Descriptive study of the patients treated at the clinic 'Integrated Dentistry for patients with Special Needs' at Complutense University of Madrid (2003-2012)

OBJECTIVES: To study clinical and epidemiological characteristics of the patients treated at the clinic 'Integrated Dentistry for Patients with Special Needs (Special Care Dentistry)' at Complutense University of Madrid (UCM),as well as to know the dental treatments performed in these patients and the modifications from the usual treatment protocol. The information obtained from the results could also be applied in order to assess the needs of dental students education about this type of patients. Study DESIGN: Medical records review of all the patients referred to the clinic of 'Integrated Dentistry for Patients with Special Needs', performing a retrospective cross-sectional study analyzing their main pathology, ASA risk score (Classification system used by the American Society of Anesthesiologists to estimate the risk posed by the anesthesia for various patient conditions), pharmacological treatment, what kind of dental treatment was necessary, whether the patient was treated or not, and if it was required to change any procedure due to the patient health status (sedation or antibiotic prophylaxis). RESULTS: The number of patients referred to the clinic was 447, of whom 426 were included in this study. Out of them, 52,35 % were men and 47,89 were women, with a mean age of 49,20 years. More frequent pathologies were cardiovascular or cerebrovascular diseases (24,29 %), infectious diseases (12,41%), endocrine diseases (11,66%)and intellectual disability (8,85%). 70'18% of the patients were treated, with sedation being necessary in 9,03% of the cases and antibiotic prophylaxis in 11,70%

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Descriptive study of the patients treated at the clinic "integrated dentistry for patients with special needs" at Complutense University of Madrid (2003-2012).

OBJECTIVES: To study clinical and epidemiological characteristics of the patients treated at the clinic "Integrated Dentistry for Patients with Special Needs (Special Care Dentistry)" at Complutense University of Madrid (UCM), as well as to know the dental treatments performed in these patients and the modifications from the usual treatment protocol. The information obtained from the results could also be applied in order to assess the needs of dental students education about this type of patients. STUDY DESIGN: Medical records review of all the patients referred to the clinic of "Integrated dentistry for patients with special needs", performing a retrospective cross-sectional study analyzing their main pathology, ASA risk score (Classification system used by the American Society of Anesthesiologists to estimate the risk posed by the anesthesia for various patient conditions), pharmacological treatment, what kind of dental treatment was necessary, whether the patient was treated or not, and if it was required to change any procedure due to the patient health status (sedation or antibiotic prophylaxis). RESULTS: The number of patients referred to the clinic was 447, of whom 426 were included in this study. Out of them, 52,35 % were men and 47,89 were women, with a mean age of 49,20 years. More frequent pathologies were cardiovascular or cerebrovascular diseases (24,29 %), infectious diseases (12,41%), endocrine diseases (11,66%) and intellectual disability (8,85%). 70'18% of the patients were treated, with with sedation being necessary in 9,03% of the cases and antibiotic prophylaxis in 11,70%. CONCLUSIONS: Given the high number of patients with some kind of pathology and the amount of medicines that they use, it seems necessary for dentistry students to have a specific training regarding how to handle and treat these patients, so they will be able to provide them the best possible care.

Cuidados orales en el paciente oncológico / Oral care in the oncological patient

El odontólogo tiene un papel muy importante no solo en la detección precoz del cáncer oral, sino en el cuidado del paciente oncológico. Los tratamientos de quimioterapia y radioterapia producen efectos adversos en la cavidad oral, y el mantenimiento de la salud a ese nivel es esencial para prevenir y minimizar dichos efectos. Las complicaciones orales más comunes en pacientes con tratamiento oncológico son la mucositis, la hiposialia, las alteraciones del gusto, la osteonecrosis, el sangrado de la mucosa oral y las infecciones por inmunodepresión. El manejo de estas complicaciones comprende la identificación de la población de riesgo, el inicio de las intervenciones antes del tratamiento oncológico y el manejo oportuno de las lesiones provocadas por el mismo. Es imprescindible llevar a cabo una evaluación de la cavidad oral antes del tratamiento oncológico, realizando los tratamientos odontológicos que estén indicadas para así reducir las complicaciones durante y después del tratamiento antineo-plásico (AU)

The dentist has a very important role not only in the early detection of oral cancer, but also in the care of the oncological patient. Chemotherapy and radiotherapy treatments produce adverse effects in the oral cavity, and the maintenance of health at this level is essential to prevent and minimise these effects. The most common oral complications in patients with oncological treatment are mucositis, hyposalivation, taste alterations, osteonecrosis, bleeding of the oral mucosa and infections due to immuno-suppression. The management of these complications includes the identification of the population at risk, the commencement of interventions before the oncological treatment and the timely management of the lesions caused by it. It is essential to carry out an evaluation of the oral cavity before the oncological treatment, performing dental treatments that are indicated in order to reduce the complications during and after the antineoplastic treatment (AU)

Diagnostic criteria in proliferative verrucous leukoplakia: Evaluation

OBJECTIVES: to evaluate the ability of the diagnostic criteria proposed by Cerero et al in 2010 to perform an early diagnose in patients with proliferative verrucous leukoplakia. Study DESIGN: retrospective study with patients diagnosed with leukoplakia at Oral Medicine Service at Oral Medicine and Surgery Department at Dentistry Faculty at Universidad Complutense of Madrid. RESULTS: the criteria were applied in 116 patients, turning positive in 40 cases. Out of these, 24 (60%) had been previously diagnosed with PVL. Most frequent criteria were major criteria A and E, concerning lesion's site and histopathology, and minor criteria b and c, concerning sex and smoking habit. CONCLUSIONS: diagnostic criteria developed by Cerero et al can be a useful tool for an early diagnose of PVL, as in 60% of the cases, the criteria would have allowed to make an early diagnose of the disease

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Síndrome de Sjögren. Revisión e implicaciones en el ámbito de la salud oral / Sjögren Syndrome. Review and impact on the area of oral health

El síndrome de Sjögren (SS) es una enfermedad crónica, sistémica, inflamatoria y autoinmune que afecta a las glándulas exocrinas salivales y lagrimales, produciendo boca seca (xerostomía) y ojos secos. El SS es la principal causa no y atrogénica de laxerostomía. Esta sensación subjetiva de sequedad orales la causante de que los pacientes consideren su salud oral deficiente. Suelen presentar dificultades para hablar, masticar y tragar, alteraciones del gusto, sensación de boca ardiente así como dolor en las glándulas salivales al comer. Actualmente no hay ninguna cura para el SS, así como ningún tratamiento que minimiceo restaure el daño hecho a las glándulas. El objetivo del tratamiento será aliviar el disconfort oral y mantener la bocahidratada

The Sjögren Syndrome (SS) is a chronic, systemic, inflammatory and autoimmune disease that affects the salivary and lacrima lexocrine glands, producing dry mouth(xerostomia) and dry eyes. SS is the principal non-iatrogenic cause of xerostomia. This subjective sensation of oral dryness is the cause of patients considering their oral health deficient. Difficulties are usually presented in speaking, chewing and swallowing, taste alterations and burning mouth sensation aswell as pain in the salivary glands wheneating. Currently there is no cure for SS, nor is the retreatment that minimises or restores the damage to the glands. The objective of the treatment shall be to alleviate the oral discomfort and maintain the mouth hydrated

Diagnostic criteria in proliferative verrucous leukoplakia: evaluation.

OBJECTIVES: to evaluate the ability of the diagnostic criteria proposed by Cerero et al in 2010 to perform an early diagnose in patients with proliferative verrucous leukoplakia. STUDY DESIGN: retrospective study with patients diagnosed with leukoplakia at Oral Medicine Service at Oral Medicine and Surgery Department at Dentistry Faculty at Universidad Complutense of Madrid. RESULTS: the criteria were applied in 116 patients, turning positive in 40 cases. Out of these, 24 (60%) had been previously diagnosed with PVL. Most frequent criteria were major criteria A and E, concerning lesion's site and histopathology, and minor criteria b and c, concerning sex and smoking habit. CONCLUSIONS: diagnostic criteria developed by Cerero et al can be a useful tool for an early diagnose of PVL, as in 60% of the cases, the criteria would have allowed to make an early diagnose of the disease.