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I know there are many of your readers who have taken the opportunity to work at least at some point in their careers in a hospital, but not everyone. Even fewer have had the chance to work at one of only three Paediatric Craniofacial units in the UK. I write to you hopefully to give the readership an insight into the Paediatric Maxillofacial world. Working in such a unit could be described as working with children with complex medical needs, complicated medical histories, complex treatment plans, at times with difficult behavioural issues, with acute and urgent needs. But I would simply describe it as the most rewarding job I have done. Why? Well, as a dentally qualified professional in a medical environment it is a challenge. There is a quick and often brutal learning curve both clinically and academically. Working with children brings in another challenging factor; they can be both predictable and unpredictable and the clinical decisions can be obvious or completely unknown territory.
Imagine being 12 years old and having to take a decision to have your permanent teeth removed because they've become too painful and mobile to eat. What will your friends say at school? Actually, will you even be able to go back to school? A real patient with Papillon-Lefèvre Syndrome.
What about being a 14-year-old girl having to undergo a mandible resection because of a large tumour. Not your fault, but what other choice do you have? It's already disfiguring but what will the outcome be? A real case presenting with a psammomatoid ossifying fibroma.
What about a 5-year-old with a fatal heart condition who desperately needs some teeth taking out so that he can go on to have his cardiac operation. Where would you start with managing his medical needs? How could you explain to his parents the real risks of their child not surviving a general anaesthetic? A real patient on a cardiac transplant list with a failing Fontan Circulation.
The knowledge and experience gained in this paediatric environment has profoundly changed my practising career. The ‘not so ordinary’ will stay with me as I go further in speciality training.