Responsiveness of the B-ECOHIS to detect changes in OHRQoL following dental treatment of children with autism spectrum disorder

Abstract The Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS) is an oral health-related quality of life (OHRQoL) questionnaire. This paper aims to investigate the responsiveness of the B-ECOHIS to dental treatment in individuals diagnosed with autism spectrum disorder (ASD) and determine if dental treatment has an impact on OHRQoL. The survey targeted 27 ASD individuals aged 4 to 14 years attending the Acolher Project of the University Federal Fluminense. This project provides children and adolescents with disabilities with oral health services. A group of randomly selected caregivers self-completed the B-ECOHIS before and 14 days after their children's dental treatment. The dental treatment included meticulous screening, preventive treatment, and restorative treatment. Responsiveness was assessed by investigating the effect size (ES) and standardized response mean (SRM). Wilcoxon test was used to evaluate internal responsiveness (distribution-based approach). The B-ECOHIS showed significant changes in the total score (p<0.001) and in all domains. The ES of the total B-ECOHIS after treatment was 1.28 and ranged between 0.70 and 1.14 for the domains. The SRM for each of the domains was large, except for the symptom domain. The B-ECOHIS is sensitive and responsive to ASD individuals undergoing dental treatment. Individuals with ASD showed improvement in their OHRQoL score after dental treatment.

Parental perceptions of oral health-related quality of life of brazilian children and adolescents with autism spectrum disorder / Percepção dos responsáveis da qualidade de vida relacionada à saúde oral de crianças e adolescentes brasileiros com transtorno do espectro do autista

Objective: This paper aimed to assess the oral health related quality of life (OHRQoL) of children and adolescents with autism spectrum disorder (ASD) using the parental/caregiver perceptions questionnaire (PCPQ). Material and methods: Children aged 2 to 14 years, enrolled in the ACOLHER/PNE project at the Fluminense Federal University, RJ, Brazil, were assessed. The main independent variable was dental caries experience, diagnosed according to the World Health Organization (WHO) criteria. The variable was categorized as caries-free when dmft / DMFT= 0 and caries experience when dmft/DMFT ≥ 1. Caregiver schooling, age, sex, and socioeconomic factors (Brazilian minimum wage ­ BMW) were the other independent variables. Quality of life (QoL) was measured using PCPQ subscales and total score. Mann-Whitney U, Kruskal-Wallis, and multivariate Poisson regression correlation analysis were performed. Results: The median age of patients was 8 (SD= 3.76). The study group consisted of 57 (76.0%) males and 18 (24.0%) females. Fifty parents (66.7%) have more than eight years of education and 35 (46.7%) earn less than 2 BWM. The impact values were significantly higher in male individuals in the oral symptoms (OS) domain and in individuals without caries experience in the social well-being (SW) domain (p < 0.05). Conclusions: these results seem to suggest that individuals with ADS without caries experience in permanent dentitions in the SW domain and males in the OS domain had a higher impact quality of life. (AU)

Objetivo: Este artigo teve como objetivo avaliar a qualidade de vida relacionada à saúde bucal (OHRQoL) de crianças e adolescentes com transtorno do espectro do autista (TEA), utilizando o questionário de percepção dos pais / cuidadores (PCPQ). Material e métodos: Foram avaliadas crianças de 2 a 14 anos matriculadas no projeto ACOLHER / PNE da Universidade Federal Fluminense, RJ, Brasil. A principal variável independente foi a experiência de cárie dentária, diagnosticada de acordo com os critérios da Organização Mundial da Saúde (OMS). A variável foi categorizada como livre de cárie quando dmft / DMFT = 0 e experiência de cárie quando dmft / CPOD ≥ 1. Escolaridade do cuidador, idade, sexo e fatores socioeconômicos (salário mínimo brasileiro - BMW) foram as outras variáveis independentes. A qualidade de vida (QV) foi mensurada usando as subescalas PCPQ e o escore total. Foram realizadas análises de correlação de regressão de Mann-Whitney U, Kruskal-Wallis e multivariada de Poisson. Resultados: A idade média dos pacientes foi de 8 anos (DP = 3,76). O grupo de estudo foi composto por 57 (76,0%) homens e 18 (24,0%) mulheres. Cinquenta pais (66,7%) têm mais de oito anos de escolaridade e 35 (46,7%) ganham menos de 2 MBM. Os valores de impacto foram significativamente maiores em indivíduos do sexo masculino no domínio de sintomas orais (OS) e em indivíduos sem experiência de cárie no domínio do bem-estar social (SW) (p <0,05). Conclusões: esses resultados parecem sugerir que indivíduos com ADS sem experiência de cárie em dentição permanente no domínio SW e homens no domínio OS tiveram maior impacto na qualidade de vida.(AU)

Oral conditions of pediatric patients with Williams-Beuren syndrome: two case reports / Condição Oral de paciente infantil com Síndrome de Williams-Beuren: dois casos clínicos

Objective: The objective of this paper was to describe the oral conditions of two children accompanied by their mothers who reported to the Department of Pediatric Dentistry of Fluminense Federal University with Williams-Beuren syndrome (WBS). Case report: The 9-year-old female patient had a family and medical history significant for placental abruption, caesarean section, delayed psychomotor development, learning disabilities, tendency to selfdistract and congenital heart disease. In contrast, the 7-year-old male patient had a normal birth and no gestational intercurrences. Discussion: Clinically, the female presented with mixed dentition, crowding in the maxillary and mandibular arches, prolonged retention of deciduous teeth, anterior and posterior cross-bite and Angle Class I malocclusion, while the male had mixed dentition and retarded psychomotor development. Due to the patients having congenital heart disease, a prophylactic antibiotic regimen was prescribed prior to the dental procedures in both of them. Conclusion: These patients had been followed up for 2 years and this case report underscores the importance of early dental evaluation and counselling for parents of WBS patients (AU)

Objetivo: O objetivo deste trabalho foi descrever as condições bucais de duas crianças acompanhadas por suas mães que relataram ao Departamento de Odontopediatria da Universidade Federal Fluminense com síndrome de Williams-Beuren (SWB). Caso clínico: Paciente do sexo feminino, 9 anos de idade, tinha história familiar de descolamento prematuro da placenta, cesariana, atraso no desenvolvimento psicomotor, dificuldades de aprendizado, tendência a auto-distribuição e cardiopatia congênita. Em contraste, o paciente de 7 anos de idade teve um parto normal e sem intercorrências gestacionais. Discussão: Clinicamente, a menina apresentava dentição mista, apinhamento nos arcos maxilar e mandibular, retenção prolongada dos dentes decíduos, mordida cruzada anterior e posterior e má oclusão de Classe I de Angle, enquanto o menino apresentava dentição mista e desenvolvimento psicomotor retardado. Devido à doença cardíaca congênita, um regime profilático de antibiótico foi prescrito antes dos procedimentos odontológicos em ambos. Conclusão: Esses pacientes foram acompanhados por dois anos e este relato de caso ressalta a importância da avaliação odontológica precoce e do aconselhamento para pais de pacientes com SWB. (AU)

Ectodermal Dysplasia in child: multidisciplinary management / Displasia Ectodérmica em criança: manejo multidisciplinar

Ectodermal Dysplasia (ED) represents a group of hereditary conditions in which anatomical structures derived from the ectoderm show defects in its development. It is observed aplasia or hypoplasia of the tissues, among them the changes of dental relevance, as the anomalies regarding the number and morphology of the teeth. Due to the particularity of the cases, the dental surgeon must adapt the operative techniques and the choice of dental materials to each individual, according to the perceived need and condition. The objective of the present study is to report the clinical case of a 10 - year old male patient with ectodermal dysplasia who was attended in the discipline of Patients with Special Needs of Dentistry of the Federal University of Fluminense and its multidisciplinary aspects. (AU)

A Displasia Ectodérmica (DE) representa um grupo de condições hereditárias em que estruturas anatômicas derivadas do ectoderma apresentam defeitos em seu desenvolvimento. Observa-se aplasia ou hipoplasia dos tecidos, dentre eles as alterações de relevância dentária, como as anomalias quanto ao número e morfologia dos dentes. Devido à particularidade dos casos, o cirurgião-dentista deve adaptar as técnicas operatórias e a escolha dos materiais dentários a cada indivíduo, de acordo com a necessidade e condição percebida. O objetivo do presente estudo é relatar o caso clínico de um paciente do sexo masculino, de 10 anos de idade, portador de displasia ectodérmica, atendido na disciplina de Portadores de Necessidades Especiais de Odontologia da Universidade Federal Fluminense e seus aspectos multidisciplinares (AU)

Individuals with special needs and their families' oral health-related quality of life

Abstract To evaluate the impact of dental caries among Brazilian individuals with special health care needs (SHCN) on their families' oral health-related quality of life (OHRQoL). A cross-sectional study was carried out with a population-based sample of 227 subjects who were enrolled from the ACOLHER-PNE project conducted at the Fluminense Federal University. Parents/caregivers answered the Brazilian version of the 14-item Family Impact Scale (B-FIS) to assess the impact on family's quality of life (QoL). The main independent variable was dental caries experience, diagnosed according to the World Health Organization (WHO) criteria. The DMFT/dmft score was categorized into 0 = caries free; 1-2 = low; 3-4 = moderate; and ≥ 5 = high experience. Mother's schooling, age, sex, SHCN conditions, and socioeconomic factors were the other independent variables. QoL was measured through FIS domains and total score. Statistical analyses was performed using the Kruskal Wallis and Mann Whitney U tests and Poisson regression (p<0.05). The impact values observed in moderate and high caries experience were significantly higher than those found in subjects without caries and low level of parental emotions. Parents' years of schooling showed more impact on total score and on parental emotions. Older subjects showed significantly higher impact on total score and in all domains. The multivariate model demonstrated that families of older subjects (> 8 years old) experience a higher impact level compared to younger subjects (PR: 2.43; 95%CI: 1.80-3.29, p = 0.001). High caries experience and other socioeconomic factors were not associated with a greater negative impact on parents' QoL.

Displasia ectodérmica: relato de caso de reabilitação estético-funcional / Ectodermal dysplasia: case report of aesthetic and functional rehabilitation

Objetivo: Relatar o caso de reabilitação estéticoprotética de um paciente do gênero masculino com 6 anos de idade diagnosticado com Displasia Ectodérmica Hipohidrótica, atendido na clínica de pacientes especiais realizada no projeto de extensão da Universidade Federal Fluminense. Métodos: Trata-se de um estudo observacional, descritivo onde o tratamento restaurador e reabilitador foi realizado e retratado correspondendo às necessidades estéticas e funcionais do paciente. Resultados: Realizou-se reanatomização dos elementos 51 e 61 e confecção de prótese removível para suprir as ausências dos elementos 71, 72, 74, 81 e 82, propiciando função, estética e satisfação relatada pelo paciente. Conclusão: Este relato de caso contribuiu para o aumento de conhecimento acerca das formas de Displasia Ectodérmica, sobre a importância do diagnóstico diferencial das mesmas, bem como para o ensino dos alunos de graduação do projeto de extensão. (AU)

Objective: The aim of this study is to report a case of esthetic and prosthetic rehabilitation of a male 6-yearold patient diagnosed with Hypohidrotic Ectodermal Dysplasia, assisted at the clinicsfor individual withspecial needs held in the extension project of the Federal Fluminense University. Methods: This is a clinical, observational and descriptive study where the restorative and rehabilitative treatment was conducted and reported corresponding to the functional and esthetic needs of the patient. Results: The anatomical shape of teeth 51 and 61 was reconstructed and a partial removable prosthesis was made to cover the absence of teeth 71, 72, 74, 81 and 82, offering function, esthetics and satisfaction, as reported by the patient. Conclusion: This case contributed to increase the knowledge about the types of Ectodermal Dysplasia, the importance of differential diagnosis, as well as teaching of undergraduate students in the extension project. (AU)

Profile of special needs patients assisted in a dental project / Perfil dos pacientes com necessidades especiais atendidos no projeto da Odontologia

Objetivo: O objetivo deste trabalho foi traçar o perfil dos pacientes com necessidades especiais que procuraram atendimento na Faculdade de Odontologia da Universidade Federal Fluminense (FO-UFF). Material e Métodos: Foram avaliados os prontuários de 17 pacientes que procuraram atendimento no período da pesquisa. As variáveis analisadas foram: sexo, idade, motivo da consulta, o uso contínuo de drogas psicotrópicas, condição socioeconômica, consumo de açúcar, frequência de escovação, oclusão dentária atendimento odontológico e duração do tratamento. Todos os pacientes foram atendidos por duas alunas de graduação ligados ao projeto, sob supervisão. Resultados: A idade média dos pacientes foi de 9,65 anos e o sexo masculino foi o mais prevalente (52,94%). Os indivíduos com deficiência mental e síndrome de Down foram os que mais procuram por atendimento (35,3%) e a dor (cárie) foi apontada como o maior motivo para procura do atendimento (58,82%). A média de ceo foi de 2,4 (±1,4) e CPOD de 0,9 (±7,07) entre os pacientes e o tratamento restaurador foi realizado em 25% dos pacientes. Conclusões: Em conclusão, a maior demanda foi por procedimentos curativos e não preventivos e que a prevalência de cárie é elevada neste grupo de pacientes

ABSTRACT Objective: The aim of this paper was to outline the profile of patients with special needs who sought treatment at School of Dentistry, Universidade Federal Fluminense (FO-UFF). Material and Methods: We evaluated the charts of 17 patients who sought care during the survey period. The variables were gender, age, reason for consultation, continuous use of psychotropic drugs, socioeconomic status, consumption of sugar, toothbrushing frequency, dental occlusion dental care and length of treatment. All patients were treated by two undergraduate students linked to the project under supervision. Results: The mean age of the patients was 9.65 years old and males were the most prevalent (52.94%). Individuals with mental retardation and Down´s syndrome were the predominant group seeking dental care (35,3%) and pain was cited as the main reason (58,82%). The average dmft 0.9 (±1,4) and DMFT was 3.29 (±7,07) among patients and restorative treatment was provided for 25% of the patients. Conclusions: In conclusion the greatest demand was for curative and not preventive procedures and that the prevalence of caries is high in this group of patients.