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Talk to Dr. Rachel Maher and you’d never suspect that she once had a fear of treating children.
In fact, it was her desire to conquer that fear that got her into pediatric and special needs dentistry. Maher took an externship at the Children’s Hospital of Philadelphia during her fourth year of training at the University of Pennsylvania’s School of Dental Medicine. She learned a lot in those two weeks before Christmas but when a resident resigned, she was asked to stay on until spring.
That experience—coupled with the fact that there was a dearth of pediatric dentists in Delaware—encouraged her to open her own pediatric office in 2004. “My doors and windows opened,” says the 47-year-old West Chester, Pennsylvania, native.
Going into dentistry had another advantage: it allowed her to stay in the medical field like the rest of her family but also afforded her the opportunity to establish her own identity.
“My mother and sister are nurses, and my dad was head of the Chester County health department for 31 years,” she explains. “He knew something about everything except dentistry, so I found my niche. Once again my doors and windows opened.”
Maher says starting kids out with a pediatric dentist by their first birthday is important for a variety of reasons. First, pediatric dentists receive two to three years additional training, most notably in behavioral management and special needs dentistry.
Second, they can advise on cavity prevention. Like other pediatric dentists, Maher conducts a Caries Risk Assessment with parents and gives them up-to-date information from the American Academy of Pediatric Dentistry on dietary restrictions and proper oral care.
“Childhood dental decay has reached epidemic proportions in this state and in the country,” says Maher. Two out of five preschoolers have decay right now.”
Maher admits that even though pediatric dentists receive training in behavioral management, the key to treating children is patience and figuring out what each child needs.
“There are a lot of scared kids and they’re afraid for different reasons,” she says. “You just have to figure out what’s going to work best for each child.”
One way pediatric dentists try to calm kids’ fears if through the “Tell, Show, Do” method. The dentist tells them about their tools, shows them what they are, what they sound like and what they do prior to the treatment.
“We do a lot of magic but sometimes we can’t do our magic and that’s why there are other options such as sedation and the operating room,” she says. Maher incorporates some of the newer technologies into her practice but rejects others. She thinks sealants are a great way to prevent cavities but will not use lasers. “I’m afraid with moving, squiggling kids that something’s bad going to happen,” she says.
She recognizes the value of digital X-rays but detects most of patients’ cavities the traditional way with a dental pick.
She finds the intraocular camera particularly useful as an educational tool. “We can take a picture of a cavity and show the patient what it looks like up on the computer screen,” she says.
Maher says patients can remain with her for as long as they want or as long as they feel comfortable in her Disney-themed office. “Usually we graduate them when they’re cooperative and have the majority of their permanent teeth. That tends to be when they’re in their mid-teens,” she says.
Away from the office, Maher enjoys visiting the Pocono Mountains and is a member of the National Ski Patrol. She’s married with four step-children. “Prince Charming found me late,” she says. “But if anyone asks if I had kids, I tell them I have 4,000 kids.”
2036 Foulk Road, Suite 200Wilmington •746-2426•dentistryforchildrende.com
For many teens, orthodontics became a rite of passage. For Robert Penna, it inspired a career.
“I had a real positive experience with my orthodontist up in Delaware County,” he says. “It was a fun office and it just seemed that everybody was happy. When I got into dentistry and had the opportunity to check out all the fields, I said ‘This is my calling.’”
Dr. Robert Pennasaw his orthodontist’s office as a happy
Orthodontics also satisfied his intellectual curiosity. “I’m not a surgeon; I’m not an immediate gratification person,” he says. “I’m a spatial person. I’m a puzzle solver so everything just pointed in the direction that this was going to be a good career for me.”
Another plus: Penna says he doesn’t have to deal with the fear people have of going to the dentist. “There’s a lot of apprehension surrounding going to see the dentist, he says. “But typically the orthodontist is a happy place.”
Penna tries to replicate his memories of going to the orthodontist for his patients by personalizing each interaction. “We encourage parents to come back into the clinical bay,” he says. “We’re not only updating them on their kid’s treatment but we’re often talking about their vacation plans, school, college trips and sports, so it really creates a family atmosphere.”
One thing that has changed since Penna found himself in the orthodontist’s chair: more and more adults are getting braces thanks to tooth-colored or clear brackets that blend with teeth.
Penna estimates that about 20 percent of his patients are adults. His oldest was an 83-year-old widow who was doing for herself what she had done for her children and grandchildren. “She even got engaged while wearing her braces,” he says. “She asked if there was any way she could get the braces off in time for her May wedding day. I told her we’d make sure to get her braces off by May.”
Penna says that grade-school kids still prefer the metal brackets. “They want to be like their peers,” he says. “Plus they get a different color every time they see me.
Treating older patients is also intellectually satisfying to Penna because the cases are often more complex and require a multidisciplinary approach. “Treating adults is a lot different than treating kids,” he says. “Patients come to you with missing teeth, crowns, bite problems, neuro-muscular problems. I love this multidisciplinary approach. We have many talented doctors in this tight-knit community who are committed to providing the best possible care they can.”
Like other dental specialties, orthodontics benefits from advances in technologies that make the work more efficient and more accurate. Digital X-rays give practitioners immediate access to high-quality images, making it easier to examine the structure of a patient’s mouth. 3D dental imaging systems provide a full set of X-rays in one 360-degree scan, creating 3D images of the patient’s dental formation. Digital scanning has also replaced manual creation of impressions for aligning equipment, reducing fit problems.
In addition to treating patients, Penna teaches at his alma mater, the University of Pennsylvania School of Dental Medicine. “It’s good to get back to the profession,” he says. “It keeps me well-read on and on the cutting edge of my field. The residents are all bright-eyed and bushy-tailed. Sometimes you have to calm them down a bit.”
Penna, a 1985 graduate of Archmere Academy, lives with his wife and teenaged daughter in Hockessin. The couple lost their son Anthony in a car accident in October 2017. “I tell people I have two kids: one I can hug and the other I can’t,” he says.
To memorialize his son, Penna has set up the Anthony Penna Charitable Fund which benefits school music programs. “Music was a big part of what Anthony did,” he says. “This past year we were able to give six $1,000 grants to school music programs. How they light up, it’s unbelievable. It’s our way of giving back.”
2710 Centerville Rd., Suite 215, Wilmington•998-8783•pennaortho.com
When Katie Matthews’ mom signed her up to work with the family dentist, little did she know that the summer gig would evolve into her daughter’s lifework.
The then 13-year-old Matthews started out by doing routine office work and some light cleaning but by the time she entered college, she was already assisting the dentist in treating patients. There was no doubt in her mind that after graduating Villanova University in 2001 she would enter dental school.
Dr. Katie Matthews enjoys the challenge of connecting with
“I found it to be a perfect fit between caring for people and using science, technology and art which were the things I was also interested in,” she says. “It’s a beautiful way to meld all these aspects together in one career.”
That compassion for people—especially children—led her into pediatric dentistry. “When I was in dental school early on, it was really clear that my desire was to work with children, especially children with special needs,” says the 40-year-old New Jersey native who trained at Temple University’s School of Dentistry. “I was challenged daily and still am challenged daily to try to find a way to connect with these individuals and to be creative in providing their care in the safest and most fun way possible.”
Communication is crucial. Matthews and her staff rely on parents to tell them how to communicate with patients who lack the ability to convey what or where the problem is.
“Parents and caregivers are the wonderful keys to our success,” she says. “We never separate the parents from the patient. It’s important for us to get a good history from the parent so we know how to communicate with the child. Once we get to that aspect, we can start to introduce things in a very neutral manner.”
Special needs patients often have dental issues that are related to their disorder. Patients who get their nutrition through feeding tubes, for example, don’t chew their food and often experience calculus accumulation. Matthews and her staff work with parents and caregivers teaching them how to care for their charges at home. Caregivers are shown how to position patients and use appliances like foam mouth props to cleanse all areas of the oral cavity.
“My staff is my backbone,” says Matthews. “They are very well educated in showing parents how to provide the care at home. We most often see patients twice a year while the caregivers and parents are providing care on a daily basis.”
Matthews also credits the low turnover among staff with making special-needs patients feel more comfortable. “The patients recognize the staff sometimes before they recognize me,” she says. “That kind of familiarity brings comfort and really helps with the children and special needs patients. We also try to keep them in the same treatment room.”
Matthews is comfortable treating patients for as long as they are comfortable in her practice. She has one special needs patient who is in her late twenties and in no hurry to leave. She realizes that transitioning to another provider can be traumatic for patients and families, so she leaves the decision up to them. “We’re comfortable with it as long as they don’t mind the child music,” she says.
Matthew is excited about the new technologies in pediatric dentistry and how they can be used to help both populations in her practice. She is getting ready to introduce a laser to treat tongue and lip ties which can interfere with feeding and cranial-facial development.
She is also using a medicament called silver diamine fluoride which arrests untreated dental cavities until the child can tolerate a more invasive procedure or the primary tooth falls out.
Matthews practices in the Hockessin office of Matthews Family Dentistry which includes her father-in-law Bruce, her brother-in-law Brian and her husband of 15 years, Dan whom she met in college.
“It’s nice to have a spouse who can understand your daily day-to-day, although I could never do what he does with the adult patients,” she says. “And he says the same thing about me that he could never do what I do with the pediatric and special needs patients.”
451 Hockessin Corner,Hockessin•234-2440•drmatthewskids.com
What do you do if you have an interest in both dentistry and surgery? If you’re like Douglas Ditty, you become an oral and maxillofacial surgeon.
Oral and maxillofacial surgeons are the most skilled and extensively trained practitioners in the field of dentistry, representing the integration of dental and medical specialties. These practitioners treat patients who experience problem wisdom teeth, facial pain and misaligned jaws. They treat accident victims suffering from facial injuries, offer reconstructive and dental implant surgery and care for patients suffering from tumors or cysts of the jaw as well as functional and esthetic conditions of the face, jaws and mouth.
The field is an ideal fit for someone like Ditty, a perfectionist who likes to restore things to their former state. “I like the challenge of getting my procedures perfect and having a good outcome,” he says.
Ditty says trauma cases are of special interest to him. “I like to be able to put all the puzzle pieces back together and make the person look like nothing happened,” he says. “With dental implants, I like to make it look like the tooth was never even lost.”
Like other dentists, Ditty has fond memories of his childhood dentist. His grandfather also provided inspiration. “He was a medical doctor and my hero,” he says. “I really looked up to him.”
Ditty also got a vote of confidence from a most unlikely source: his boss on a summer construction job. “He told me dentistry was a lot like construction except the tools are smaller,” he says.
Ditty says his boss was so excited about his going into dentistry that he encouraged his daughter to enter the field. “I taught her at the University of Pennsylvania and hired her,” he says.
Ditty, a Lehigh Valley, Pennsylvania, native, attended Muhlenberg College, which had an arrangement with the University of Pennsylvania School of Dentistry allowing students to enter dental school after three years of college instead of the usual four.
After dental school, Ditty completed a residency in oral and maxillofacial surgery. During residency, Ditty also completed medical school, including two years of general surgery training, eight months of intensive care and trauma surgery training and four months as a second-year anesthesia resident, all at the University of Pennsylvania.
Choosing to attend the University of Pennsylvania for dental training proved to be both professionally and personally rewarding for Ditty. It was there that he met his wife, orthodontist Jane Ahl. Ditty was the teaching assistant in a class Ahl was taking. “We didn’t start dating until the class was over,” he notes.
Like his colleagues, Ditty is most excited about the advent of 3D technology which has digitized the planning process.
When he’s not performing surgery, Ditty still gets involved in construction. He does home-repair projects and volunteers for Habitat for Humanity.
He bikes and enjoys traveling and spending time with his wife and three kids. At 45, he’s also teaching himself how to play the guitar. “I’ve been playing for a year and a half now. It’s amazing how good you can get if you keep working at it.”
1004 South State St. Suite 1, Dover• 674-4450•firststateoms.com