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Fanconi anemia hits home for Rhode Island oral surgeon

February 06, 2012

By Jean Williams, ADA News Staff


Personal connection: Dr. David Fiaschetti, an oral and maxillofacial surgeon based in Rhode Island, with his son, Peter, 12, who has Fanconi anemia.
Middletown, R.I.—Dr. David Fiaschetti, an oral and maxillofacial surgeon here, helped the Fanconi Anemia Research Fund develop its fact sheet for dentists who may encounter an FA patient.

Dr. Fiaschetti has a personal interest in the disease—his son was born with it.

FA patients should be seen every six months by their dentists and receive a thorough oral cancer screening, but otherwise, they’re like any other dental patient, Dr. Fiaschetti said.

“Dentists who find themselves treating FA patients need not be apprehensive,” he said. “If the patient is not hematologically compromised, the dentist can treat the patient in the normal fashion.”

Likewise, FA patients shouldn’t shy away from routine dental procedures. Said Dr. Fiaschetti: “Being a dentist, I am often approached by other Fanconi anemia families who have questions regarding dental care and procedures. My general answer is, 'Follow the advice of your dentist; maintaining optimal oral health is imperative.'“

Dr. Fiaschetti’s expertise in the oral cavity is coincidental to his son, 12-year-old Peter, having FA, a disease in which there is a 500- to 700-fold increase of head and neck squamous cell carcinomas and oral cancer.

“I was already an oral and maxillofacial surgeon when my son was born,” said Dr. Fiaschetti, who practiced for 21 years in the Army before retiring in 2009 and relocating to Rhode Island, where he is in private practice.

Although some parents don’t learn for years that their child has FA, Dr. Fiaschetti and his wife, Mary Ann, knew early on that Peter had the disease. “There are some particular anomalies that Fanconi anemia patients can have, and he was born with hypoplastic thumbs, which led us to consultations with a geneticist and developmentalists,” Dr. Fiaschetti said. “At six months, he was diagnosed with Fanconi anemia.”

Though he is not Peter’s dentist, Dr. Fiaschetti acknowledges that it’s an advantage for his son that he is an expert in the oral cavity.

“Given Peter’s age, I obviously see his oral cavity often. I’m always observing for changes,” Dr. Fiaschetti said. “However, I don’t rely on myself for his screenings. Every six months, Bhuvanesh Singh, M.D., an ENT who specializes in Fanconi anemia, as well as Peter’s general dentist, Dr. James Cavanaugh, are performing the standardized oral cancer examination.”

As a parent of a child with Fanconi anemia, Dr. Fiaschetti obviously stays abreast of new developments toward finding a cure. He works with the Fanconi Anemia Research Fund and he sits on a Congressionally Directed Medical Research Programs peer review panel for bone marrow failure research.

His personal interest, of course, keeps him more attuned to developments in funding and research. But every dentist can potentially play a part in prolonging the life of an FA patient.

Said Dr. Fiaschetti: “As a dentist with an FA patient, you are seeing the patient every six months, if not more often, while providing care. As such, you have the opportunity to observe the oral cavity more often than most health care providers. Early detection and treatment of squamous cell carcinoma is critical for a Fanconi anemia patient.”