Fetal alcohol spectrum disorders (FASD) is an umbrella term that describes the range of effects that can occur in a person whose mother drank alcohol while pregnant. Each year, FASD affect an estimated 40,000 infants in the United States—more than spina bifida, Down syndrome, and muscular dystrophy combined. Dentists have found themselves to be in a unique position to aid children with FASD because, oftentimes, they may see patients on a more frequent basis than a physician.

Defects caused by prenatal exposure to alcohol have been identified in virtually every part of the body. These areas include the brain, kidney, heart, ears, bones—and face.  Dentists are now learning how to spot orofacial characteristics that often affect children with FASD, according to an article published in the September 2010 issue of AGD Impact, the monthly newsmagazine of the Academy of General Dentistry (AGD).

A thin upper lip, a smooth philtrum (the depression between the nose and upper lip), and a flat nasal bridge are all potential signs of FASD. In some cases, recognition of these specific orofacial characteristics can help lead to an accurate diagnosis, because other manifestations of FASD, particularly cognitive and behavioral ones, overlap with those of many other conditions, such as attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD) and autism.

"Dentists are a critical part of each family's health care team and by learning the orofacial cues of FASD, not only can we provide the best care to children with the condition but also help the child's primary care physician to diagnose patients early on," says Peter G. Bastian, DDS, MAGD, spokesperson for the AGD. "An early diagnosis of FASD can improve the way in which the child's physician tailors the patient's treatments and visits to the office, as well as to improve the patient's overall care. Because of their disabilities, patients with FASD often have special needs that require supportive services."

A proper diagnosis also aids the dentist in his or her patient treatment plan. "Oral challenges that dentists may face with children who have FASD include widespread cavities; mouth breathing caused by facial deformities, which leads to dry mouth; and jaw joint disorders," Dr. Bastian says.

The majority of children with FASD are diagnosed well after birth. While there is no cure for FASD, -people with FASD can still succeed with support programs and services, including special education, vocational programs, tutors, and structured environments, as needed.