Dissecting the Dental Divide

Sleep problems can occur at any age, but when toddlers, children or young adults are the ones experiencing them, they can have a big impact on the entire family. Specifically, one to five percent of children, from newborns to teenagers, experience obstructive sleep apnea. While the effects may be significant, many children are not diagnosed or treated due to insufficient access to testing. A team at Children’s Hospital Colorado has been preparing a recommendation on how and when to use home sleep apnea testing in kids. To explore this topic, we are joined by Antoinette Burns, DO, who specializes in pediatrics and sleep medicine at Children’s Colorado. She is also an associate professor of clinical practice, Department of Pediatrics-Pulmonary Medicine, at the University of Colorado School of Medicine. Some highlights from this episode include:    An explanation of obstructive sleep apnea.  New modalities for sleep apnea testing.  Barriers for accessing testing and how to combat them.  Suggestions on what primary care providers should do when they think their patient might have obstructive sleep apnea.  For more information on Children’s Colorado, visit: childrenscolorado.org.    

Knowing something is wrong with your child is terrifying for any parent, but the mystery becomes more frightening when the symptoms even puzzle the experts. In 2018, at a peak in cases of acute flaccid myelitis, also known as AFM, otherwise healthy kids experienced debilitating paralysis. Researchers of this perplexing illness braced for a surge in 2022 that never came, and now there is talk about a possible increase of AFM this year. To break down the past and prepare for the future, we are joined by two experts. Kevin Messacar, MD, and Hai Nguyen-Tran, MD, both specialize in pediatric infectious disease at Children’s Hospital Colorado. Dr. Messacar is an associate professor and Dr. Nguyen-Tran is an assistant professor at the University of Colorado School of Medicine. Some highlights from this episode include:    What the history of AFM tells the medical community  Why it’s so tricky to diagnose and identify  How primary care providers can properly prepare   For more information on Children’s Colorado, visit: childrenscolorado.org.    

In just the United States, more than 15,000 children are diagnosed with cancer each year. Globally, that number is greater than 300,000. As difficult as those numbers may be, there is good news: Our cancer therapies continue to improve. In the 1960s, only about 5% of children survived leukemia. Today, that number is 90% or better. Many more pediatric oncology patients are now transitioning into survivors of childhood cancer and have the opportunity to achieve their hopes and dreams as adults. This means primary care providers are caring for these patients in increasing numbers. What’s important to know about this group of kids? In this episode, we discuss how to best integrate survivorship care with pediatric care. The Children’s Hospital Colorado HOPE Cancer Survivorship Program is one of the longest running survivorship programs in the nation. Leading that charge is Jenna Demedis, MD, who specializes in pediatric hematology and oncology. Dr. Demedis completed her training at Children’s Colorado and is currently an assistant professor at the University of Colorado School of Medicine. When a patient can transition into survivorship  How to keep patient families engaged in these programs  How primary care providers can partner with survivorship programs    For more information on Children’s Colorado, visit: childrenscolorado.org.    

  The mouth is a fundamental part of the human body. It allows us to eat, drink, breathe, speak, smile and express ourselves. Naturally, that means oral health is connected to our broader physical health, but in the United States, medical and dental care are structurally separate. Despite their connections, the two have entirely different systems of professional training schools, insurance coverage and care networks. This is referred to as the dental divide, and it results in varied levels of access and health outcomes. The repercussions of these barriers are significant, especially for children in our most vulnerable communities. To discuss this important topic, we are joined by Patricia Braun, MD. Dr. Braun is a primary care pediatrician at Denver Health, as well as a professor of pediatrics at the University of Colorado School of Medicine. She is the immediate past chair of the Section on Oral Health for the American Academy of Pediatrics, and her research focuses on oral health outcomes and program evaluation. She also currently directs the Rocky Mountain Network for Oral Health Integration. Some highlights from this episode include:    How to understand the dental divide  Ways this divide leads to poor oral health for children  Options for the medical community to combat these barriers  What primary care providers can look for in their visits with patients  For more information on Children’s Colorado, visit: childrenscolorado.org.    

When you work in neonatology, you are surrounded by babies. You’re regularly meeting new parents in the Neonatal Intensive Care Unit, some who are living the best days of their lives, and others who are experiencing the very worst. But as a doctor, you never expect to become the patient. We go beyond the white coat in this episode with a story of tragedy and personal discovery from Laurie Sherlock, MD, that changed how she interacts with her patients and practices medicine. “I’ve been gifted through the accident and my son’s death. I’ve been gifted so much compassion for what our families are going through. I think my bandwidth is so much higher because it’s so easy for me to put myself in their shoes,” says Dr. Sherlock. Dr. Sherlock specializes in neonatal and perinatal pediatric medicine at Children’s Hospital Colorado and is an assistant professor of pediatrics and neonatology at the University of Colorado School of Medicine. Mostly importantly, she is a survivor who is using her own narrative to help others. Some highlights from this episode include:    Dr. Sherlock’s personal story and the impact it’s had on her career  Using personal experience to be a better doctor  Tapping into compassion at the bedside  Advice for patients and families experiencing tragedy  For more information on Children’s Colorado, visit: childrenscolorado.org.    

Innovations and techniques to enhance spinal surgical care, and support patient- centric outcomes, have made big strides in the last decade. Technology like surgical robots, 3D printed models customized to the patient, and a new procedure called vertebral body tethering are just a few examples of the many incredible advancements.   Two leading experts on scoliosis surgery at Children’s Hospital Colorado join us to discuss these impressive changes and how they are impacting patient care. Mark Erickson, MD, is the medical director of the Children’s Hospital Colorado Spine Program, as well as a specialist in orthopedic surgery. He’s also a professor of pediatrics at the University of Colorado School of Medicine. Sumeet Garg, MD, a pediatric orthopedic specialist, is the quality and safety director for the Spine Program, as well an associate professor at the University of Colorado School of Medicine.  Some highlights from this episode include:    An orthopedic surgeon’s approach to spinal surgery and how it’s evolved over time  How surgery can improve a patient’s quality of life   A look at new, customized patient approaches  How the use of robotics is advancing treatment  What’s on the horizon in spine surgery innovation  For more information on Children’s Colorado, visit: childrenscolorado.org.    

  When babies enter the world, there’s a plethora of diagnoses providers need to look out for. Some are simple fixes, while others are a bit more complicated. When parents take their kids home, how should they know what to keep an eye out for? In this episode, we explore one potential diagnosis for an infant: tongue ties. How can you tell if a baby has one, and if they do, when should it be fixed? Looking at the concerns and consequences of tongue ties is important in making a decision on how to treat it.  To provide guidance in making these decisions, Soham Roy, MD, is our guest for this episode. Dr. Roy specializes in pediatric otolaryngology at Children’s Hospital Colorado, and he’s a visiting professor of otolaryngology at the University of Colorado School of Medicine.  Some highlights from this episode include:    How to identify a tongue tie and variability in diagnoses   Why tongue ties are controversial    Identifying fact versus fiction in understanding tongue ties   The upsides and downsides of the tongue tie procedure   How providers can learn more  For more information on Children’s Colorado, visit: childrenscolorado.org.    

The care of children with cleft lip and palate spans an entire lifetime. It requires methodical care with a multidisciplinary team, and a special emphasis on the family. Integration with a child’s pediatrician, medical home and their loved ones is key. While the oral cleft is the most common craniofacial malformation in a newborn, the three main types differ vastly.   We are in for a treat with the guest for this episode. We are joined by a gifted plastic surgeon who has traveled the world to perform these life-changing surgeries and bring smiles to everyone involved. Phuong Nguyen, MD, specializes in plastic and reconstructive surgery here at Children’s Hospital Colorado. In addition, he is the associate vice chair of global surgery, chief of plastic surgery, co-director of the cleft lip and palate program and a professor of surgery at the University of Colorado School of Medicine.  Some highlights from this episode include:  Prevalence and diagnosis of cleft lip and palate  The role of the pediatrician or PCP throughout the lifespan of these patients  Understanding if treatment is unique per patient  Global impact of specialists, like Dr. Nguyen, traveling to treat patients  For more information on Children’s Colorado, visit: childrenscolorado.org   

You’ve likely heard of CRISPR, the comprehensive gene editing technology that emerged in the 2010s and has since revolutionized biological research. Additionally, the medical community has long been using the concept of gene therapy. What’s new is that both approaches have now successfully been harnessed for the treatment of human disease. In December 2023, the FDA approved two therapies for the treatment of sickle cell disease; one utilizing CRISPR technology and the other using a gene transfer therapy approach. These therapies now have the opportunity to change the life course of this terrible disease.   Our guest for this episode is Christopher McKinney, MD, who specializes in pediatric hematology here at Children’s Hospital Colorado. Dr. McKinney has been the hospital’s site principal investigator in some of the clinical trials that are contributing to these new sickle cell therapies, and he is an assistant professor of pediatrics at the University of Colorado School of Medicine.   Some highlights from this episode include:  How these treatments work for diseases like sickle cell  What we know about the effectiveness of these therapies thus far  Important side effects and risks to take into consideration  Regardless of FDA approval, what barriers are in place  Powerful patient examples  For more information on Children’s Colorado, visit: childrenscolorado.org   

In its 7th season, Charting Pediatrics has hit 2 million lifetime downloads! What an accomplishment. Our podcast team wants to thank each of you, our listeners, for tuning in each week to learn about the latest and greatest in pediatric healthcare. This accomplishment would not be possible without each of you, and we are thrilled to have you on this journey. 2024 has a lot of unique opportunities in store. Get ready for more content, new ideas, and further educational opportunities.  In this special episode, our hosts, David Brumbaugh, MD, Alison Brent, MD, and Dan Nicklas, MD, reflect on the growth of this podcast and the advancements that have happened since its inception. “And I am 100% convinced that we are, right now, in what will eventually be referred to as a golden era of pediatric medicine in terms of developing new treatments,” Dr. Brumbaugh says.  Here’s to 2 million more lifetime downloads, with listeners who are changing the realm of pediatric medicine every day. Thank you for all that you do!  For more information on Children’s Colorado, visit: childrenscolorado.org