Charting Pediatrics – Details, episodes & analysis

From playground falls to sports injuries, oral trauma is part of growing up. But when a tooth gets chipped, knocked out or a lip is cut, it can be stressful for families and challenging for providers. In this episode, we take a closer look at pediatric dental and oral trauma from the primary care perspective. We are focusing on what to look for, when to act and how to guide families through those anxious first moments after an injury.

This episode was recorded on the exhibit floor at the 2025 American Academy of Pediatrics Conference in Denver, Colorado. Joining us is Erica Brecher, DMD. She is a pediatric dentist with Duke Street Pediatric Dentistry and is on staff at Duke Children's Hospital. She is also an adjunct professor at the University of North Carolina School of Dentistry.

Some highlights from this episode include: 

• Most common oral and dental traumas in kids 
• How outcomes differ from baby teeth to permanent teeth 
• What steps a pediatrician can take to save a tooth 
• Why a strong partnership between the pediatric and dental home can improve outcomes 

To access the dental trauma guide mentioned in this episode, click here. To access the app "Tooth SOS" click here. For more information on Children's Colorado, visit: childrenscolorado.org. 

Groin bulges, scrotal swelling, and nonpalpable testes are findings that often surface during routine well-child exams, and they can raise immediate questions for pediatricians and families alike. Is this normal? Will it resolve on its own? Or does it require surgical referral? In this episode, we take a closer look at three common genitourinary conditions in children: inguinal hernias, hydroceles, and undescended testes. We diagnose the details to help clarify the evaluation process, management strategies, and referral guidelines that every pediatrician should know. 

This episode was recorded on the exhibit floor at the 2025 American Academy of Pediatrics Conference in Denver, Colorado. Joining us is Eric Bortnick, MD. He is a Urologist and Assistant Professor of Urology at the Yale School of Medicine.  

Some highlights from this episode include: 

• How common these conditions are in the pediatric population 
• When pediatricians can make a difference in these patients lives, versus when referral is really necessary. 
• Key takeaways to performing a successful physical exam 
• Creating a safe space for proper diagnosis 

For more information on Children's Colorado, visit: childrenscolorado.org. 

For kids with eczema the discomfort of dry patches, constant itching and sleepless nights, can be relentless. For their parents, the search for answers is as well. In this episode, we're scratching beneath the surface of one of the most common skin conditions in pediatrics. We'll explore how to spot triggers, calm flare-ups, choose the right treatments and know when it's time to call in a dermatologist. Whether it's helping a toddler stop scratching or giving a teen the confidence to ditch the long sleeves, we're here to equip pediatricians with the tools to help their patients find relief and reclaim their skin.

For this episode, we are joined by Emily Gurnee, MD. She is a Dermatologist at Children's Hospital Colorado as well as an Assistant Professor at the University of Colorado School of Medicine. 

Some highlights from this episode include: 

• The most up-to-date information with eczema 
• Medication versus other remedies  
• How to provide care that fits into a family's routine
• Best ways PCPs can support kids with eczema  

For more information on Children's Colorado, visit: childrenscolorado.org. 

Vaccines are so successful that many people have never seen the diseases they prevent, resulting in misperceptions that vaccines are not needed. While anti-vaccination sentiment and misinformation increased during the COVID-19 pandemic, about 88% of Americans still say they feel the overall benefits of childhood vaccines outweigh the risks. Communicating vaccine science to the public is even more crucial than in times past. It's up to our doctors and medical experts to relay factual information that is backed by science and supported by research. Without receiving proper vaccinations, preventable diseases will keep recurring.

In today's episode, we are joined by Paul Offit, MD, whose path toward infectious disease prevention started at the young age of 5 when a failed foot operation landed him in a hospital in suburban Baltimore for nearly six weeks. "If you're in a chronic care facility in the mid 1950s, because I was born in 1951, you're in a polio ward. So, I remember that," Dr. Offit says.

Now Dr. Offit is a professor of vaccinology at the Perelman School of Medicine at the University of Pennsylvania. He is an attending physician in the division of infectious diseases at Children's Hospital of Philadelphia, as well as the director of the Vaccine Education Center. "I think the scars of our childhood invariably become the passions of our adulthood. I think it's the reason I became a doctor, I think it's the reason my first book was about polio and the polio vaccine, I think it's why I went into infectious diseases," Dr. Offit says.

This episode was recorded at the 2023 American Academy of Pediatrics National Conference and Exhibition in Washington, DC. Some highlights from the episode include: 

• Reasons why people have become so hesitant about vaccines
• Some of the biggest misconceptions and stigmas around vaccine science
• Why we need more societal trust in vaccines
• The role of mRNA
• How we can use communication to better our future

For more information on Children's Colorado, visit: childrenscolorado.org  

For most of our careers, our treatments for genetic -based diseases have been supportive, not curative. Our medication recommendations for patients have been based on the expected response of the average individual, but as experts explain, these practices are going to change fast. We are on the cusp of a revolution for two main reasons. First, the ability to understand one's unique genetic profile through genetic sequencing has become more accessible to clinical teams. Second, there are now mechanisms for manipulating one's genetic code to overcome diseases. So what does this mean we can expect over the next decade? Scott Demarest, MD, shares his experience in precision medicine and what that foreshadows for treatments to come. "This is sort of the most extreme version of personalized care that you can imagine and it was something that redefined what we think of as possible within medicine," Dr. Demarest says.

Dr. Demarest is an associate professor of pediatric neurology at the University of Colorado School of Medicine and the clinical director of the Precision Medicine Program at Children's Hospital Colorado. He's a perfect expert for this topic, as his research has focused on the characterization of clinical features and clinical trial design for disease -modifying treatments, as well as the development of novel precision therapies for epilepsy and neurogenetic conditions. "I think it's really important that we embrace the genomic era but that we do it very carefully and responsibly," Demarest says.

Some highlights from this episode include: 

• Explanation of precision medicine
• What types of treatments have evolved over time that allow us to manipulate someone's genetic code
• Current barriers to more regular use of precision medicine
• How ethics play a role in this specified type of medicine
• Experience designing a treatment for one individual patient

 For more information on Children's Colorado, visit: childrenscolorado.org    

Our medical community stretches far and wide, with experts that wear many hats. One prevalent group making an impact on the future of childhood medicine is our pediatric trainees. In 1989, the American Academy of Pediatrics (AAP) founded the Section on Pediatric Trainees with a goal to empower and enable pediatric trainees to be strong leaders and advocates for the health and well-being of children. This group aims to be the central source of information, education, and networking for their peers. With over 16,000 members to date, medical students, residents, and fellowship trainees are learning to make a difference in the lives of each child they work with. We recorded this episode at the 2023 AAP National Conference and Exhibition, which couldn't have served as a more perfect place to discuss this topic. "For the medical students listening out there, if you have any interest or if you think you know what specialty you're interested in, just going to these conferences and getting plugged in with these organizations really opens your eyes to a lot of networking opportunities," Amundam Mancho, MD, MPH, says.

Today we are joined by Dr. Mancho, a resident physician at Boston Children's Hospital and Boston Medical Center. She also leads the Section on Pediatric Trainees as the executive coordinator on equity, diversity, and inclusion, or DEI. DEI work is central to her advocacy, and she hopes to expand opportunities for other students making their way through their medical education. "We want trainees to feel like even though that representative isn't necessarily there, that people feel empowered they feel culturally competent and also have that understanding to recognize differences that our patients bring to the space," Dr. Mancho says.

Some highlights from this episode include:  

• How DEI plays a role within the Section on Pediatric Trainees 
• Exposing medical students and residents to advocacy opportunities within pediatrics 
• The benefits organizations like AAP can provide for medical students

  For more information on Children's Colorado, visit: childrenscolorado.org   

Respiratory Syncytial Virus (RSV) is one of the most common causes of childhood respiratory illness, resulting in annual outbreaks among all age groups. In the United States, an estimated 60,000 to 80,000 children, the majority of whom are under 6 months of age, are hospitalized each year. Approximately 100 to 300 kids die from this infection each year. RSV is the single most common cause of death from respiratory illness, after the newborn period, in developing countries. This year, the medical community has made history with the first RSV vaccine approvals for pregnant individuals, infants and the elderly. In this episode, we are taking a deep dive into RSVpref, which is the first RSV vaccine for use in pregnant individuals to protect newborns and infants from severe RSV in the first six months. We are also discussing nirsevimab, a monoclonal antibody, which protects infants and some children against RSV. That includes children 8 –19 at increased risk for severe disease. This is a significant milestone for the scientific community and for public health. "I think now, in another two or three years, we will decrease ER visits, we will decrease hospital visits and I hope we decrease ICU visits. And the next phase of course, hopefully in my lifetime, we get it into developing countries and see impacts on mortality," Eric Simoes, MD, says.

Dr. Simoes has been a part of the creation of these vaccines since the beginning and is our guest for this highly requested topic. He is a clinical professor of pediatrics and infectious disease at the University of Colorado School of Medicine, as well as a professor of epidemiology at the Colorado School of Public Health. He is currently an active clinical infectious disease physician at Children's Hospital Colorado. Of important note, Dr. Simoes served as the global primary investigator for the RSVpreF and lead investigator for the development of nirsevimab.

Some highlights from this episode include: 

• How these vaccines received approval and became available on market 
• Indications to delivering this vaccine to a pregnant person 
• Benefits of receiving these vaccines
• The future of this vaccine and its impact on people of different ages   

For more information on Children's Colorado, visit: childrenscolorado.org 

The preteen and teenage years are taxing and have become increasingly difficult for a multitude of reasons. This is a part of the patient population that pediatricians really worry about. Part of the angst of this time of life has always been the changes that occur to kids' bodies as they grow – particularly for young girls. This experience is different as they experience menarche, the onset of menstruation, which can be both psychologically and physically challenging. Menstrual irregularities are very common, occurring in an estimated 14% to 25% of all women of childbearing age. Many gynecologic conditions diagnosed during childhood require treatment that extends into adulthood and it's hard to stay abreast of all the new therapies and hormonal management strategies of menstruation. "When you can really connect with a teen who is so vulnerable so has just been struggling that recognizes that this is normal, that they are not alone, and that we can help, that's pretty great," Tricia Huguelet, MD, says.

Today we are joined Dr. Huguelet, a pediatric and adolescent gynecologist at Children's Hospital Colorado. While she didn't always plan for this career route, she developed a love for pediatrics from an early age. She fondly reflects on her memories going on rounds with her father who was a pediatrician focusing on pediatric infectious disease. Combining her love for children with her passion for surgery, she has become the section chief of pediatric and adolescent gynecology at Children's Colorado, as well as a faculty member in the OBGYN department at the University of Colorado School of Medicine. "When I discovered that not only could I do reproductive care for women but then specifically focus in kids and teens it was a no brainer that that was where I was going to focus my time," Dr. Huguelet says.

Dr. Huguelet explains how menstrual abnormalities are not just physically demanding, but can create a strain on mental health. "I mean I've had patients with bleeding disorders who we send letters to school and they still aren't excused. So just the embarrassment over that and day to day life when you don't want to talk about it, you certainly don't want to show it, has a tremendously negative impact," Dr. Huguelet says.

Some highlights from this episode include:  

• Most common menstrual abnormalities in children
• How to normalize these conversations between kids and parents
• Management and treatment of these abnormalities
• Mental health impacts from menstruation abnormalities

  For more information on Children's Colorado, visit: childrenscolorado.org   

We live in a country where medical experts are breaking barriers and changing outcomes on a daily basis, so it's always exciting when we get to celebrate one of our own. Recorded at the 2023 American Academy of Pediatrics (AAP) National Conference and Exhibition in Washington, D.C., this episode honors David Keller, MD, who was recently named the recipient of the 2023 AAP Job Lewis Smith Award. "I want to be a part of the solution to problems," Dr. Keller says.  

The award recognizes lifelong outstanding career achievement in community pediatrics and is the highest award bestowed by the council. Dr. Keller has dedicated more than 40 years to advancing child health and he currently serves as the Department of Pediatrics Vice Chair of Clinical Strategy and Transformation at Children's Hospital Colorado. "We as pediatricians need to remember that children always live in context. There is no such thing as an isolated child. They live in the context of their families, but they also live in the context of their communities. If we don't understand the communities that our kids live in, then it's really challenging to understand how illness interacts with that community and how you can intervene," Dr. Keller says. 

Some highlights from this episode include:  

• Dr. Keller's early career influences
• How he earned this prestigious award 
• How we learn more about the context of our patients 
• Advice for young doctors and medical professionals trying to make their own imprint 

For more information on Children's Colorado, visit: childrenscolorado.org   

In the United States, 77% of vector-borne diseases are transmitted by ticks and numbers have increased dramatically in recent decades. While Lyme disease may be the most common in the country, with an estimated 475,000 new cases each year, there are many other vector-borne diseases affecting people every day. Information is constantly shifting related to current and predicted changes in the epidemiology of tick-borne diseases, age -specific clinical and laboratory manifestations, as well as treatment. In addition, there are many public misconceptions regarding vector-borne infections and approaches to infection. What is the risk of labeling someone as having Lyme disease and possibly missing the true diagnosis? We answer that question and many more on today's episode. "When we think about tick-borne infections, I always like to focus on the tick, the organism that it transmits to and then on the disease process," Lourdes Eguiguren, MD says. 

This episode was recoded at the 2023 American Academy of Pediatrics National Conference and Exhibition in Washington, D.C., which provided us an opportunity to speak with experts in- person from across the country. As an infectious disease expert with a focus on tick-borne infection at Children's Nebraska, Dr. Eguiguren is here to share her knowledge. She is an assistant professor in the division of infectious diseases at the University of Nebraska Medical Center. She has a passion for teaching trainees and connecting with her patients on a personal level. "Many times, we actually come up with a differential diagnosis or even the final diagnosis by talking to parents", Dr. Eguiguren says.  

Some highlights from this episode include: 

• Key details about Lyme disease 
• How disease is transmitted from tick to organism 
• The impact of climate change on the prevalence of ticks 
• Breaking down misconceptions about vector-borne infections 
• What treatment options look like   

For more information on Children's Colorado, visit: childrenscolorado.org