Baylor College of Dentistry
Orofacial clefts
and quality of life
Pediatric dentistry resident’s award-winning research
sheds light on ways to improve some young patients
experiences at the dentist
By Jennifer Eure Fuentes
Just a few weeks into her pediatric dentistry residency at Texas
A&M University Baylor College of Dentistry, Dr. Angela Cook
noticed a concerning pattern. Her patients with orofacial clefts
appeared more hesitant to receive treatment than their peers.
“They were a lot more anxious, more timid,” says Cook. She offers
an explanation for why children with cleft lip and/or cleft palate
— a malformation in which the tissues of the lip or palate fail to
fuse in the embryo, creating an opening in the upper lip or the
roof of the mouth — may feel this way. “They’ve had a history of
procedures around their mouths, so that makes them a lot more
sensitive to invasive dental treatment,” Cook says. “I had to learn
how to approach them in a manner that made them feel comfortable and safe, even though they have had surgeries throughout
their lives.”
Those patient care experiences formed the foundation of her
master’s thesis,“Quality of Life Associations with Caries and
Behavior in the Dental Setting Among Children with Orofacial
Clefts,” which assesses quality-of-life issues — specifically the
correlation between psychological and dental conditions. To do
this, Cook gathered input from 4- to- 10-year old orofacial cleft
patients and their parents, comparing it with demographics, surgical history, behavior and dental clinic records. The results
demonstrate a significant connection among negative behavior
in the dental chair, reduced health-related quality of life and
increased incidence of cavities and decay.
The findings are garnering national attention. On April 22, Cook
presented her research during the American Cleft PalateCraniofacial Association annual meeting as a recipient of the
2015 Mary J. Hauk, DDS, MPH Memorial Scholarship for
Dental Residents. Come May, she also shared the same
findings with attendees of the American Academy of Pediatric
Dentistry Annual Session in Seattle, where she also was recognized as a winner of the Graduate Student Research Award.
As part of the TAMBCD residency, Cook rotates to pediatric dentistry clinics affiliated with Dallas hospitals. The college’s partnership with Children’s Health of Dallas means residents have
exposure to the hospital’s Pediatric Plastic and Craniofacial
Surgery team, a multidisciplinary group dedicated to treating
patients with conditions such as orofacial cleft.
It’s how Cook met Dr. Celia Heppner, a pediatric psychologist on
the craniofacial team at Children’s and assistant professor at UT
Southwestern Medical Center, who with Dr. Carolyn Kerins,
pediatric dentistry graduate program director at TAMBCD, has
worked as a mentor on Cook’s thesis.
“Angela’s project is calling attention to what providers may see
clinically and behaviorally during dental visits and what might
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