Enfermedades bucales en pacientes especiales menores de 15 años. Sancti Spíritus. 2016 / Oral diseases presented in special needs patients younger than 15 years. Sancti Spiritus. 2016

RESUMEN Fundamento: Las enfermedades bucales son frecuentes en los pacientes especiales y las enfermedades sistémicas que presentan dificultan la atención en la consulta de estomatología. Objetivo: Describir el estado de salud bucal de un grupo de pacientes especiales menores de 15 años de Sancti Spíritus. Metodología: Se realizó un estudio observacional, descriptivo, transversal en el período comprendido de septiembre de 2016 a febrero de 2017. El universo estuvo conformado por 64 pacientes especiales y la muestra por 55 pacientes menores de 15 años atendidos en la consulta del Hospital Pediátrico Provincial de Sancti Spíritus. Resultados: Las edades predominantes fueron de 6 a 10 años y el sexo masculino, la caries dental fue la enfermedad bucal que más se encontró en los pacientes, seguido de la enfermedad periodontal. Los factores que más incidieron fueron la deficiente higiene bucal y la dieta cariogénica. Conclusiones: Las afecciones estomatológicas más frecuentes fueron la caries dental y la enfermedad periodontal y los factores que más incidieron fueron la deficiente higiene bucal y la dieta cariogénica.

ABSTRACT Background: Oral diseases are common in special needs patients and the systemic diseases they present make difficult the assistance to the stomatology office. Objective: To describe the oral health status from a group of special needs patients younger than 15 years in Sancti Spiritus. Methodology: An observational, descriptive, cross-sectional study was carried out from September 2016 to February 2017. The universe consisted of 64 special needs patients and the sample by 55 patients younger than 15 years of age assisted in the consulting of the Sancti Spíritus Provincial Pediatric Hospital Results: The predominant ages were from 6 to 10 years and the male sex, dental caries was the most common oral disease in patients, followed by periodontal disease. The most influenced factors were poor oral hygiene and the cariogenic diet. Conclusions: The most frequent stomatology conditions were dental caries and periodontal disease and the most influenced factors were poor oral hygiene and cariogenic diet.

Enfermedades bucales en pacientes especiales menores de 15 años. Sancti Spíritus. 2016 / Oral diseases presented in special needs patients younger than 15 years. Sancti Spiritus. 2016

RESUMEN Fundamento: Las enfermedades bucales son frecuentes en los pacientes especiales y las enfermedades sistémicas que presentan dificultan la atención en la consulta de estomatología. Objetivo: Describir el estado de salud bucal de un grupo de pacientes especiales menores de 15 años de Sancti Spíritus. Metodología: Se realizó un estudio observacional, descriptivo, transversal en el período comprendido de septiembre de 2016 a febrero de 2017. El universo estuvo conformado por 64 pacientes especiales y la muestra por 55 pacientes menores de 15 años atendidos en la consulta del Hospital Pediátrico Provincial de Sancti Spíritus. Resultados: Las edades predominantes fueron de 6 a 10 años y el sexo masculino, la caries dental fue la enfermedad bucal que más se encontró en los pacientes, seguido de la enfermedad periodontal. Los factores que más incidieron fueron la deficiente higiene bucal y la dieta cariogénica. Conclusiones: Las afecciones estomatológicas más frecuentes fueron la caries dental y la enfermedad periodontal y los factores que más incidieron fueron la deficiente higiene bucal y la dieta cariogénica.

ABSTRACT Background: Oral diseases are common in special needs patients and the systemic diseases they present make difficult the assistance to the stomatology office. Objective: To describe the oral health status from a group of special needs patients younger than 15 years in Sancti Spiritus. Methodology: An observational, descriptive, cross-sectional study was carried out from September 2016 to February 2017. The universe consisted of 64 special needs patients and the sample by 55 patients younger than 15 years of age assisted in the consulting of the Sancti Spíritus Provincial Pediatric Hospital Results: The predominant ages were from 6 to 10 years and the male sex, dental caries was the most common oral disease in patients, followed by periodontal disease. The most influenced factors were poor oral hygiene and the cariogenic diet. Conclusions: The most frequent stomatology conditions were dental caries and periodontal disease and the most influenced factors were poor oral hygiene and cariogenic diet.

Perfil, sentimentos e qualidade de vida dos cuidadores de pacientes com deficiência atendidos na Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul: cuidadores de pacientes com deficiência com a palavra / Profile, feelings and quality of life of caregivers of patients with disabilities attended at the Dentistry College of the Federal University of Rio Grande do Sul: caregivers of patients with disabilities with the word

Objetivo: avaliar a qualidade de vida de cuidadores de pacientes atendidos na clínica da disciplina eletiva de Pacientes com Necessidades Especiais (PNE) da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul (FO-Ufrgs). Metodologia: Foi um estudo longitudinal, observacional e analítico, aplicado por dois examinadores calibrados para 97 cuidadores que compareceram na clínica da disciplina de PNE da FO- -Ufrgs. Resultados: 51,54% tinham idade entre 40 e 59 anos; 89,7% eram do sexo feminino sendo que 75,3% eram as mães dos PNEs; 59,8 % eram donas de casa, e 73,2% viviam com uma renda mensal de 1 a 3 salários mínimos; 58,76% achavam que ter qualidade de vida é "ser saudável" e, 67% sentiram que, por causa do tempo cuidando do PNE não tiveram tempo para si próprio, 52,6 % não se sentiram estressados para cuidar do PNE e suas outras responsabilidades com a família, 66 % não sentiram que sua saúde foi afetada, 72,2% não sentiram que a sua vida social teria sido prejudicada e, 70,1% sentiram que não tem dinheiro suficiente para cuidar do PNE somando-se as suas outras despesas 88,6% afirmaram que não gostariam de simplesmente deixar que outra pessoa cuidasse do PNE e, 54,6% responderam que deixaram de fazer algumas coisas por causa do PNE. Conclusão: Há uma necessidade de atenção não somente para os PNEs, mas, também, para os seus cuidadores que necessitam de uma abordagem multidisciplinar tendo uma rede de apoio àquele que cuida, visando a uma melhora de sua qualidade de vida.(AU)

Objective: to assess the quality of life of caregivers of patients treated at the Special Needs Patients (SNP) elective course clinic of the School of Dentistry of the Federal University of Rio Grande do Sul (FO-UFRGS). Methodology: Longitudinal, observational, and analytical study applied by two calibrated examiners to 97 caregivers who attended the FO-UFRGS SNP clinic. Results: A rate of 51.54% were between 40 and 59 years old, 89.7% were women, and 75.3% were the mothers of SNP. A rate of 59.8% were housewives and 73.2% lived on a monthly income of 1 to 3 minimum wages. A rate of 58.76% believed that quality of life is "being healthy" and 67% felt the time spent taking care of the SNP did not leave any for themselves. A rate of 52.6% were not stressed to take care of their SNP and other family responsibilities and 66% did not feel their health was affected. A rate of 72.2% did not feel their social life would have been impaired and 70.1% felt like not having enough money to take care of the SNP when adding other expenses. A rate of 88.6% said they would not want to let someone else take care of the SNP and 54.6% said they stopped doing some things because of the SNP. Conclusion: There is a need for attention not only for SNP, but also for their caregivers, who need a multidisciplinary approach with a support network to improve their quality of life.(AU)

Effect of occlusal calculus utilized as a potential "biological sealant" in special needs patients with gastric feeding tubes: a qualitative in vitro contrast to pit and fissure sealant restorations.

The aim of this case report and in vitro investigation was to evaluate the marginal microleakage of intact occlusal calculus of primary molars extracted from a special needs patient who received nutrition via a gastric feeding tube. An adolescent with a history of developmental disturbance presented for routine dental care in a hospital facility. Prophylaxis was performed, and 2 mandibular permanent molars were restored. Five primary molars were extracted due to mobility and delayed retention. Heavy deposits of intact calculus were present on the occlusal surfaces of the primary teeth. The extracted teeth were immersed in methylene blue dye solution, invested in acrylic resin, sectioned into blocks, and photographed at 20× and 40× magnification. Previously photographed calculus-free molars with pit and fissure sealants were reviewed and served as contrasting "restorations." The occlusal calculus on the primary teeth extracted from the patient absorbed the dye, while the comparison teeth containing pit and fissure sealants exhibited varying degrees of marginal dye penetration (microleakage). No marginal microleakage was noted in the calculus specimens, indicating that this substrate may serve as a "natural" occlusal surface sealant and that its removal from occlusal surfaces during routine oral prophylaxis may be unnecessary.

Dental treatment under general anesthesia for special-needs patients: analysis of the literature.

The aim of the present review was to identify the studies published on dental treatment under general anesthesia for special-needs patients. A comprehensive search of the reported literature from January 1966 to May 2012 was conducted using PubMed, Medline, and Embase. Keywords used in the search were "dental treatment under general anesthesia", "special-needs patients", "medically-compromised patients", and "children", in various combinations. Studies published only on dental treatment under general anesthesia and in English were included. Only 10 studies were available for final analysis. Age range from 1 to 50 years, and restorative procedures, were most prevalent. Only two studies discussed repeated general anesthesia, with rates of 7.2% and 10.2%. Over time, the provision of general anesthesia for special-needs patients has changed from dental clinics to general hospitals. The demand for dental treatment for special-needs patients under general anesthesia continues to increase. Currently, there are no certain accepted protocols for the provision of dental treatment under general anesthesia.

Does caries risk assessment predict the incidence of caries for special needs patients requiring general anesthesia?

OBJECTIVES: The aim of this study was to correlate the caries-related variables of special needs patients to the incidence of new caries. MATERIALS AND METHODS: Data for socio-demographic information and dental and general health status were obtained from 110 patients treated under general anesthesia because of their insufficient co-operation. The Cariogram program was used for risk assessment and other caries-related variables were also analyzed. Within a defined follow-up period (16.3 ± 9.5 months), 64 patients received dental examinations to assess newly developed caries. RESULTS: At baseline, the mean (SD) values of the DMFT (decayed, missing and filled teeth) and DT (decayed teeth) for the total patients were 9.2 (6.5) and 5.8 (5.3), respectively. During the follow-up period, new caries occurred in 48.4% of the patients and the mean value (SD) of the increased DMFT (iDMFT) was 2.1 (4.2). The patients with a higher increment of caries (iDMFT ≥3) showed significantly different caries risk profiles compared to the other patients (iDMFT <2) (p < 0.05). Close correlations existed between the caries increment and several caries-related variables; baseline DMFT, insufficient self-tooth-brushing and malocclusion were greatly associated with new caries development. CONCLUSIONS: Caries risk assessment could predict the incidence of future caries in hospital-based dentistry. Past caries experience and inadequate oral hygiene maintenance were largely related to caries development in special needs patients.

Dental care management in a child with recessive dystrophic epidermolysis bullosa

Epidermolysis bullosa (EB) is a heterogeneous group of rare genetic disorders characterized by marked fragility of the skin and mucous membranes in which vesiculobullous lesions occur in response to trauma, heat or no apparent cause. The recessive form of EB presents the greatest oral alterations including repeated blistering and scar formation leading to limited oral opening, ankyloglossia, tongue denudation, microstomia, vestibule obliteration and predisposition to oral carcinoma. Routine dental care may cause bullae formation on the lips and oral mucosa. Together with the ingestion of soft and frequently carbohydrate food, these anomalies lead to a high caries risk. This paper documents a case of a child diagnosed with recessive dystrophic epidermolysis bullosa (RDEB); describes the phases and difficulties of dental treatment and the measures that dentists and health care providers should adopt in order to provide a safe and effective dental treatment as well as earlier prevention to these patients.

Epidermólise bolhosa compreende um grupo heterogêneo de desordens genéticas raras caracterizadas pela fragilidade da pele e do tecido mucoso, nos quais surgem lesões bolhosas em resposta à injúrias traumáticas, ao calor ou até mesmo sem causa aparente. Na forma recessiva da doença, repetidos episódios de bolhas e formação de tecido cicatricial nos tecidos orais acabam por tornar a mucosa atrófica causando microstomia, anquiloglossia, desnudamento da língua e predisposição a desenvolvimento de carcinomas. Os simples cuidados rotineiros com a saúde bucal podem levar a formação das bolhas na mucosa bucal e nos lábios. A falta de higiene adequada associada a um consumo elevado de carboidratos e alimentos mais pastosos aumentam o risco de cárie nestes pacientes. Este relato documenta o caso de uma criança com diagnóstico de epidermólise bolhosa distrófica recessiva, descrevendo as dificuldades e as fases do tratamento odontológico realizado, enfatiza as medidas adotadas pelos profissionais de saúde para propiciar um tratamento seguro e efetivo, bem como a importância de se instituir um programa de prevenção bucal o mais precoce possível.