Predictors of dental complications post-dental treatment in patients with sickle cell disease

Dental Patients' Medical Information Disclosure and Sociodemographic Determinants: A Cross Sectional Study

OBJECTIVE

To evaluate the patient's willingness to declare their medical history to their dentists against demographic and medical information.

METHODS

A self-administered structured questionnaire regarding common chronic condition and pregnancy awareness and attitude toward medical information disclosure to their dentists was designed employing a five-point Likert-type scale. The questionnaire was distributed to among sample of adults. Data were collected and statistically analyzed using descriptive statistics, t-tests, ANOVA, and P values.

RESULTS

A total of 573 questionnaires were completed. Only 61.3% were willing to share their medical history with the dentist and 76.1% will disclose previous complications of their condition in the dental office. Two third 71.9%of the sample will disclose about medications and 76.1% will disclose pregnancy month. There was lack of education regarding health conditions, 73.3% did not receive any information about their medications. While 72.8% did not receive any information regarding complications of their disease and 76.3% were not told what to do if complication arises.

CONCLUSION

The population's willingness to reveal their medical information in the dental office is crucial. Though was within acceptable limit but still deficient. Age, education, occupation and marital status have a significant effect on disclosing and awareness. Educating patients and raising their awareness may aid in reducing emergencies, errors, and legal issues in the dental office.

Orofacial Manifestation and Dental Management of Sickle Cell Disease: A Scoping Review

Aims

Sickle cell disease (SCD) is an upcoming global health problem with rapid progress in therapy especially since 2017. However, systematic reviews found no clinical trials on the dental treatment of sickle cell disease (SCD). This article aims to outline the oral features of the sickle disease and discuss oral management strategies that can serve as guidelines for dental professionals. Material and Methods. A comprehensive literature review was conducted using PubMed, Google Scholar, and Web of Science. The search strategies were developed to cover publications from January 2010 to March 2020. With the help of keywords, multiple abstracts were identified. These abstracts were further reviewed, which included the information about the SCD manifestation, particularly about the oral health features. Based on all these articles and clinical experience, a narrative review was constructed, which summarizes all the aspects of the oral manifestation in people with SCD.

Results

The results of this study demonstrate that there is distinct evidence available, indicating the developmental enamel defect leading to hypoplasia and increasing susceptibility to dental caries. Another important result of this review found that people with SCD have a vaso-occlusive crisis in the microcirculation in the dental pulp leading to symptomatic and asymptomatic pulpal necrosis without any signs of odontogenic pathology in an apparently healthy tooth. The study also found that early detection, intervention, and prevention are crucial for improving oral health care, and involving a multidisciplinary approach plays an important role in managing people with SCD.

Conclusion

Patients with sickle cell disease have chronic overall health problems. The hematological disorder becomes their main concern and impaired oral health becomes secondary, increasing the risk for dental caries at the most. This paper broadly describes the oral manifestations of SCD, additionally; this paper also provides recommendations for better dental management of patients with SCD. Patients with SCD are often misjudged and, due to lack of knowledge and guidelines, dental providers are not able to provide adequate care. This paper attempts to highlight the essential measures to provide better dental care.

Predictors of dental complications post-dental treatment in patients with sickle cell disease

Objective

Our aim was to explore potential medical or dental indicators associated with dental complications and the utilization of emergency services in sickle cell disease (SCD), especially that clinical reports on adverse outcomes post‐dental treatment are scarce.

Materials and methods

A retrospective analysis of dental treatments of 47 eligible adults with confirmed SCD between May 2016 and October 2019. Logistic regression analysis was used whether clinical outcomes, course of dental treatment, and regularity of dental care are associated with dental complications after dental procedures and/or resulted in emergency care or hospital admissions.

Results

We identified a new, statistically significant association (p‐value = .01) between the number of prescription medications taken and complications (10%) after dental procedures. The most frequent dental procedures were tooth extractions (36%) and pain management (28%) during a non‐scheduled dental encounter (68%). The majority of cases did not participate in regular recall exams and periodical oral hygiene maintenance.

Conclusions

A higher number of prescription medications was associated with an increased risk of post‐dental complications in SCD patients. A thorough medical history, including a list of prescribed medications, and collaboration with the patient medical team are important to assess the risk of complications post‐dental procedures and the need for antibiotic prophylaxis according to the case complexity.