Evaluation of oral diseases in a population of special needs patients / Avaliação das doenças orais em uma população de pacientes com necessidades especiais

Objective: To evaluate the oral health status of a population of patients with special needs cared for in the specialization course of the Brazilian Association of Dentistry, Ceará Branch. Methods: In this cross-sectional, descriptive study the indexes DMFT and CPI were used to evaluate dental caries and periodontal disease, respectively, from August 2009 through March 2010. The need for dental treatment and other soft tissue lesions were also investigated. Results: 88 patients selected by convenience sampling were examined intraorally, and the mean age was 43.8 ± 16. Most of the patients fell within the group of systemic diseases (68.1%), especially cardiovascular diseases (15.9%). The mean DMFT index was 17.54 ± 7.13, and 87.5% of patients presented active dental caries. According to the highest degree of periodontal condition observed in the individual, the dental tartar (index 2) was present in a greater number of patients (50.9%). Regarding the need for dental treatment, 68.1% of patients needed restorative treatment, 43.1% of patients needed surgery (extractions) and 21.5% of patients needed endodontic treatment. There were no soft-tissue abnormalities in most patients (89.7%). Conclusion: The examined patients showed a high prevalence of oral diseases such as dental caries and gingivitis/periodontitis, and therefore a great need for dental treatment. Given the results, it becomes important to stimulate dental care and preventive practices focused on this segment of the population.

Objetivo: Avaliar a condição de saúde bucal de uma população de pacientes com necessidades especiais atendida no curso de especialização da Associação Brasileira de Odontologia, Seção Ceará.Métodos: Nesse estudo de natureza descritiva e transversal utilizou-se os índices CPO-D e IPC para avaliação das doenças cárie e periodontal, respectivamente, entre os meses de Agosto de 2009 e Março de 2010. Necessidades de tratamento dentário e outras lesões em tecidos moles orais também foram investigadas. Resultados: Realizaram-se exames bucais em 88 pacientes selecionados por conveniência, sendo a média de idade correspondente a 43,8 ± 16 anos. A maioria se enquadrava no grupo de doenças sistêmicas (68,1%), destacando-se as diseases cardiovasculares (15,9%). O índice CPO-D médio foi 17,54 ± 7,13, com 87,5% dos pacientes apresentando cárie ativa. Segundo o maior grau de condição periodontal observado no indivíduo, o cálculo dental (índice 2) foi o que esteve presente em um maior número de pacientes (50,9%). Quanto às necessidades de tratamento dental, 68,1% deles necessitaram de tratamento restaurador, 43,1% de tratamento cirúrgico (exodontias) e 21,5% de tratamento endodôntico. Não foram encontradas anormalidades em tecido mole na maioria dos pacientes (89,7%). Conclusão: Os pacientes examinados possuíam alta prevalência de doenças orais, como cárie e gengivite/periodontite e, conseqüentemente, grande necessidade de tratamento odontológico. Diante dos resultados, torna-se importante motivar a atenção odontológica e as práticas preventivas voltadas para essa parcela da população.

Therapeutic Factors in the Long-Term Outpatient Group Psychotherapy with the Chronically Mentally Ill / 신경정신의학

OBJECTIVES: The long-term outpatient group psychotherapy with the chronically ill is an effective, expedient therapeutic modality that makes patients maintain medication and improve their symptoms, helps patients resolve emotional conflict, and corrects their maladaptive interpersonal relationship. Therefore, we performed weekly the semi-opened, heterogeneous, long-term(open-ended), outpatient group psychotherapy to be applicable effectively for the chronically ill. The objectives of this study are as follows; first, we introduce therapeutic principles and management methods of the group psychotherapy to be applicable in the clinical environment with the chronically ill; second, we examine the therapeutic factors in each group development stage which are helped by participants, and analyze the characteristics showed in the process of study; third, we verify the appropriateness and the validity of this group psychotherapy and then establish the base of the effective long-term outpatient therapy for the chronically ill that will be settled down as a applicable treatment modality economically and efficiently in the present medical environment of Korea. METHODS: This study was performed in the subject of the chronically ill who attended at the day care program of Community Mental Health Center in Hanam city from January 1998 to June 1999. The participants were 27 patients, but we dropped 7 patients who attended under 6 months because of long-term group. So the last subjects were 20 patients (12 males and 8 females) who attended for 18 months. The 13 therapeutic factors scale was filled out by participants just after each session and the self-report total assessment questionnaire was performed at the time of study-termination and patient-termiation. RESULTS: The ranks of 13 therapeutic factors scale are as follows: in the forming stage, the upper ranks of therapeutic factors were existential factor, guidance of therapists, instillation of hope, altruism, and catharsis in order. And in the storming stage, the upper ranks of therapeutic factors were existential factor, instillation of hope, guidance of therapists, catharsis, and group cohesiveness in order. Lastly in the norming stage, the upper ranks of therapeutic factors were existential factor, altruism, corrective recapitulation, interpersonal learning, and catharsis in order. According to the total assessment questionnaire about group psychotherapy reported by the participants 90% of them were helped, 80% of them had an idea to recommend this program to other patients actively, and 75% of them had an opinion to attend again this program if given for them. And they evaluated positively about the structure of this program and the therapist. CONCLUSIONS: The long-term outpatient group psychotherapy would be applicable effectively to the chronically ill as a economic, efficient therapeutic modality for rehabilitation. It is much more effective for therapist to perceive in detail the therapeutic factors in each group develop-ment stage when he perfoms the group psychotherapy.