[Table/Fig-9]:

Dental management protocol.

1. Detailed case history should be taken.

2. Special psychological behaviour management is mandatory [4].

3. Conductive hearing loss may be present [4]. Hearing aid should be adjusted to prevent amplification of sounds in dental operatory.

4. Delayed eruption of permanent teeth may be seen [4]. Investigation is warranted to determine whether the teeth are missing or eruption is delayed. All children with this condition should be evaluated for orthodontic needs by five or six years as Class III malocclusion is of concern [8].

5. Shunt placed due to hydrocephalous causes difficulty in head control during dental treatment. Precaution should be taken before dental treatment to stabilize the head as there is a possibility of foramen magnum stenosis, limitation in neck extention which can lead to respiratory complication. Antibiotic prophylaxis before treatment becomes necessary [4].

6. It is advised to perform dental treatment under local anaesthesia, because general anaesthesia poses certain complications due to anteriorly placed epiglottis, small nasal pharynx and larynx, difficulty in intubation, lumbar lordosis, narrowing of spinal cord and small chest [7].

7. Based on the treatment needs of the patient, dental procedures can be carried out.