality cleft, and jaw corrective cleft orthognathic surgery. 

Dr Pratibha Kukreja Pandit, Pediatric and Preventive dentist, has a vast experience of treating dental problems in children with cleft deformity at Smile Train Centre at KLE Hospital in Belgaum. She has also completed her training at Chang Gung Memorial Hospital at Taiwan for Nasoalveolar molding and dental rehabilitation of children with clefts. Cleft care being a multidisciplinary speciality, Pandit clinic offers a team that is well trained, competent and experienced.

The challenges accompanying cleft defects:

An array of symptoms accompany the development of cleft lip and palate. The most common functional difficulties that accompany cleft lip and palate include:

1) Feeding difficulties: one of the earliest challenges 

2) Hearing difficulties and repeated ear infections: A common clinical observation among children with cleft palate is high prevalence of recurrent upper and lower respiratory tract infection.

3) Teeth: Misaligned teeth, irregular spacing and crossbites are common issues.

4) Mental retardation: If the cleft is part of a cluster of other problems (a syndrome), learning ability is sometimes affected. It is estimated that more than 40% of children with cleft palate but without cleft lip have it as part of a syndrome. Van der Woude syndrome, Pierre Robin sequence, Stickler syndrome and Treacher Collins syndrome are some of the syndromes related with cleft lip and palate. 

5) Speech: The gaps caused due the cleft lip and palate lead to an inability to speak normally.

Early Dental Care

With proper care, children born with a cleft lip and/or palate can have healthy teeth. This requires proper cleaning, good nutrition, and fluoride treatment. 

Appropriate cleaning with a small, soft-bristled toothbrush should begin as soon as teeth erupt. We recommend that the first dental visit be scheduled at about one year of age or even earlier if there are special dental problems. The early evaluation is usually provided through the Cleft Palate Team at Pandit Clinic. The treatment recommended depends upon many factors. Some children require only preventative care while others will need fillings or removal of a tooth.

The Cleft Lip and Palate procedure can be carried out at any stage of the child’s dental development, especially when there is a caries problem. Erosive tooth surface loss due to the excessive intake of acidic food or drink is also a potential problem in this age group. Any observed tooth wear needs to be carefully monitored and addressed.

Dental care for children with cleft lip and palate:

  1. Difficulties with tooth brushing often arise as the upper permanent incisors erupt, due to lack of sulcus depth and tightness of the repaired lip.

  2.  Simple measures such as showing the child and parent the cleft region in a hand mirror and disclosing the plaque deposits, especially on the teeth around the cleft, will assist with toothbrushing instruction. This will also help the child in coming to terms with the appearance of the cleft.

  3. Worries about bleeding from inflamed gingiva around the cleft region should be identified. The child and parent can be nervous about brushing the area for fear of traumatizing the soft tissues, especially following alveolar bone graft surgery.

  4. Oral hygiene before bone grafting must be of a very high standard as gingival inflammation can cause loss of the new bone.

  5. Access to the teeth in the cleft region is often difficult and a baby-sized toothbrush is still useful even at this age, especially where the upper lip is tight. This can be supplemented with an interspace brush. Teeth often need to be targeted individually when toothbrushing, as conventional brushing round the arch will exclude abnormally positioned teeth in the cleft region, particularly those placed palatally. The child is shown by the dentist how to lift the upper lip out of the way to facilitate brushing . The cleaning of any anterior teeth positioned high in the labial sulcus should be given attention.

  6.  Home use of disclosing tablets and the importance of a hand-held or bathroom mirror to aid toothbrushing should be discussed. Parental support with toothbrushing is helpful throughout the mixed dentition period and supervision is advised until at least 7–8 years of age.

  7. Fissure sealants are an important consideration for this group of patients. The procedure is advisable for first and second permanent molars, and premolars where indicated. Fissure sealing should be carried out as soon as the teeth have erupted sufficiently to allow adequate moisture control of the occlusal surfaces.

  8. The application of fluoride varnish is a valuable preventive measure. It is particularly useful for hypoplastic permanent incisors, areas of early demineralisation, teeth in the cleft region and partially-erupted permanent molars prior to fissure sealing. Fluoride tablet supplements should be continued throughout this phase if appropriate, or fluoride mouthwash usage could be introduced at this stage if only a topical effect is required.

Restorative Care

A child with a cleft lip/palate requires the same regular preventive and restorative care as the child without a cleft. However, since children with clefts may have special problems related to missing, malformed, or mal positioned teeth, they require early evaluation by a dentist who is familiar with the needs of the child with a cleft.

  • If restorative work is needed it should be carried out to a high standard.
  • Pulp treatment procedures and stainless steel crowns for primary molars should be used where appropriate.
  • The aim is for these teeth to exfoliate naturally, thereby maintaining the original arch relationships and space for the permanent successors, unless extractions are indicated for orthodontic reasons.
  • Sealant restorations provide a solution to the early carious lesion, especially in the occlusal surfaces of permanent molar teeth.

Communication with the Cleft Team

  • Good communication with the cleft team becomes particularly important from the mixed dentition stage onwards, as orthodontic treatment is often started early for this group of patients.
  • Teeth with a poor prognosis should be discussed with the orthodontist involved with cleft care. Extractions should be carried out only after consultation with the orthodontist.
  • The dentist should ensure that the child is seen regularly throughout any course of orthodontic treatment for specific toothbrushing instruction, reinforcement of dietary advice and the use of a fluoride mouth rinse where necessary.

The permanent dentition – adolescence to adulthood

  • The presence of the permanent dentition usually heralds the start of definitive orthodontic treatment. Patients with a cleft lip and palate often undergo a long course of appliance therapy, sometimes in conjunction with orthognathic surgery to correct the jaw relationship.
  • Once again the main role of the dentist is to help the patient maintain good oral health and prevent dental disease.
  • During the teenage years the patient can lack motivation and find it difficult to visualize the end result of the orthodontic treatment.
  • Peer group pressures are strong and school commitments become more demanding. Avoid missed dental appointments.
  • It is important to be aware that as patients with clefts you are not necessarily as dentally-motivated as routine orthodontic patients.
  • The latter are a selected group who have chosen to proceed with orthodontic treatment. The dentist is in a position to encourage and support the patient in carrying out the appropriate preventive measures and making them aware of the importance of attending both orthodontic and regular dental check-up appointments.
  • The adolescent with a cleft may have to make multiple hospital visits for cleft-related care in addition to other possible medical problems and this should be taken into account.
  • These may involve the number, size, shape, and position of both the baby teeth and the permanent teeth. The teeth most commonly affected by the clefting process are those in the area of the cleft, primarily the lateral incisors. Clefts occur between the cuspid and the lateral incisor. In some cases the lateral incisor may be entirely absent. In other cases there may be a “twinning” (twin = two) of the lateral incisor so that one is present on each side of the cleft. In still other cases the incisor, or other teeth, may be present but may be poorly formed with an abnormally shaped crown and/or root. Finally, the teeth in the area of the cleft may be displaced, resulting in their erupting into abnormal positions. Occasionally the central incisors on the cleft side may have some of the same problems as the lateral incisor.

Orthodontic Care for Cleft Lip

The first orthodontic evaluation may be scheduled even before the child has any teeth. The purpose of this visit is to assess facial growth, particularly the growth of the jaws. Later as teeth begin to erupt, the orthodontist will make plans for the child’s short and long-term dental needs. For example, if a child’s upper teeth do not fit together (occlude) properly with the lower teeth, the orthodontist may suggest an early period of treatment to correct the relationship of the upper jaw to the lower jaw. It is not unusual for this initial period of treatment to be followed by a long rest period when the orthodontist monitors facial growth and dental development. With the eruption of the permanent teeth, the final phase of orthodontics completes alignment of the teeth.

Coordinated Dental-Surgical Care for Cleft Lip 

Coordination of treatment between the surgeon and dental specialist is important since several procedures may be completed during the same anesthesia. Restorations or dental extractions can be scheduled at the same time as other surgery.

Coordination between the surgeon and the orthodontist becomes most important in the management of the bony defect in the upper jaw that may result from the cleft. Reconstruction of the cleft defect may be accomplished with a bone graft performed by the surgeon. The orthodontist may place an appliance on the teeth of the upper jaw to prepare for the bone graft. A retainer is usually placed after the bone graft until full braces are applied. When the child approaches adolescence the orthodontist and the surgeon again coordinate their efforts if the teeth do not meet properly because the jaws are in abnormal positions. If the tooth relations cannot be made normal by orthodontics alone, a combined approach of both orthodontics and surgical repositioning of the jaws is necessary. Such surgery is usually performed after the pubertal growth spurt is completed.

Prosthodontic Care for Cleft Lip

The maxillofacial prosthodontist is a dental specialist who makes artificial teeth and dental appliances to improve the appearance of individuals with cleft and to meet their functional requirements for eating and speaking. The prosthodontist may make a dental bridge to replace missing teeth. Oral appliances called “speech bulbs” or “palatal lifts” may help close the nose from the mouth so that speech will sound more normal. The prosthodontist must also coordinate treatment with the surgeon and/or the orthodontist to assure the best possible result. When a speech bulb or palatal lift is developed, the prosthodontist usually coordinates treatment with the speech pathologist to help in normalizing the child’s speech patterns. 

Pandit Clinic is a leader in Cleft Lip and Palate cases. Our team is dedicated to ensuring that our patients end up leading lives which are normal and face minimum restrictions even when they endure problems like Cleft Lip and Palate.

Virtual Video Consultations

100% SAFE AND SECURE CALLS WITH ENCRYPTION. YOUR PRIVACY AND CONFIDENTIALITY IS GUARANTEED.

Consult Dr. Pratibha Kukreja Pandit
(Pediatric Dentist)

Start here, by making an appointment for a virtual consultation with our expert Dr. Pratibha Kukreja Pandit (NEW PATIENTS ONLY).

Dr. Pratibha Kukreja Pandit is available for Virtual Video Consultations from Monday – Saturday between the hours of 11 am – 2pm and 4pm – 7pm.

If you are already our valued patient with questions or have an emergency please contact the clinic on +91 9822053446

Your virtual video consultation includes:

  • Discussion of problems that your child is facing like tooth pain, swelling or any other emergencies
  • Dr. Pratibha will recommend a course of treatment or medications for your child.

Virtual Video Consultation Fees Rs. 300

The Consultation Fees Must Be Paid Online by GOOGLE PAY BEFORE YOUR APPOINTMENT. See The Instructions On Appointment Confirmations
Dr Pratibha kukreja Pandit Pediatric and Special Needs Dentist

Dr. Pratibha Kukreja Pandit

BDS, MDS

Meet the Doctor

Pediatric and Preventive Dentistry Specialist

Dr. Pratibha is the Chief Dentist at Pandit Clinic. She is also a Consultant Pediatric Dentist at Kotbagi Hospital and KEM Hospital, Pune.

Dr. Pratibha has trained at the prestigious Chang Gung Memorial Hospital, Taiwan, in advanced areas including Pediatric dental treatment under General Anesthesia and Intravenous sedation, Dental Rehabilitation of children with special health care needs, and Nasoalveolar molding and dental rehabilitation of cleft lip and cleft palate.

She’s the lifetime member of Student Clinician Association, American Dental Association (SCADA), USA.

Professional Affiliations and Skills

  • Trained in Pediatric dental treatment under General Anesthesia and Intravenous sedation at Chang Gung Memorial Hospital, Taiwan
  • Trained in Dental Rehabilitation of children with special health care needs at CGMH, Taiwan
  • Trained in Nasoalveolar molding and dental rehabilitation of Cleft lip and palate at craniofacial centre, CGMH, Taiwan
  • Awarded Lifetime membership, SCADA (Student Clinician Association, American Dental Association), USA.

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