Gingivitis in children with down syndrome: Review of local and systemic factors

Objective@#To describe various local and systemic factors as the cause of gingivitis and to find out the main etiological factors of gingivitis in children with DS.@*Methods@#We searched PubMed and Google Scholar for Indonesian and English references either in the form of textbook, research results, reviews, and internet articles on the topic. We screened and selected the relevant articles for inclusion into the review. @*Results@#In children with DS, apart from poor oral hygiene, the increasing incidence of gingivitis is caused by changes in other local factors related to systemic factors, such as oral dysfunction, dental and gingival abnormalities, changes in the oral microbial profile, and salivary characteristics. Furthermore, systemic immunodeficiency, changes in inflammatory mediators and proteolytic enzymes, and intellectual subnormality are considered as systemic factors.@*Conclusion@#There is no main etiological factor of gingivitis in children with DS since various local and systemic factors are interrelated with each other causing gingivitis. The severity of gingivitis in children with DS presumably were caused by the systemic factors. Furthermore, good oral hygiene habits and the dentist's intervention in periodontal health can significantly reduce gingivitis in DS patients.

Henoch-Schönlein Purpura (Childhood Immunoglobulin A Vasculitis) caused by dental infection in one of fraternal twins: A case report

@#Henoch-Schönlein purpura (HSP) is the most common form of vasculitis in children that is clinically characterized by the classic triad of palpable purpura, joint symptoms, and abdominal pain. A 6-year-old girl, one of fraternal twins, was admitted to the Pediatric Department, Universitas Airlangga with fever, rashes on legs and arms and intermittent mild abdominal pain. She had multiple purpuric rashes on her extremities, abdomen and buttocks. Laboratory investigation revealed immunoglobulin A level of 289.6 mg/dL. The patient was diagnosed as HSP vasculitis according to EULAR criteria and treated with intravenous methylprednisolone. She was discharged after three days with normal physical examination and laboratory findings. Intraoral examination showed dental infection in the upper tooth region. The paediatrician suspected a correlation between HSP and her dental infection. The dental infection and genetic susceptibility may be the stimulant factors for the autoimmune reactions that caused HSP vasculitis. Hence, it might be useful to investigate the presence of dental infection in the etiology of HSP cases.

William-Beuren Syndrome: Comprehensive dental care in child patient

@#The most common symptoms of Williams-Beuren syndrome (WBS) are heart defects and unusual facial features. The objective of this case report was to highlight the preparation of comprehensive dental care for this syndrome. A seven-year-old boy came with multiple dental caries as a chief complaint. Parents reported a history of corrected tetralogy of Fallot (ToF) three years ago. The routine medical check-up was carried out annually. Based on the typical signs and symptoms, a diagnosis of William-Beuren Syndrome was made. Comprehensive dental care under general anesthesia on a patient with a history of heart defect and multiple dental caries was the best choice and exhibits a high success rate. Extraction treatment was carried out to avoid the risk of endocarditis infection, restoration to prevent the progressivity of caries, and space maintainers to restore function and aesthetics.

Complete dental management of an Autism and Intellectual disability patient under general anaesthesia: A case report

@#Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and the presence of restricted interests and repetitive behaviours. Comorbidities following ASD, such as seizure, intellectual disability, and sensory impairment worsen patients’ ability to care for themselves. We present the case of a 22-year-old man with autism, intellectual disability and visual impairment who had recurrent pain in his upper and lower left posterior teeth that had cavities. On the first visit, the patient was observed and had panoramic x-ray. Clinical examination could not be done properly due to lack of patient cooperation. Restoration, pulp capping, tooth extraction, and odontectomy were planned under general anaesthesia.

Oral Mucocele and its surgical approach as treatment: Case series

@#A common benign lesion in children’s oral cavity is mucocele on the lower lips that originates from the accumulation of mucous due to local trauma and a lip-biting habit. Lip-biting is often motivated by a psychological condition of anxiety. Mucoceles are painless but can be bothersome for patients when eating and speaking. Mucoceles can affect the general population but are more common among the young. The etiology of oral mucoceles may vary, and surgical treatment is best chosen for its convenience, child-friendliness, and high treatment success rate. Awareness education for children and parents is necessary to eliminate a lip-biting habit. If the pattern persists due to anxiety, it is essential to inquire more about the etiology and consult a professional psychologist.

Parents' behavior related to caries status of children with Down Syndrome in Surabaya

Background@#Down syndrome (DS) is a chromosome disorder due to the presence of all or part of a third copy of chromosome 21 (trisomy 21) caused by a failure in chromosome segregation. Following Riset Kesehatan Dasar (RISKESDAS) in 2013, the number of people with DS in Indonesia increased compared to 2010, with an estimated 924 children with DS in Surabaya. Data regarding caries status in children with DS in Surabaya is limited. @*Objective@#To evaluate parents’ behavior (predisposing, enabling, and reinforcing factors) related to the caries status of children with DS. @*Methods@#This observational analytic cross-sectional study included children aged ≤18 years with DS and parents who were members of the Parents' Association of Children with Down Syndrome (POTADS). Caries status were measured using the DMF-T/def-t score, and parents were asked to fill out a questionnaire. Data were analyzed using Spearman’s correlation test. @*Result@#We included 46 children with DS in this study. The DMF-t / def-t index of children with DS (7.2) was categorized as very high according to WHO. There was a significant relationship between lack of knowledge of parents and caries status in children with DS. Enabling factors and reinforcing factors were not significantly correlated with caries status. @*Conclusion@#Parents' behavior is correlated with the caries status of children with DS. All combination of three factors behavior, including predisposing, enabling and reinforcing, are needed to reduce the number of caries in children with DS.

Bohn’s nodule: A rare case in a 7-month-old male infant

@#Bohn’s nodule is a soft white cyst filled with keratin and is often found in a newborn's oral cavity. This case has a high prevalence in newborns and is rarely seen in infants after three months. In this case, we report our observation and evaluation of a Bohn’s nodule case in a seven-month-old male infant. Clinical diagnosis of the conditions is vital to avoid unnecessary therapeutic procedures and provide timely information for parents to manage the lesion.

Orthodontics treatment strategy and management in a child with attention deficit hyperactivity disorder

@#This is a case of an 8-year-old male patient diagnosed with class 1 angle malocclusion, 9 mm overjet and 4.5 mm overbite, with thumb-sucking habit. The patient also has attention deficit hyperactivity disorder (ADHD). The goal of this study is to identify and determine appropriate orthodontics treatment management for patients with ADHD. Management behavior using behavioral shaping and tell-show-do technique during orthodontic treatment in patients with special needs contributes to how well the patient will cooperate with the dentists during treatment.

Correlation between mother's behavior with periodontal status and periodontal treatment needs in children with autism

Background@#Autism is a neurological and developmental disorder. Children with autism have problems related to physical, psychological, and mental barriers that can hinder their ability to achieve optimal dental health status. Maintaining the dental health of children with autism is influenced by parents' teaching skills and habits. From previous study, there were about 17.4% children with autism in Saudi Arabia suffering from bleeding of the gingiva. Periodontal disease is often found in children with autism.@*Objective@#This study analyzes the relationship between mother’s behavior with periodontal status and periodontal treatment needs of children with autism.@*Methods@#Analytical observational study with cross-sectional approach at AGCA Centre Surabaya with a total sample of 34 pairs of children with autism and their mothers. This study used the HU-DBI questionnaire which consisted of knowledge, attitude, and mother’s action and oral examination of children with autism with the CPITN index.@*Results@#Of the children with autism, 55.8% had healthy periodontal status. The knowledge, attitudes, and actions of mothers were high. Statistical results with Spearmen correlation test obtained a value of p>0.05 on aspects of knowledge, attitudes, and actions towards the CPITN index and periodontal treatment needs.@*Conclusion@#There was no significant correlation between the mother’s behavior and the periodontal status and periodontal treatment needs of children with autism in managing their oral health.