Salud Bucodental de los pacientes internados en el centro de atención a discapacitados psíquicos de Albacete / Oro-dental health of residential patients in the care centre for the mentally handicapped in Albacete, Spain

Objetivo. Determinar la prevalencia de patología oral, sobre todo de caries y afectación peridontal, en una población de disminuidos psíquicos ingresados en una institución, así como su relación con la deficiente higiene oral y los fármacos consumidos. Emplazamiento y participantes. 100 personas disminuidas psíquicas internadas en el CADP (Centro de Atención a Discapacitados Psíquicos) de Albacete. Mediciones. Edad, sexo, grado de discapacidad, diagnóstico de base, enfermedades asociadas y capacidad para comunicarse, medicación, tipo de dieta, lugar de tratamiento (consultao quirófano) y datos odontológicos (placa, sarro, caries, CAO, gingivitis, periodontitisu otras).Resultados. La edad media es de 42,9 años, teniendo el paciente más joven 18 años y el mayor 71. En cuanto a la distribución por sexo, 57 son hombres (57%) y 43 son mujeres(43%). El grado de discapacidad mínimo es 70 y el máximo 100, con una media de 91.3.El grupo de pacientes más numeroso son los que están diagnosticados de retraso mental(59%), seguido del síndrome Down (11%), parálisis cerebral (11%), encefalopatía (11%)y autismo (3%). La enfermedad asociada más frecuente es la epilepsía (36%). El 7% delos pacientes no pudo ser explorado. El 60% de los pacientes padece caries, el 63% sufre pérdida de dientes y el 2% presenta obturaciones realizadas. El 8% de los pacientes están desdentados totales. La media de índice CAO es 11,66.Conclusión. Los pacientes estudiados son grandes discapacitados y con altas necesidades odontológicas. El tratamiento dental más utilizado en ellos es la exodoncia dental (AU)

Objective. To determine the prevalence of oral disease, especially caries and periodontal disease in a population of mentally handicapped persons residing in a care centre, and its relationship with inadequate oral hygiene and consumption of medicines. Setting and participants. One hundred mentally handicapped persons residing in the Care Centre for the Mentally Handicapped (CADP) in Albacete, Spain. Measurements. Age, sex, disability level, underlying diagnosis, associated diseases and ability to communicate, medication, diet, treatment site (clinic or surgery) and odontological data (plaque, tartar, caries, DMF index, gingivitis, periodontitis and others).Results. The mean age was 42.9 years, the youngest patient being 18 years old and the eldest71 years old. There were 57 men (57%) and 43 women (43%). The disability level was from 70 to 100 with a mean of 91.3. Most of the patients had been diagnosed as mentally retarded (59%), followed by Down’s syndrome (11%), cerebral palsy (11%), encephalopathy(11%) and autism (3%). The most frequent associated disease was epilepsy (36%). A dental examination could not be performed on 7% of the patients. Sixty percent had caries,63% had missing teeth and 2% had fillings. Eight percent of patients were completely endentulous. The mean DMF index was 11.66.Conclusion. The patients studied were severely handicapped and greatly in need of dental care. Tooth extraction was the most common dental treatment applied to these patients (AU)

Results of a major ambulatory oral surgery program using generalinhalational anesthesia on disabled patients

Objectives: To assess the demographic characteristics and comorbidities of the group to be studied, as well as variousquality indicators of a Major Ambulatory Surgery (MAS) program. Quantification of the surgical-anestheticincidents. Study design: We aimed to perform a retrospective and descriptive analysis of disabled patients who hadreceived oral ambulatory surgery under general anesthesia. Data obtained from the clinical history and telephoneinterview included the demographic characteristics, socioeconomic status, previous dental history, cause of themental disability, degree of mental retardation, comorbidity measured according to the scale of the AmericanSociety of Anesthesiologists (ASA), anesthesia or preoperative surgical treatments, level of analgesia, length ofstay, incidents in the Resuscitation Ward, the rate of substitution, suspensions, patients admitted, complicationsand the degree of patient satisfaction. Results: We included 112 oral surgery procedures performed on disabledpatients who were treated under general inhalational anesthesia as part of MAS during the years 2006-2007. Duringthis period, 577 restorations, 413 extractions, 179 sealants, 102 pulpectomies, 22 root canal treatments, 17gingivectomies and 3 frenectomies were performed. A total of 75% (78 cases) of the patients had coexisting medicalpathology. The average surgery time per patient was 72.69 ±29.78 minutes. The rate of replacement was 100%.The rate of suspension was 1.92%. The percentage of patients readmitted was 1.92%,due to significant bleedingin the mouth, which did not require treatment and the patients were discharged from hospital 24 hours after beingadmitted. The rate of patients who required re-hospitalization was 3.84%. Conclusions: The MAS performed inthis group, despite being on patients with high comorbidity resulted in only a low number of medical incidentsreported (AU)

Results of a major ambulatory oral surgery program using general inhalational anesthesia on disabled patients.

OBJECTIVES: To assess the demographic characteristics and comorbidities of the group to be studied, as well as various quality indicators of a Major Ambulatory Surgery (MAS) program. Quantification of the surgical-anesthetic incidents. STUDY DESIGN: We aimed to perform a retrospective and descriptive analysis of disabled patients who had received oral ambulatory surgery under general anesthesia. Data obtained from the clinical history and telephone interview included the demographic characteristics, socioeconomic status, previous dental history, cause of the mental disability, degree of mental retardation, comorbidity measured according to the scale of the American Society of Anesthesiologists (ASA), anesthesia or preoperative surgical treatments, level of analgesia, length of stay, incidents in the Resuscitation Ward, the rate of substitution, suspensions, patients admitted, complications and the degree of patient satisfaction. RESULTS: We included 112 oral surgery procedures performed on disabled patients who were treated under general inhalational anesthesia as part of MAS during the years 2006-2007. During this period, 577 restorations, 413 extractions, 179 sealants, 102 pulpectomies, 22 root canal treatments, 17 gingivectomies and 3 frenectomies were performed. A total of 75% (78 cases) of the patients had coexisting medical pathology. The average surgery time per patient was 72.69 +/- 29.78 minutes. The rate of replacement was 100%. The rate of suspension was 1.92%. The percentage of patients readmitted was 1.92%,due to significant bleeding in the mouth, which did not require treatment and the patients were discharged from hospital 24 hours after being admitted. The rate of patients who required re-hospitalization was 3.84%. CONCLUSIONS: The MAS performed in this group, despite being on patients with high comorbidity resulted in only a low number of medical incidents reported.

Estudio epidemiológico de Salud Bucodental en pacientes con Parálisis Cerebral / Epidemiological study of dental health in patients with cerebral palsy

Objetivo. Describir el estado de salud bucodental y las intervenciones realizadas en pacientes conparálisis cerebral.Diseño. Estudio observacional descriptivo.Emplazamiento. Unidad de salud buco-dental.Participantes. Se realizó un estudio epidemiológico de salud bucodental en 45 pacientes con parálisiscerebral, tratados en la Unidad de Salud Bucodental de Discapacitados (USBD-D) de Albacete, después de dos años de funcionamiento. Los pacientes proceden de toda la comunidad autónoma de Castilla La Mancha.Mediciones principales. Se registraron datos sociodemográfi cos (sexo, edad, procedencia y tipode convivencia), tipo de dieta, diagnóstico de base, enfermedades asociadas y capacidad para comunicarse,consumo de medicación, lugar de tratamiento (en consulta o en quirófano), datos odontológicos (presencia o no de sarro, gingivitis, periodontitis u otras), tratamiento bucodental realizado y aparición de complicaciones.Resultados. Una parte de ellos (20) fueron tratados en consulta y el resto (25) fueron intervenidos enel quirófano bajo anestesia general. Presentaba sarro el 85 %, gingivitis el 57,8%, periodontitis leveel 11,1%, periodontitis moderada el 2,2% y periodontitis severa el 2,2%. El hábito más frecuente erala respiración oral, presente en el 58%, seguida de bruxismo en el 7% y succión digital en el 2,2%.Fueron realizadas 142 obturaciones de dientes defi nitivos, 1 obturación de dientes temporales, 47sellados, 74 exodoncias, 2 frenectomías y 9 gingivectomías

Objective. To describe the state of dental health and the interventions carried out in patients withcerebral palsy.Design. Descriptive observational study.Setting. Dental Health Unit.Participants. An epidemiological study of dental health was carried out in 45 patients with cerebralpalsy, treated in the Dental Health Unit for the Disabled (USBD-D) of Albacete, in operation for twoyears. The patients were from the entire Autonomous Community of Castilla La Mancha.Main measurements. Sociodemographic data were recorded (sex, age, place of origin and cohabitation),type of diet, initial diagnosis, associated illnesses and ability to communicate, medication taken,place of treatment (clinic or surgery), odontological data (presence or absence of tartar, gingivitis,periodontitis or others), dental treatment carried out and complications.Results. Part of the sample (20 patients) were treated in a clinic and the remaining patients (25) weresurgically intervened under general anaesthetic. A total of 85% had tartar, 57.8% gingivitis, 11.1%mild periodontitis, 2.2% moderate periodontitis and 2.2% severe periodontitis. The most common habit was mouth respiration in 58%, followed by bruxism in 7% and thumb or fi nger sucking in 2.2%.A total of 142 obturations were performed of permanent teeth, 1 obturation of primary teeth, 47 sealings,74 exodontias, 2 phrenectomies and 9 gingivectomies

Evaluación del 1º año de tratamiento bucodental a discapacitados psíquicos en la Unidad de Salud Bucodental de Albacete / Evaluation of the first year of dental treatment in mentally handicapped patients in the Dental Care Unit of Albacete

Objetivo. Describir las características del Programa de Salud Bucodental para Discapacitados psíquicos del SESCAM y mostrar los resultados tras un año de funcionamiento. Diseño. Estudio observacional descriptivo. Emplazamiento. Consultas de Atención Primaria. Participantes. Fueron estudiados 273 pacientes, procedentes de las diferentes Unidades de Salud Bucodental (USBD) que existen en la comunidad autónoma de Castilla-La Mancha. Mediciones principales. Lugar de tratamiento (en consulta o en quirófano), datos sociodemográficos (sexo, edad, procedencia y tipo de convivencia), diagnóstico de base, enfermedades asociadas y capacidad para comunicarse, consumo de medicación, tipo de dieta, datos odontológicos (presencia o no de sarro, gingivitis, periodontitis u otras), tratamiento bucodental realizado y aparición de complicaciones. Resultados. Una parte de ellos (145) fueron tratados en consulta y el resto (125) fueron intervenidos en el quirófano bajo anestesia general. Presentaba sarro el 72,5 %, gingivitis el 49,8%, periodontitis leve el 9,2%, periodontitis moderada el 5,1% y periodontitis severa el 4,8%. El hábito más frecuente era la respiración oral, presente en el 49,5%, seguida de bruxismo en el 5.5%, succión digital en el 1.8% e interposición lingual en el 0.7%. Fueron realizadas 670 obturaciones de dientes definitivos, 41 obturaciones de dientes temporales, 181 sellados, 13 endodoncias, 432 exodoncias, 4 frenectomías y 16 gingivectomías. Conclusiones. Tras un año de trabajo de la USBD-discapacitados, los resultados expuestos confirman la viabilidad del proyecto, suponiendo un aumento importante de las prestaciones sanitarias en materia de salud bucodental, en un colectivo que lo demandaba y lo necesitaba. Por otra parte, se trata de un buen ejemplo de colaboración entre Atención Primaria y Atención Especializada, la cual es fundamental para el buen desarrollo del programa (AU)

Objective. To describe the characteristics of the Dental Health Programme for mentally handicapped of the SESCAM and to present the results after one year. Design. Descriptive observational study. Setting. Primary Care clinics. Participants. A total of 273 patients from different Dental Care Clinics in the Autonomous Community of Castille-La Mancha were studied. Main Measurements. Place of treatment (clinic or surgery), sociodemographic data (gender, age, origin and cohabitation), background diagnosis, associated illnesses and ability to communicate, medication taken, type of diet, odontological data (presence or not of tartar, gingivitis, periodontitis or others), dental treatment carried out and incidence of complications. Results. Some patients (145) were treated in the clinic and the rest (125) underwent surgical intervention in the operating theatre under general anaesthetics. A total of 72.5% had tartar, 49.8% gingivitis, 9.2% mild periodontitis, 5.1% moderate periodontitis and 4.8% severe periodontitis. The most common habit, present in 49.5% was oral respiration, followed by bruxism in 5.5%, finger or thumb sucking in 1.8% and lingual interposition in 0.7%. A total of 670 permanent fillings, 41 fillings of milk teeth, 181 sealants, 13 endodontias, 432 exodontias, 4 phrenectomies and 16 gingivectomies. Conclusions. After one year of work with the USBD-handicapped, the results obtained confirm the feasibility of the project, which implies an important increase in healthcare benefits for dental health in a population group that both required and demanded it. On the other hand, this is also a good example of collaboration between Primary Care and Specialist Healthcare, which is essential for the programme to develop successfully (AU)