Evaluating global research trends in special needs dentistry: A systematic bibliometrix analysis.

OBJECTIVES: Special needs dentistry (SND) is a vast and fragmented field of study. This comprehensive bibliometric analysis aimed to evaluate the scope of SND, including the existing knowledge base, distribution structure, quantitative relationships, and research trends. MATERIAL AND METHODS: A systematic search was conducted on March 10, 2022, using the Web of Science Core Collection database, covering the period from 1985 to 2021, focusing on studies reporting on special needs populations in a dentally relevant context. Records were title-screened and analyzed for key bibliometric indicators. RESULTS: Among 48,374 articles, 13,869 underwent bibliometric analysis. Peak SND research occurred during 1985-1997. United States led in productivity, trailed by Brazil and Japan. University of Sao Paulo excelled in Brazil, University of Washington and University of North Carolina in the United States. The Journal of Dental Research was the most productive source of research and also had the highest number of citations, followed by Community Dentistry and Oral Epidemiology. Keyword analysis revealed that "elderly", "caries", and "epidemiology" were the most commonly used author keywords. CONCLUSIONS: This study represents the first bibliometric analysis of SND literature. It emphasizes the need for increased collaboration between institutions and authors. Furthermore, it suggests focusing on research input from non-dental disciplines and populations with rarer intellectual or developmental conditions.

[Dental and oral surgical treatment of the mentally retarded in Hungary: the situation in the past, currently and hopes for the future]. / A szellemi fogyatékosok fogászati-szájsebészeti ellátásának múltja, jelene és remélt jövoje Magyarországon.

Introduction: Dental care for mentally disabled people poses a growing challenge for healthcare. In Hungary, the number of mentally disabled people needing special dental care is ca. 100 000. Aim: The aim of our retrospective analysis is to provide a summary of the demographic data and the treatment outcomes of patients with mental disorders treated at the Department of the Oral and Maxillofacial Surgery of the Semmelweis University in the past five years. Method: Dental care for patients with a severe level of mental disability can be carried out in general anaesthesia only. At Semmelweis University, in the Oral and Maxillofacial Department, 1717 mentally disabled adults received dental care during the past five years. (Patients included people with a mild, medium or severe level of mental disability, patients with Down's syndrome, autism, epilepsy or panic disorder.) Results: The single biggest achievement seems to be the fact that the issue of acute dental care and oral surgery has basically been settled. A workable relationship has been forged with foundations and organizations dealing with the problems of these patients. It has been realized, however, that in the case of mentally disabled patients there is an enormous need for prevention and ongoing care. Conclusions: Up to now no survey has been carried out in Hungary with the aim of objectively revealing the dental care needs of these patients. Internationally, however, several surveys have been published. It can be stated on the basis of these that both caries frequency and the presence of parodontal diseases increase in correlation with age and the level of disability. Oral hygiene is insufficient, patients or their caretakers do not get proper information, only a few of them receive adequate training and they are not motivated to keep up oral health. Dental care, except for tending acute cases, is not satisfactory. For the sake of prevention, cooperation is needed with non-governmental organizations, foundations, special education teachers and psychiatrists specialized in this field. Orv Hetil. 2019; 160(35): 1380-1386.

Estado de salud bucodental en niños con discapacidad intelectual / Oral health status in children with intellectual disability

Conocer el estado de salud bucodental en niños con discapacidad intelectual. Se seleccionaron 51 niños y niñas que padecen de discapacidad intelectual no asociada a otros síndromes, de ambos géneros y en edades comprendidas entre 5 y 14 años. Se aplicaron los índices descritos por la Organización Mundial de la Salud (OMS) y la Encuesta Básica de Salud Bucodental. Se realizó una estadística descriptiva a través del paquete estadístico SPSS 15.0 para el análisis de resultados. El mayor porcentaje de la población no presenta alteraciones en el desarrollo del esmalte, ni fluorosis dentaria. El 86% presenta placa dental y un 6% cálculo dental. La mayoría de la población no presenta caries, sólo en un pequeño porcentaje es observada y se incrementa en la dentición primaria (24% dentición permanente y 31.4% dentición temporal con un CPOD= 0.60 y Ceod= 0.70. En los dientes permanentes los tratamientos preventivos, sellantes de fosas y fisuras y tratamientos restauradores son los que más requeridos (96%, 78.45% y 33.3%, respectivamente). En los dientes primarios 58.8% requieren tratamientos preventivos y 41.2% obturaciones. El mayor porcentaje de la población presentó alteraciones en la relación molar semi-cúspide y de cúspide completa (41% y 11%, respectivamente). El mayor porcentaje de la población estudiada no presentan alteraciones en el desarrollo del esmalte, fluorosis, ni caries dental. Sí presentaron elevados porcentajes de placa dental, un alto porcentaje de necesidades preventivas y restauradoras y alteraciones en la relación molar.

To know the status of oral health in children with intellectual disability. It was considered a sample of 51 children suffering from intellectual disability which was not associated to other syndromes, they were both male and female with ages ranging between 5 and 14 years. Indexes described by the World Health Organizations (WHO) and the Basic Oral Survey were applied. Later, a descriptive statistics was performed. The higher percentage of the population does not show either enamel development alterations or fluorosis. About 86% presented dental plaque and 6% presented dental calculus. Most of the population do not have caries, only in a short percentage of caries is shown and it increases for temporary teeth (24% permanent teeth and 31.4% temporary teeth) with a CPOD= 0.60 and Ceod= 0.70. In permanent teeth, preventive treatments, pit and fissure sealants and restorative treatments are the most required treatments (96%, 78.45% y 33.3%, respectively). In temporary teeth about 58.8% require preventive treatments and fillings for about 41.2%. The higher percentage of the participants showed alterations in the relationship molar semi-cuspid and complete cuspid (41% and 11%, respectively). The higher percentage of the participants does not present enamel development alterations, fluorosis or dental caries. There are high percentages of dental plaque, a high percentage of preventive and restorative needs and alterations in the molar relationship.

[Special care dentistry for dependent elderly and people with disabilities]. / Zahnmedizinische Betreuung von Pflegebedürftigen und Menschen mit Behinderungen.

In 2009, 7.1 million people (8% of the population) were officially recognized as having severe disabilities in the Federal Republic of Germany. At the same time, about 2.34 million Germans were in need of special care with some overlap between these groups. Although structured preventive programs in Germany helped to improve oral health generally (DMS IV 2006), care recipients and people with disabilities did not benefit to the same extent from this development. They often show a higher risk of caries and periodontal diseases due to both a lack of compliance and insufficient personal plaque control. It is desirable that care recipients and persons with disabilities attain the same level of oral health as persons without impairments. All care givers ought to be aware of the dental problems of these groups and should be sufficiently trained to deal with them. Dental care should compensate any deficits to ultimately attain the same standard of oral health. To achieve these goals, ease of access to dental care as well as dental services appropriate to the impairments have to be established.

Transtorno obsessivo compulsivo em crianças e adolescentes: revisão de literatura e abordagem odontológica / Obsessive compulsive disorder in children and adolescents: literature review and dental approach

O transtorno obsessivo compulsivo (TOC) é um transtorno psiquiátrico crônico que atinge de 1 a 2% da população de crianças e adolescentes, necessitando de uma abordagem adequada durante o atendimento odontológico devido ao aumento da ansiedade, às medicações utilizadas no tratamento do transtorno e, possivelmente, devido a comportamentos compulsivos. O objetivo deste trabalho foi fazer um levantamento bibliográfico a respeito das principais características do TOC na infância e adolescência e trazer informações importantes para o atendimento odontológico destes pacientes. Após a análise da literatura, ficou claro que o TOC é um transtorno de ansiedade, e, por esta razão, é natural que estes pacientes apresentem-se muito ansiosos durante uma consulta odontológica. Sendo assim, é de grande importância que o odontopediatra tenha conhecimento de técnicas de controle de comportamento e ansiedade adequadas a estes pacientes. Além disso, o profissional deve avaliar possíveis interações com antibióticos, anestésicos e vasoconstrictores, com o objetivo de minimizar os riscos para o paciente. O uso de antidepressivos frequentemente resulta em hipossalivação. O incentivo a uma boa higiene bucal (com vigilância do responsável à compulsão por limpeza) associado ao uso de cremes e géis fluoretados, colutórios antissépticos e visitas frequentes ao dentista podem reduzir a incidência de lesões de cárie rampantes, doença periodontal e outros distúrbios associados à deficiência na produção de saliva.

Programa lúdico-pedagógico para o controle do biofilme dental em indivíduos com deficiência visual / Playful-teaching program for the control of dental biofilm in the visually impaired

Objetivo: Desenvolver um programa de prevenção e motivação odontológica para deficientes visuais, utilizando materiais lúdico-pedagógicos. Além disso, buscou comparar a eficácia do mesmo através do índice de higiene oral simplificado (IHOS) e do índice gengival (IG), em um grupo de cegos (grupo experimental) e portadores de visão subnormal (grupo controle). Materiais e Métodos: Foram avaliados 15 indivíduos com deficiência visual da Associação de Pais e Amigos dos Deficientes Visuais (APADEV), de Caxias do Sul/RS, de ambos os sexos e idades entre 13 e 49 anos. Foram divididos em dois grupos: cegos(grupo experimental) e portadores de visão subnormal (grupo controle). Durante seis encontros (inicial, 15, 45, 75, 105 e 120 dias), todos os participantes receberam as mesmas informações e participaram das mesmas atividades conduzidas pelo mesmo examinador (kappa=0,86). Após cada atividade realizava-se o IG e IHOS. Os dados foram avaliados considerando-se o nível de significância de 5% e utilizando-se os testes de Friedman e Mann-Whitney. Resultados: Em relação ao IHOS, houve diminuição do índice com diferença significativa para o grupo controle durante os momentos de 15 a 105 dias (p<0,01), o que não ocorreu como grupo experimental (p=0,77). Na avaliação do IG, observou-se diminuição do índice ao longo de todo o período no grupo controle (p<0,01). No grupo com deficiência visual o IG diminuiu entre 75 e 105 dias. Para o IHOS não houve diferenças estatisticamente significantes. Conclusão: Os indivíduos com visão subnormal apresentaram um efeito melhor (IG e IHOS) após o programa quando comparados com os indivíduos cegos.

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)

Oral health in Alzheimer's disease: a review.

The main data on oral health and dental pathologies affecting Alzheimer's disease (AD) patients were reviewed. Oral health declines and dental pathologies increase with progression of AD. Poor oral hygiene, difficulty in wearing dentures, and the inability to self-care, including carrying out oral hygiene procedures are the most probable cause of impaired oral health in AD. Collection of information on oral/dental conditions from AD patients or their caregivers/relatives is often difficult and scientific literature on the topic is sparse . The majority of data on the subject consist in retrospective studies affected to some extent by subjective views of dental professionals involved. Appropriate dental interventions in adult-onset dementia disorders will decrease pain and oral pathology and consequently could contribute to maintain enough oral and nutritional health in these patients. Dental treatment in early stages of the disease are important and should be finalized at producing a stable oral condition. This could improve the quality of life and contribute to decrease worsening of oral situations in the later stages of the disease when dental treatment may be difficult. The problem of awareness of good oral health for keeping quality of life more acceptable in adult-onset dementia disorders is discussed.

Special needs dentistry: the next ten years.

There is no doubt that in special needs dentistry, Australasia is one of the major global players. There is now an accepted scope of practice, accredited training programs and specialists registered with their local dental boards. These early achievements reflect the tremendous input provided by the primary stakeholders, such as the Royal Australasian College of Dental Surgeons. But the honeymoon is now over. Where will Special Needs Dentistry be in ten years? This paper discusses the journey so far and where the discipline will be heading.

Estrategia mediadora para la promoción de salud bucal en niños y adolescentes con síndrome de Down / No disponible

Objetivo: Diseñar, implementar y evaluar juegos colectivos con componente didáctico adaptados a los intereses y potencialidades de personas con síndrome de Down, como estrategias mediadoras para la promoción de la salud bucal. Materiales y métodos: Participaron en el estudio 100 niños y adolescentes Down de 4 a 19 años, 47 padres y 49 docentes, integrantes de APADIM, escuela de discapacitados intelectuales de la Ciudad de Córdoba (Argentina). Se diseñaron juegos colectivos con componente didáctico de acuerdo con el diagnóstico psico-pedagógico y los aportes de los docentes. Dichos juegos se incluyeron en las actividades del aula y fuera del aula con la participación de otros mediadores: padres, hermanos, abuelos. Los juegos fueron evaluados por partes de los mediadores (maestros y padres) a través de encuestas. Resultados: La evaluación de las estrategias implementadas resultó positiva. Los mediadores expresaron que hubo cambio de conducta en los niños y adolescentes respecto al cuidado de su salud; el examen clínico reveló disminución en el Índice de Higiene oral y un importante aumento en el número de elementos obturados, lo que evidenciaría la toma de conciencia y movilización de la familia con respecto a la necesidad de consulta e intervención del profesional odontólogo; en relación a los hábitos de higiene, se observó aumento del uso de cepillo y mejora sustancial en la calidad del cepillado. Conclusiones: Los juegos con contenidos de salud bucal dotaron a los mediadores de una herramienta apropiada para que los niños y adolescentes lograran la apropiación de conductas saludables, dado que el diseño de las mismas respetó el diagnóstico de sus potencialidades (AU)

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A look at the (near) future based on the (recent) past - how our patients have changed and how they will change.

Remedies for dental diseases have been in use for as long as 4,000 years, and various materials and methods have been used over the millennia. Dentistry continues to change in response to changes in the age distribution, origins, financial means and health of the population, as well as to changes within the profession itself. The Canadian population is very unevenly distributed geographically and ethnically. Furthermore, it is aging rapidly and life expectancy is increasing. Although the average income of Canadians has increased, the increase was unevenly distributed, and the gap between rich and poor continues to expand. There has been a steady rise in the number of Canadians with dental insurance, although the proportion of the population with insurance varies from one province to another. Not surprisingly, people with dental insurance compared to those without are more frequent users of dental services. The rate of caries attack has diminished in industrialized countries, but people are keeping their teeth longer, so caries will remain a significant public health problem, particularly among elderly people. In addition, smoking tobacco is strongly associated with periodontal disease; thus, there should be more action within the dental community in support of smoking cessation programs. The composition of the dental care community is also changing. The ratios of dentists and dental hygienists to the population have increased, the services offered by dental technicians have expanded greatly, and the services offered by denturists have also increased as these services gain more widespread acceptance. Use of dental services in Canada remains reasonably broad; however, denture-wearers continue to regard uncomfortable dentures as a normal part of aging. The pattern of uneven distribution of disease and access to service remains the major challenge facing the dental profession.