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Salerno C, Cirio S, Zambon G, D’Avola V, Parcianello RG, Maspero C, Campus G, Cagetti MG. Conscious Sedation for Dental Treatments in Subjects with Intellectual Disability: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1779. [PMID: 36767145 PMCID: PMC9914902 DOI: 10.3390/ijerph20031779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
This systematic review and meta-analysis was aimed to investigate the conscious sedation efficiency in patients with intellectual disability undergoing dental treatment (PROSPERO CRD42022344292). Four scientific databases were searched by ad-hoc prepared strings. The literature search yielded 731 papers: 426 were selected, 42 were obtained in full-text format, and 4 more were added after hand searching. Fourteen studies were finally included, 11 of which were included in the meta-analysis (random effect model). A high heterogeneity in the drugs used and route of administration was retrieved. Success rate, occurrence of side effects, and deep sedation occurrence were combined to give an overall efficiency of each drug. N2O/O2 reported the highest efficiency (effect size = 0.90; p < 0.01) and proved to be more efficient when used alone. Nine papers reported a success rate of sedation of 80% or more. The prevalence of side effects (6 studies) ranged from 3% to 40%. Enteral and parenteral benzodiazepines showed the same overall efficiency (effect size = 0.86). No meta-analysis has yet been conducted to define the most effective and safest way to achieve conscious sedation in patients with intellectual disability; nitrous oxide appears to be the best choice to perform conscious sedation in patients with intellectual disability undergoing dental treatment.
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Affiliation(s)
- Claudia Salerno
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
| | - Silvia Cirio
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
| | - Giulia Zambon
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
| | - Valeria D’Avola
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
| | - Roberta Gaia Parcianello
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
| | - Cinzia Maspero
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3012 Bern, Switzerland
| | - Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
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Nonoyama T, Nonoyama K, Shimazaki Y. Cross-sectional study of the factors associated with the number of teeth in middle-aged and older persons with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:793-804. [PMID: 35929423 PMCID: PMC9544665 DOI: 10.1111/jir.12967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND We investigated the number of teeth in middle-aged and older individuals with intellectual disability and evaluated the related factors. METHODS A questionnaire survey on oral health was administered to 604 persons over 40 years old with intellectual disabilities in Aichi Prefecture, Japan. The questionnaire designed for this study included items on diagnosis of disability, severity of intellectual disability and type of residence. As oral-health-related factors, the proxy-reported number of teeth, family dentist, regular dental check-ups, problems during dental treatment and tooth-brushing frequency were evaluated. A multinomial logistic regression analysis was performed using the proxy-reported number of teeth (≥20, 10-19 or 0-9) as the dependent variable, and the odds ratios (ORs) and 95% confidence intervals (CIs) of independent variables were calculated. In addition, linear regression analysis was performed using the proxy-reported number of teeth as the dependent variable. RESULTS In the multivariate multinomial logistic regression analysis, age, diagnosis of disability and type of residence were significantly associated with having 10-19 versus ≥20 teeth. Participants with autism spectrum disorder had a significantly lower OR for 10-19 teeth compared with those with intellectual disability [OR (95% CI): 0.49 (0.22-1.08)]. Age, diagnosis of disability, regular dental check-ups and tooth-brushing frequency were significantly associated with having 0-9 versus ≥20teeth. Participants with Down syndrome had a significantly higher OR for 0-9 teeth compared with those with intellectual disability [OR (95% CI): 3.17 (1.09-9.23)]. The ORs for 0-9 teeth of participants who did not attend regular dental check-ups and who brushed their teeth 1 time/day compared with ≥3 times/day were significantly high, and the OR (95% CI) was 2.37 (1.06-5.30) and 4.76 (1.09-20.77), respectively. [Corrections made on 22 August 2022, after first online publication: in the previous sentence, "who attend" has been changed to "who did not attend".] In the multivariate linear regression analysis, age, diagnosis of disability and regular dental check-ups were significantly associated with the proxy-reported number of teeth. The proxy-reported number of teeth was -0.42 less with each 1-year increase in age. With autism spectrum disorder, the proxy-reported number of teeth was 0.74 more compared with intellectual disability. In Down syndrome, the proxy-reported number of teeth was -0.93 less compared with intellectual disability. The proxy-reported number of teeth was -2.12 less for those who did not have regular dental check-ups. CONCLUSIONS The number of teeth in middle-aged and older individuals with intellectual disability was related to age and the type of disability. Regular dental visits may be effective at preventing tooth loss in middle-aged and older persons with intellectual disability.
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Affiliation(s)
- T. Nonoyama
- Department of Preventive Dentistry and Dental Public Health, School of DentistryAichi Gakuin UniversityNagoyaJapan
| | - K. Nonoyama
- Department of Preventive Dentistry and Dental Public Health, School of DentistryAichi Gakuin UniversityNagoyaJapan
- Nonoyama Dental OfficeTogoJapan
| | - Y. Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of DentistryAichi Gakuin UniversityNagoyaJapan
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Parry J, Newton T, Linehan C, Ryan C. Dental Visits for Autistic Children: A Qualitative Focus Group Study of Parental Perceptions. JDR Clin Trans Res 2021; 8:23800844211049404. [PMID: 34693784 PMCID: PMC9772888 DOI: 10.1177/23800844211049404] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Patient groups who pose behavioral challenges during dental attendance may be offered more restricted dental treatment options. Unsuccessful participation with dental visit tasks and demands has been commonly reported for autistic children. OBJECTIVES This study aimed to examine parental perceptions of difficulties associated with dental attendance and oral care for autistic children and young adults, to highlight reported challenges and potential adaptations, and to identify interventions that will encourage positive experiences of dental attendance. METHODS Qualitative data were gathered through 2 focus groups with parents of primary school and secondary school pupils with autism, interviewed in separate groups. Questions about parents' perceptions of dental attendance and oral care were asked. The groups were audio-recorded and transcribed verbatim. The transcripts were analyzed and initial codes generated. Development of subthemes and themes followed a process of thematic analysis. RESULTS Parental perceptions, which confirmed data from other studies, included the need for understanding and training, awareness of sensory issues, recognition of the individuality of autistic traits, time and clarity for communication, and factors affecting the confidence of parents to advocate in the clinical environment. Focus group participants identified the critical value of empathizing with an autistic perspective and highlighted the importance of positive oral health messages. They also noted the lack of understanding regarding the complexity of altering self-imposed, ritualistic dietary regimes and attempting to enact good dental preventive habits for their children. CONCLUSIONS Analysis of data from parent focus groups provided a greater understanding of the needs and responsivity required for successful dental visits for autistic children and young adults. A range of potential interventions was identified and incorporated within a model of needs. Interventions based on Partnership Working, System Change, and Training of Dental Staff could be effective in reducing challenges posed by dental attendance for many children with autism. KNOWLEDGE TRANSFER STATEMENT Sensory sensitivities, communication difficulties, comorbid intellectual disability, and dental anxiety are barriers to successful participation during dental attendance for autistic children. This research proposes that interventions supporting Partnership Working, System Change, and Training of Dental Staff can reduce challenges posed by dental attendance. The model of interventions developed as part of this project can be used by oral care teams to help reduce barriers and improve the success of dental visits for autistic children.
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Affiliation(s)
- J.A. Parry
- School of Applied Psychology, University College Cork, Cork, Ireland
- Special Care Dental Service, Sussex Community NHS Foundation Trust, Haywards Heath Health Centre, Haywards Heath, UK
| | - T. Newton
- Centre for Oral, Clinical and Translational Sciences, King’s College London, London, UK
| | - C. Linehan
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - C. Ryan
- School of Applied Psychology, University College Cork, Cork, Ireland
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Curtis JS, Kennedy SE, Attarha B, Edwards L, Jacob R. Upper Gastrointestinal Disorders in Adult Patients with Intellectual and Developmental Disabilities. Cureus 2021; 13:e15384. [PMID: 34094790 PMCID: PMC8170855 DOI: 10.7759/cureus.15384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The purpose of this literature review is to address the diagnosis and treatment of upper gastrointestinal (GI) disorders in patients with intellectual and developmental disabilities (IDD). Manifestations of upper GI dysmotility and disorders include dysphagia, pulmonary aspiration, malnutrition, gastroesophageal reflux, and gastritis, all of which can impact a person’s quality of life and lead to chronic, life-threatening conditions. This article will explore the existing diagnostic methods and treatments for gastrointestinal disorders as they relate to patients with IDD.
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Affiliation(s)
- Jack S Curtis
- Internal Medicine, University of Florida College of Medicine, Gainesville, USA
| | - Sara E Kennedy
- Internal Medicine, University of Florida College of Medicine, Gainesville, USA
| | - Barrett Attarha
- Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Linda Edwards
- Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Rafik Jacob
- Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
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Choi YS, Kim H, Rhee SH, Ryoo SH, Karm MH, Seo KS, Kim HJ. Multiple implant therapy with multiple inductions of general anesthesia in non-compliant patients with schizophrenia: A case report. J Dent Anesth Pain Med 2019; 19:239-244. [PMID: 31501783 PMCID: PMC6726886 DOI: 10.17245/jdapm.2019.19.4.239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/18/2019] [Accepted: 08/22/2019] [Indexed: 12/05/2022] Open
Abstract
The effectiveness of dental implants in patients with disability, who are non-compliant during treatment, is controversial because of their poor oral health. Thus, oral health-care and management in such patients is concerning. Moreover, limited information is available on prognosis after implant placement. Herein, we describe a patient with schizophrenia who underwent dental implantation under multiple inductions of general anesthesia (5 times) and required conservative treatment and tooth extraction for multiple dental caries and retained roots because of inadequate oral health-care. Postoperatively, fracture of the prosthodontics and progression of dental caries were observed, and with 3 additional inductions of general anesthesia, conservative treatment, implant surgery, and prosthesis implantation were conducted. Postoperative 12-month follow-up since the last prosthesis implantation showed successful results. For patients with schizophrenia, multiple implantation can reduce horizontal bone loss and achieve aesthetic results compared to treatment with removable prosthodontics and could serve as an alternative treatment modality.
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Affiliation(s)
- Yong-Suk Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hyungseok Kim
- Oral Oncology Clinic, National Cancer Center, Gyeonggi-do, Goyang, Korea
| | - Seung-Hyun Rhee
- Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea
| | - Seung-Hwa Ryoo
- Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea
| | - Myong-Hwan Karm
- Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea
| | - Kwang-Suk Seo
- Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea
| | - Hyun Jeong Kim
- Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea
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Couto P, Pereira PA, Nunes M, Mendes RA. Characterization of oral health in a Portuguese population with mild intellectual disability. SPECIAL CARE IN DENTISTRY 2019; 39:298-305. [PMID: 30990923 DOI: 10.1111/scd.12376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/20/2019] [Accepted: 03/22/2019] [Indexed: 12/01/2022]
Abstract
AIMS This study aims to characterize the hygiene habits, the self-perception of the need for treatment and the oral condition of a population with a disability. METHODS AND RESULTS This research is part of an observational, cross-sectional epidemiological study on oral health and quality of life of people with mild intellectual disabilities living in (or attending) institutions of the Central Region of Portugal that were affiliated with HUMANITAS (Portuguese Federation for Mental Disability) in 2016. A sociodemographic and oral health questionnaire, applied on the form of an interview to 240 individuals aged between 18 and 64 years, was used. Statistical analyses were performed using SPSS version 22.0. It was verified that 32.9% of the individuals had less than 20 teeth. Only 15% of all individuals used removable prosthesis. About 21% didn't do oral hygiene daily. Only 28.4% of the sample visited the dentist in the last 6 months. Note that 75.2% of the sample stated their need for dental treatment and less than half (37.4%) described their oral condition as good or superior. CONCLUSION Dental care among adults with intellectual disability is one of the most unattended health needs. Evidence suggests that inadequate oral health habits are more prevalent in the studied population than in the Portuguese population.
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Affiliation(s)
- Patrícia Couto
- Faculty of Health Sciences, Beira Interior University, Covilhã, Portugal
| | - Paulo Almeida Pereira
- Department of Economics, Management and Social Sciences, Portuguese Catholic University, Viseu, Portugal
| | - Manuel Nunes
- Faculty of Health Sciences, Beira Interior University, Covilhã, Portugal
| | - Rui Amaral Mendes
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
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Abstract
Down syndrome is a common disorder with many oral conditions and systemic manifestations. Dentists need to take a holistic approach including behavioral, oral, and systemic issues. This review of the literature focuses on oral anomalies, systemic interaction, management, and recommendations.
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Affiliation(s)
- Azizah Bin Mubayrik
- Department Oral Medicine & Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
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Couto P, Pereira PA, Nunes M, Mendes RA. Oral health-related quality of life of Portuguese adults with mild intellectual disabilities. PLoS One 2018; 13:e0193953. [PMID: 29561892 PMCID: PMC5862473 DOI: 10.1371/journal.pone.0193953] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 02/21/2018] [Indexed: 01/30/2023] Open
Abstract
Individuals with disabilities are regarded as a highly vulnerable population group, particularly as far as oral health is concern. However, few studies have assessed the impact of the oral condition on the quality of life of these individuals. Therefore, the aim of this study is to expand knowledge on the oral health status of the Portuguese adults with mild intellectual disability, and to assess how the patient's oral health is related to their quality of life. A sample of 240 adults with mild intellectual disabilities linked to the Portuguese Federation for Intellectual Disability, were interviewed using a previously validated version of the Oral Health Impact Profile. An oral health examination was also conducted using three oral health indexes: Clinical Oral Health Index (COHI); Clinical Oral Care Needs Index (COCNI) and the Clinical Oral Prevention Index (COPI). Sociodemographic characteristics and dental health factors were also collected, following statistical analysis. More than half of the individuals (54,9%) presented one or more problems of major to severe impact on health (COHI level 2); only 4,6% of the individuals do not need treatment or examination (COCNI level 0) and 85% of the study sample needs measures of educational or preventive action (COPI level 1). In 76,9% of the participants, oral health had impact on the quality of life. The most affected dimensions of life were physical pain with 61,9%, followed by psychological discomfort and psychological disability with 45,1% and 45%, respectively. With relation to oral health factors and sociodemographic variables it was verified that fewer teeth and higher self-perception of need for dental treatment had a negative impact on the quality of life. On the other hand, institutionalization and an increase in at least one category in the self-perception of the oral health status had a positive impact on the quality of life. Given the high burden of oral disease and the considerable impact on quality of life found in this study, the establishment of guidelines to improve the oral health and quality of life of these individuals should be regarded as imperative.
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Affiliation(s)
- Patrícia Couto
- Faculty of Health Sciences, Beira Interior University, Covilhã, Portugal
- * E-mail: (PC); (RAM)
| | - Paulo Almeida Pereira
- Department of Economics, Management and Social Sciences, Portuguese Catholic University, Viseu, Portugal
| | - Manuel Nunes
- Faculty of Health Sciences, Beira Interior University, Covilhã, Portugal
| | - Rui Amaral Mendes
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
- * E-mail: (PC); (RAM)
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Pan MY, Hsieh TC, Tai HC, Lin MS, Lin YC, Chen MY. Prevalence of and factors associated with fewer than 20 remaining teeth in Taiwanese adults with disabilities: a community-based cross-sectional study. BMJ Open 2017; 7:e016270. [PMID: 28993381 PMCID: PMC5639993 DOI: 10.1136/bmjopen-2017-016270] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To examine the prevalence of and the factors associated with a number of remaining teeth (NRT) <20 among adults with disabilities. DESIGN A community-based, cross-sectional descriptive study. SETTING This study was part of a health promotion programme designed for community-dwelling adults with disabilities. PARTICIPANTS A total of 549 adults with disabilities, aged 20-80 years, living in the community in Chiayi County in Taiwan. OUTCOME MEASURES Various parameters, including NRT, oral health behaviours (ie, oral hygiene, dietary habits and substance use), comorbidities, disability classification and capability for performing activities of daily living, were measured. Data were statistically analysed using descriptive statistics and multivariate logistic regression analysis. RESULTS The mean NRT was 18.1 (SD=10.9); 44.8% of participants had NRT <20 (including 13.7% edentulous participants). Most participants had poor oral hygiene: 83.4% reported seldom using dental floss, 78% did not undergo regular 6-monthly dental check-ups and 77.4% seldom brushed their teeth after meal. After adjusting for potentially confounding variables, the intellectual disability group had a significantly higher risk of an NRT <20 than the physical disability group (OR 2.30, 95% CI 1.30 to 4.08). Additionally, the rare use of dental floss and hypertension significantly increased the possibility of an NRT <20 (OR 1.73-2.12, 95% CI 1.15 to 3.71). CONCLUSIONS An NRT <20 and edentulism were highly prevalent among adults with disabilities, who displayed poor oral hygiene behaviours. Adults with intellectual disabilities had a greater likelihood of having an NRT <20 than did those with physical disability. In addition to unmodifiable factors, the poor use of dental floss was significantly associated with an NRT <20.
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Affiliation(s)
- Mei-Yu Pan
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | | | - Hung-Cheng Tai
- Department of General Education, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Ming-Shyan Lin
- Department of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yu-Chen Lin
- Department of Health Promotion, Chiayi Bureau of Health, Taiwan
| | - Mei-Yen Chen
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
- Department of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Nursing, Chang Gung University, Taoyuan, Taiwan
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Kim IH, Kuk TS, Park SY, Choi YS, Kim HJ, Seo KS. Prognosis following dental implant treatment under general anesthesia in patients with special needs. J Dent Anesth Pain Med 2017; 17:205-213. [PMID: 29090251 PMCID: PMC5647824 DOI: 10.17245/jdapm.2017.17.3.205] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 09/11/2017] [Accepted: 09/14/2017] [Indexed: 11/15/2022] Open
Abstract
Background This study retrospectively investigated outcomes following dental implantation in patients with special needs who required general anesthesia to enable treatment. Methods Patients underwent implant treatment under general anesthesia at the Clinic for the Disabled in Seoul National University Dental Hospital between January 2004 and June 2017. The study analyzed medical records and radiographs. Implant survival rates were calculated by applying criteria for success or failure. Results Of 19 patients in the study, 8 were males and 11 were females, with a mean age of 32.9 years. The patients included 11 with mental retardation, 3 with autism, 2 with cerebral palsy, 2 with schizophrenia, and 1 with a brain disorder; 2 patients also had seizure disorders. All were incapable of oral self-care due to serious cognitive impairment and could not cooperate with normal dental treatment. A total of 27 rounds of general anesthesia and 1 round of intravenous sedation were performed for implant surgery. Implant placement was performed in 3 patients whose prosthesis records could not be found, while 3 other patients had less than 1 year of follow-up after prosthetic treatment. When the criteria for implant success or failure were applied in 13 remaining patients, 3 implant failures occurred in 59 total treatments. The cumulative survival rate of implants over an average of 43.3 months (15-116 months) was 94.9%. Conclusions For patients with severe cognitive impairment who are incapable of oral self-care, implant treatment under general anesthesia showed a favorable prognosis.
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Affiliation(s)
- Il-Hyung Kim
- Department of Oral and Maxillofacial Surgery, Seoul National University, School of Dentistry, Seoul, Korea
| | - Tae Seong Kuk
- Department of Oral and Maxillofacial Surgery, Seoul National University, School of Dentistry, Seoul, Korea
| | - Sang Yoon Park
- Department of Oral and Maxillofacial Surgery, Seoul National University, School of Dentistry, Seoul, Korea
| | - Yong-Suk Choi
- Department of Oral and Maxillofacial Surgery, Seoul National University, School of Dentistry, Seoul, Korea
| | - Hyun Jeong Kim
- Department of Dental Anesthesiology, Seoul National University, School of Dentistry, Seoul, Korea
| | - Kwang-Suk Seo
- Department of Dental Anesthesiology, Seoul National University, School of Dentistry, Seoul, Korea
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Brown LF, Ford PJ, Symons AL. Periodontal disease and the special needs patient. Periodontol 2000 2017; 74:182-193. [DOI: 10.1111/prd.12198] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 12/22/2022]
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García-Carrillo A, Jover A, Plá R, Martorell A, Sota C, Gómez-Moreno G, Figuero E, Sanz M, Herrera D. Manual versus
sonic powered toothbrushing in patients with intellectual disability: a cluster-randomized clinical trial. J Clin Periodontol 2016; 43:684-93. [DOI: 10.1111/jcpe.12567] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | - Antonio Jover
- Section of Graduate Periodontology; Faculty of Odontology; University Complutense; Madrid Spain
| | - Rafael Plá
- Section of Graduate Periodontology; Faculty of Odontology; University Complutense; Madrid Spain
| | | | | | | | - Elena Figuero
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; Faculty of Odontology; University Complutense; Madrid Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; Faculty of Odontology; University Complutense; Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; Faculty of Odontology; University Complutense; Madrid Spain
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Khocht A, Albandar JM. Aggressive forms of periodontitis secondary to systemic disorders. Periodontol 2000 2015; 65:134-48. [PMID: 24738590 DOI: 10.1111/prd.12015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A number of systemic disorders increase a patient's susceptibility to destructive periodontitis and have impacts on periodontal disease progression and severity. The underlying factors are usually genetic and are mainly related to alterations in the immune response and in certain endocrine functions, leading to various syndromes in which periodontitis and/or early tooth loss are secondary manifestations. Neutrophils are important immune defense cells that play a significant role in controlling the spread of microbial plaque infections in the dentogingival region. This review focuses on a selected group of systemic disorders that are associated with alterations in either neutrophil counts (quantitative disorders) or function (qualitative disorders), and defects in the mineralization of bone and dental tissues. In most of these diseases controlling the periodontal disease progression is very challenging. Proper diagnosis is a prerequisite for proper management of the periodontal problem. Future advances in research, including gene targeting and the resolution of enzyme deficiencies, may bring about remedies of the underlying systemic disorders and may significantly improve the outcome of periodontal treatment in these patients.
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Mac Giolla Phadraig C, Guerin S, Nunn J. Should we educate care staff to improve the oral health and oral hygiene of people with intellectual disability in residential care? Real world lessons from a randomized controlled trial. SPECIAL CARE IN DENTISTRY 2015; 35:92-8. [DOI: 10.1111/scd.12102] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Caoimhin Mac Giolla Phadraig
- Department of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland
| | - Suzanne Guerin
- School of Psychology, University College Dublin, Dublin, Ireland
| | - June Nunn
- Department of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland
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15
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Yap E, Parashos P, Borromeo GL. Root canal treatment and special needs patients. Int Endod J 2014; 48:351-61. [PMID: 24871933 DOI: 10.1111/iej.12321] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 05/22/2014] [Indexed: 11/26/2022]
Abstract
AIM To identify current trends of root canal treatment for patients with special needs. METHODOLOGY A postal questionnaire was sent to General Dentists in Victoria, Australia and Endodontists and Special Needs Dentists across Australia to determine the extent of root canal treatment performed on special needs patients. RESULTS Over a four-month period, 1120 questionnaires were distributed with an overall response rate of 63.9% (n = 716). Response rates were 63.2% (n = 655), 68.5% (n = 50) and 100.0% (n = 11) amongst General Dentists, Endodontists and Special Needs Dentists, respectively. Endodontists (95.7%) and Special Needs Dentists (100.0%) performed significantly more root canal treatment on adult patients with special needs compared with 51.2% of General Dentists, (P < 0.001 and P = 0.001 respectively; Fisher's exact test). The most common reasons for not undertaking root canal treatment included limited cooperation, poor oral hygiene and uncontrolled movement. Amongst General Dentists, 75.7% opted for extraction in preference to root canal treatment. Significantly, more specialist practitioners performed root canal treatment utilizing conscious sedation (P < 0.001) and general anaesthesia (P = 0.003). Most specialist practitioners (69.1%) had undertaken single-visit root canal treatment on special needs patients compared with only 29.7% of General Dentists (P < 0.001). CONCLUSIONS Root canal treatment in special needs patients was more likely to be carried out by specialist dental practitioners who were more likely to utilize a pharmacological approach for behaviour guidance and to perform single-visit root canal treatment compared with General Dentists. A multidisciplinary approach for special needs patients who require root canal treatment provides an opportunity for these patients to retain their dentition.
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Affiliation(s)
- E Yap
- Faculty of Medicine, Dentistry and Health Sciences, Melbourne Dental School, University of Melbourne, Carlton, Australia
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Phadraig C MG, Burke E, McCallion P, McGlinchey E, Nunn J, McCarron M. Dental attendance among older adults with intellectual disabilities in Ireland. SPECIAL CARE IN DENTISTRY 2014; 34:265-72. [DOI: 10.1111/scd.12067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Mac Giolla Phadraig C
- Dublin Dental University Hospital; Department of Child and Public Dental Health; Dublin Ireland
- School of Dental Science; Trinity College; Dublin Ireland
| | - Eilish Burke
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
| | - Philip McCallion
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
- School of Social Welfare; University at Albany; Albany Canada
| | - Eimear McGlinchey
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
| | - June Nunn
- Dublin Dental University Hospital; Department of Child and Public Dental Health; Dublin Ireland
- School of Dental Science; Trinity College; Dublin Ireland
| | - Mary McCarron
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
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Numoto Y, Mori T, Maeda S, Tomoyasu Y, Higuchi H, Egusa M, Miyawaki T. Low bone mass is a risk factor in periodontal disease-related tooth loss in patients with intellectual disability. Open Dent J 2013; 7:157-61. [PMID: 24358063 PMCID: PMC3866628 DOI: 10.2174/1874210601307010157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 10/26/2013] [Accepted: 10/31/2013] [Indexed: 11/25/2022] Open
Abstract
Teeth are fundamental to maintaining good quality of life, but are often lost prematurely in individuals with intellectual disability. Furthermore, since bone mass decreases in menopausal women, women with intellectual disability have an augmented risk of losing their teeth. However, the relationship between periodontal disease-related tooth loss and bone mass has never been studied specifically in patients with intellectual disability. This study evaluated this relationship in a retrospective cohort study.
Participants were female dental patients aged between 20 and 50 years and with an intellectual disability, who were treated in the Special Needs Dentistry unit of the Okayama University Hospital from January 2009 to March 2010. Logistic regression analysis was used to analyze which factors affect periodontal disease-related tooth loss. Information relating to 12 predictor variables, including age and bone mass level, was derived from medical records.
The 27 subjects had a total of 704 teeth at the time of initial examination, but 20 teeth (2.8%) had been lost owing to periodontal disease by the time bone mass measurements were recorded. Results of the multinomial logistic regression analysis indicated a significant odds ratio for three items: number of missing teeth at the time of initial examination, bone mass, and living environment.
This result suggests that low bone mass is an independent risk factor in tooth loss secondary to periodontal disease in patients with intellectual disability. Dentists should thus take account of this heightened risk of tooth loss when caring for post-menopausal women with intellectual disability.
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Affiliation(s)
- Yoko Numoto
- Department of Dental Anesthesiology and Special Care Dentistry, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takayuki Mori
- Center of the Special Needs Dentistry Okayama University Hospital, Okayama, Japan
| | - Shigeru Maeda
- Department of Dental Anesthesiology, Okayama University Hospital, Okayama, Japan
| | - Yumiko Tomoyasu
- Department of Dental Anesthesiology and Special Care Dentistry, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hitoshi Higuchi
- Department of Dental Anesthesiology, Okayama University Hospital, Okayama, Japan
| | - Masahiko Egusa
- Center of the Special Needs Dentistry Okayama University Hospital, Okayama, Japan
| | - Takuya Miyawaki
- Department of Dental Anesthesiology and Special Care Dentistry, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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18
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Ohtawa Y, Tsujino K, Kubo S, Ikeda M. Dental treatment for patients with physical or mental disability under general anesthesia at Tokyo Dental College Suidobashi Hospital. THE BULLETIN OF TOKYO DENTAL COLLEGE 2013; 53:181-7. [PMID: 23318923 DOI: 10.2209/tdcpublication.53.181] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Dental treatment for patients with physical or mental disability is often performed under general anesthesia due to level of cooperation with treatment, type and location of treatment, time required, or number of times patient is required to attend hospital. University hospitals are receiving an increasing number of requests from local private dentists and dental clinics to provide dental care for patients with physical or mental disability which can only be performed under general anesthesia. We carried out a retrospective survey of the routes of referral and types of dental treatment carried out in such patients under general anesthesia at Tokyo Dental College Suidobashi Hospital. The survey covered a 5-year, 9-month period from April 2006 to December 2011, during which 163 patients, comprising 106 men and 57 women, were treated. Their age ranged widely, from 2 to 53 years, with a high proportion (118 patients, 72.4%) being minors aged under 20. Among the total number of patients, 69 (42.3%) had disorders associated with mental retardation. One hundred and two patients (62.6%) had been referred from other medical institutions, with a particularly high number coming from public dental clinics for patients specializing in such patients. Conservative restorative procedures were performed in most cases (59.4%), with composite resin restorations being particularly frequent. After treatment, many patients returned to their referring medical institutions, which were responsible for subsequent management, but information on the posttreatment status was not available for some patients. Tokyo Dental College Suidobashi Hospital frequently collaborates with local medical institutions, and the present results suggest the importance of improving such collaboration.
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Affiliation(s)
- Yumi Ohtawa
- Division of Specific Care Dentistry, Department of Oral Health Science, Tokyo Dental College, Tokyo, Japan.
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19
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Zizzi A, Piemontese M, Gesuita R, Nori A, Berlin RS, Rocchetti R, Carle F, Rubini C, Aspriello SD. Periodontal status in the Down's syndrome subjects living in central-eastern Italy: the effects of place of living. Int J Dent Hyg 2013; 12:193-8. [DOI: 10.1111/idh.12062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2013] [Indexed: 12/13/2022]
Affiliation(s)
- A Zizzi
- Department of Biomedical Sciences and Public Health; Section of Pathologic Anatomy and Histopathology; Polytechnic University of Marche; Ancona Italy
| | - M Piemontese
- Department of Clinical Special and Dental Science, Periodontology; Polytechnic University of Marche; Ancona Italy
| | - R Gesuita
- Centre of Epidemiology; Biostatistic and Medical Statistics; Polytechnic University of Marche; Ancona Italy
| | - A Nori
- SOD of Odontostomatological and Special Surgery; United Hospital of Ancona; Ancona Italy
| | - RS Berlin
- SOD of Odontostomatological and Special Surgery; United Hospital of Ancona; Ancona Italy
| | - R Rocchetti
- Department of Biomedical Sciences and Public Health; Section of Pathologic Anatomy and Histopathology; Polytechnic University of Marche; Ancona Italy
| | - F Carle
- Centre of Epidemiology; Biostatistic and Medical Statistics; Polytechnic University of Marche; Ancona Italy
| | - C Rubini
- Department of Biomedical Sciences and Public Health; Section of Pathologic Anatomy and Histopathology; Polytechnic University of Marche; Ancona Italy
| | - SD Aspriello
- Department of Clinical Special and Dental Science, Periodontology; Polytechnic University of Marche; Ancona Italy
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20
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Finkelman MD, Stark PC, Tao W, Morgan JP. Relationship between duration of treatment and oral health in adults with intellectual and developmental disabilities. SPECIAL CARE IN DENTISTRY 2013; 34:171-5. [DOI: 10.1111/scd.12049] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Matthew D. Finkelman
- Assistant Professor, Department of Public Health and Community Service; Tufts University School of Dental Medicine; Boston MA
| | - Paul C. Stark
- Professor, Department of Public Health and Community Service; Tufts University School of Dental Medicine; Boston MA
| | - Wen Tao
- Health Quality Data Analyst; Children's Hospital Boston; Boston MA
| | - John P. Morgan
- Associate Professor, Department of Public Health and Community Service; Tufts University School of Dental Medicine; Boston MA
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21
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Gabre P, Moberg Sköld U, Birkhed D. Simplified methods of topical fluoride administration: effects in individuals with hyposalivation. SPECIAL CARE IN DENTISTRY 2012; 33:111-7. [PMID: 23600981 DOI: 10.1111/scd.12002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Pia Gabre
- Public Dental Health; Uppsala County Council; Uppsala; Sweden
| | - Ulla Moberg Sköld
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg; Sweden
| | - Dowen Birkhed
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg; Sweden
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22
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The oral health status of 4,732 adults with intellectual and developmental disabilities. J Am Dent Assoc 2012; 143:838-46. [DOI: 10.14219/jada.archive.2012.0288] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Hickey F, Hickey E, Summar KL. Medical update for children with Down syndrome for the pediatrician and family practitioner. Adv Pediatr 2012; 59:137-57. [PMID: 22789577 DOI: 10.1016/j.yapd.2012.04.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Fran Hickey
- Department of Pediatrics, Medical Director of The Anna and John Sie Center for Down syndrome, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, 80045, USA.
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24
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Ribeiro CG, Siqueira AF, Bez L, Cardoso AC, Ferreira CF. Dental Implant Rehabilitation of a Patient With Down Syndrome: A Case Report. J ORAL IMPLANTOL 2011; 37:481-7. [DOI: 10.1563/aaid-joi-d-10-00003.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract
Implant-supported rehabilitations show higher patient satisfaction when compared with conventional prostheses. Systemic conditions, however, can affect treatment planning of dental implant supported rehabilitations. The oral structures that are commonly affected in patients with Down syndrome include the tongue (macroglossia), teeth (number and shape), and poor quality alveolar and jaw bones (osteoporotic-like). This clinical case presents an interdisciplinary team approach aimed at achieving functional, phonetic, and esthetic outcomes in a patient with Down syndrome.
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Affiliation(s)
- Cleide Gisele Ribeiro
- Department of Dental Clinic, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | | | - Leonardo Bez
- Department of Periodontology, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Antônio Carlos Cardoso
- Department of Prosthodontics, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Cimara Fortes Ferreira
- Department of Periodontology, University of Tennessee School of Dentistry, Memphis, Tenn
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25
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Anders PL, Davis EL. Oral health of patients with intellectual disabilities: a systematic review. SPECIAL CARE IN DENTISTRY 2010; 30:110-7. [PMID: 20500706 DOI: 10.1111/j.1754-4505.2010.00136.x] [Citation(s) in RCA: 232] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A systematic review of original studies was conducted to determine if differences in oral health exist between adults who have intellectual disabilities (ID) and the general population. Electronic searching identified 27 studies that met the inclusion criteria. These studies were assessed for strength of evidence. People with ID have poorer oral hygiene and higher prevalence and greater severity of periodontal disease. Caries rates in people with ID are the same as or lower than the general population. However, the rates of untreated caries are consistently higher in people with ID. Two subgroups at especially high risk for oral health problems are people with Down syndrome and people unable to cooperate for routine dental care. Evidence supports the need to develop strategies to increase patient acceptance for routine care, additional training for dentists to provide this care, and the development of more effective preventive strategies to minimize the need for this care.
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Affiliation(s)
- Patrick L Anders
- Department of Oral Diagnostic Sciences, State University of New York at Buffalo School of Dental Medicine Buffalo, New York, USA.
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Klingberg G, Hallberg U, Oskarsdóttir S. Oral health and 22q11 deletion syndrome: thoughts and experiences from the parents' perspectives. Int J Paediatr Dent 2010; 20:283-92. [PMID: 20536590 DOI: 10.1111/j.1365-263x.2010.01052.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND 22q11 deletion syndrome (22q11DS) is one of the most common multiple anomaly syndromes, and many dentists are likely to meet patients with the syndrome. Odontological research has focused on describing and analysing conditions/concepts based on the current state of knowledge within the dental profession. Yet, these research topics are not necessarily the most important issues for the patients. AIMS To explore and describe, by use of Grounded theory, parents' experiences of oral health issues and needs for dental care in their children with 22q11DS. DESIGN Twelve parents from different regions in Sweden were interviewed. Analyses were carried out according to Grounded theory. RESULTS Parents recognised good oral health as important for the wellbeing of their children. Oral health was a concern and the parents described the fight for this as struggling in vain for good oral health in their child. CONCLUSIONS Parents not only described their children's oral health as important but also hard to gain. Thus, it is important that all patients with disabilities, regardless of whether there is a defined medical diagnosis or not, are identified and well taken care of in the dental care system.
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Affiliation(s)
- Gunilla Klingberg
- Mun-H-Center, National Orofacial Resource Centre for Rare Disorders, and Department of Pediatric Dentistry, The Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
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27
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Fung K, Lawrence H, Allison P. A paired analysis of correlates of dental restorative care in siblings with and without Down syndrome. SPECIAL CARE IN DENTISTRY 2008; 28:85-91. [PMID: 18489654 DOI: 10.1111/j.1754-4505.2008.00018.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study examined the hypothesis that age-matched siblings with and without Down syndrome (DS) have the same risk of ever having had a tooth restored. A sibling-matched, population-based, cross-sectional survey design was used with the help of the Canadian Down Syndrome Society whose members were the sample source. The relationship between DS status and restorative status was evaluated using conditional multiple logistic regression with matching by sibling status and adjustment to control for sociodemographic and clinical variable. Data from 793 sibling pairs were used for the analyses. DS status was strongly related to dental restoration in that subjects with DS had reduced odds for ever having had a tooth restored (OR: 0.28; 95% CI: 0.18-0.43). An analysis of the results suggested that, controlling for age and family-related factors commonly associated with dental care, children with DS were less likely to have had a tooth restored than their sibling without DS.
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Affiliation(s)
- Karen Fung
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
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28
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Seirawan H, Schneiderman J, Greene V, Mulligan R. Interdisciplinary approach to oral health for persons with developmental disabilities. SPECIAL CARE IN DENTISTRY 2008; 28:43-52. [DOI: 10.1111/j.1754-4505.2008.00010.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cheng RH, Leung WK, Corbet EF. Non-Surgical Periodontal Therapy With Adjunctive Chlorhexidine Use in Adults With Down Syndrome: A Prospective Case Series. J Periodontol 2008; 79:379-85. [DOI: 10.1902/jop.2008.070247] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hallberg U, Klingberg G. Giving low priority to oral health care. Voices from people with disabilities in a grounded theory study. Acta Odontol Scand 2007; 65:265-70. [PMID: 18092201 DOI: 10.1080/00016350701545734] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Our knowledge of how people with disabilities look upon oral health and dental care is limited. The aim of this study was thus to explore how the people with disabilities experience the encounter with dental health care. MATERIAL AND METHODS With a focus on dental care and oral health, qualitative interviews with 16 informants with cognitive and/or physical disabilities were analysed in accordance with the qualitative method of grounded theory. RESULTS A core category identified and labeled "giving low priority to oral health care" was found to be related to four other categories: "being afraid of losing control", "having difficulties complying with instructions", "having a desire for continuity", and "wishing to be just like everyone else". The results show that oral health and dental care are important, but are not considered a priority by the people with disabilities. General health issues have much higher priority but do not include oral health, which consequently can affect oral health negatively. CONCLUSIONS Of several factors identified that could be improved to make dental visits more pleasant for patients are enhancing a sense of control in the patient and improving continuity.
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31
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Butler DR, Chilvers CR, Cane RJ. The implications and management of acute odontogenic infection in association with Down and Eisenmenger syndromes and schizophrenia in a rural setting. Aust Dent J 2007; 52:61-6. [PMID: 17500166 DOI: 10.1111/j.1834-7819.2007.tb00467.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND This report describes the case management of a 32 year old special needs patient with life-threatening odontogenic infection. The combination of schizophrenia, Down and Eisenmenger syndromes presented significant challenges to managing his oral health, particularly within the rural context. In this case, dental treatment was limited to a full dental clearance during a high risk general anaesthesia session. METHOD A comprehensive work-up prior to general anaesthesia was an essential aspect of care. This included a full medical history and examination, communication between medical specialists, the dentist and family consultation. The anaesthetic procedure was undertaken using a careful regimen of drugs and monitoring to minimize the impact on his cardiovascular system. Techniques to minimize bleeding from extraction sites were also important. RESULTS Three weeks postsurgically the patient was reviewed and his family reported that he was interacting positively with them after years of surliness and conflict. This was attributed to a managed psychotropic medication regimen and improved dental condition, which has led to a sustained improvement in quality of life. CONCLUSIONS The management of acute odontogenic infection for special needs patients in the rural setting requires a local interdisciplinary team approach, careful consideration of related pathophysiology and its potential impact on general anaesthesia, and close consultation with family and carers.
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32
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Cheng RHW, Leung WK, Corbet EF, King NM. Oral health status of adults with Down syndrome in Hong Kong. SPECIAL CARE IN DENTISTRY 2007; 27:134-8. [DOI: 10.1111/j.1754-4505.2007.tb00335.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tsai WC, Kung PT, Chiang HH, Chang WC. Changes and factors associated with dentists' willingness to treat patients with severe disabilities. Health Policy 2007; 83:363-74. [PMID: 17416437 DOI: 10.1016/j.healthpol.2007.02.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2006] [Revised: 01/23/2007] [Accepted: 02/24/2007] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study investigated changes in dentists' willingness to treat severely disabled patients and to understand dentists' opinions on reimbursements after the implementation of a dental care financial reward program in Taiwan. METHODS Three hundred dentists from 29 teaching hospitals were randomly selected to answer a structured questionnaire, and 184 structured questionnaires were returned. Multiple regression analysis was used to examine the factors associated with dentists' willingness to treat severely disabled patients. RESULTS Approximately 60% of the dentists said reimbursements for treatment of severely disabled patients were reasonable. 50.4% of dentists were willing or very willing to treat disabled patients. Seventy-nine percent dentists affected by the program had a higher willingness but 83.7% dentists said this program did not make a significant difference to their income. 52.8% of dentists agreed the program would increase the quality of dental care. The factors significantly affecting dentists' willingness included dentist's age, specialty field, perception of the program in promoting the quality of dental services, and perception of the ability to provide adequate treatments for severely disabled patients. CONCLUSIONS The rewards program significantly increased the willingness of most hospital-base dentists to treat the severely disabled patients although the effect of incentive to their income was limited.
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Affiliation(s)
- Wen-Chen Tsai
- Department of Health Services Management, China Medical University, Taichung, Taiwan, ROC
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34
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Durham TM, King T, Salinas T, Franco T, Ross J. Dental Implants in Edentulous Adults with Cognitive Disabilities: Report of a Pilot Project. SPECIAL CARE IN DENTISTRY 2006; 26:40-6. [PMID: 16703934 DOI: 10.1111/j.1754-4505.2006.tb01509.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Individuals with cognitive disabilities face many barriers to oral care, often suffering from partial or complete edentulism. While the use of implant reconstruction is becoming more common in the general population, such care is still being used infrequently in individuals with intellectual impairment. A pilot project in 1995 surgically placed and restored implant-supported prostheses in six edentulous adults who had varying degrees of cognitive impairment. This report presents the dentists' reconstruction experiences and the patients' follow-up care, and discusses the results in relationship to current literature. Experiences from these patients suggest that behavior during the restorative process, prosthetic complications post placement, and patients' oral hygiene practices should influence patient selection and prosthetic design. Anteriorly placed fixtures and removable designs, which make self-care and repair easier, can be used to treat an edentulous population.
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Affiliation(s)
- Timothy M Durham
- University of Nebraska Medical Center College of Dentistry, Department of Adult Restorative Dentistry, Omaha, USA
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35
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Schrojenstein Lantman-de Valk HMJ. Health in People with Intellectual Disabilities: Current Knowledge and Gaps in Knowledge. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2005. [DOI: 10.1111/j.1468-3148.2005.00265.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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36
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Fung K, Allison PJ. A Comparison of Caries Rates in Non-Institutionalized Individuals With and Without Down Syndrome. SPECIAL CARE IN DENTISTRY 2005; 25:302-10. [PMID: 16463603 DOI: 10.1111/j.1754-4505.2005.tb01405.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The caries rate of people with Down syndrome (DS) was compared to an age-matched control population without DS. A cross-sectional study design was used. Caries rates were assessed by an adjusted DFT score, expressed as a proportion of number of teeth in the mouth, to control for hypodontia in the subjects with DS. Bivariate and multiple linear regression analyses were used to compare caries rates in persons with and without DS. The sample size was 128, in which 44 were subjects with DS and 84 were subjects without DS. On a range of 0-1, the mean adjusted DFT scores were 0.10 in subjects with DS and 0.18 in the control group. Although this difference was significant at the bivariate level of analysis, in the multiple linear regression model, adjusted DFT was associated with age and professional fluoride therapy only. When expressed as a proportion of number of teeth, caries rates were not different in people with and without DS.
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Affiliation(s)
- Karen Fung
- Faculty of Dentistry, McGill University, Montreal, Canada
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37
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Pezzementi ML, Fisher MA. Oral health status of people with intellectual disabilities in the southeastern United States. J Am Dent Assoc 2005; 136:903-12. [PMID: 16060471 DOI: 10.14219/jada.archive.2005.0291] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The U.S. surgeon general's report, Oral Health in America, stated that people living below the poverty level and those with mental retardation and/or physical disabilities have poorer oral health than the general population. METHODS The calibrated examiners (volunteer dentists and dental students) assessed the oral health status of intellectually disabled people with or without a physical disability via screening examinations provided to 12,099 Special Olympics athletes at 53 sites, including 1891 people from seven states in the southeastern United States. Measurements of gingivitis, untreated decay, missing molars, sealants, restorations and treatment urgency were recorded. RESULTS The authors found that athletes from the very poor southeastern states were 1.6 times (odds ratio [OR] = 1.64; 95 percent confidence interval [CI]: 1.10 to 2.46) more likely to have restorations and almost one-third as likely (OR = 0.35; 95 percent CI: 0.21 to 0.60) to have sealants than were athletes from the poor states, after restricting the analysis by age. CONCLUSIONS Among intellectually disabled people in this study, oral health disparities were associated with poverty. Special Olympics athletes from the poorest states were significantly more likely to have restorations and less likely to have received preventive treatment.
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Affiliation(s)
- Maureen L Pezzementi
- Department of Comprehensive Dentistry, University of Alabama at Birmingham School of Dentistry, AL 35294, USA.
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Yoshihara T, Morinushi T, Kinjyo S, Yamasaki Y. Effect of periodic preventive care on the progression of periodontal disease in young adults with Down's syndrome. J Clin Periodontol 2005; 32:556-60. [PMID: 15882211 DOI: 10.1111/j.1600-051x.2005.00712.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the effect of periodic preventive care on the progression of periodontal disease in 24 young adults with Down's syndrome (DS) (mean age+/-SD: 20.8+/-5.6 years) MATERIAL AND METHODS Subjects were divided into two groups: 13 subjects who had frequently visited our clinic (mean interval between visits: 3.7+/-1.3 months; managed group) and 11 subjects who had not visited our clinic for more than 1 year (mean duration of no visits: 27.5+/-10.1 months; interrupted group). The progression of periodontal disease in the subjects was evaluated clinically, microbiologically and roentgenologically. RESULTS Clinical parameters (probing depth, frequency of the presence of a pathological periodontal pocket, alveolar bone loss, frequency of the incidence of pathological bone loss, and modified total PMA (M-PMA)) and benzoyl-DL-arginine-naphthylamide (BANA) scores in the interrupted group were significantly higher than those in the managed group. Subject age showed significant positive correlations with probing depth and alveolar bone loss. BANA scores showed significant positive correlations with probing depth, alveolar bone loss and M-PMA in the interrupted group. CONCLUSIONS The results suggest that periodic preventive care is effective for suppressing the progression of periodontal disease in young adults with DS.
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Affiliation(s)
- Toshihiro Yoshihara
- Department of Pediatric Dentistry, School of Dentistry, Kagoshima University, Kagoshima 890-8544, Japan.
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Sakellari D, Arapostathis KN, Konstantinidis A. Periodontal conditions and subgingival microflora in Down syndrome patients. A case-control study. J Clin Periodontol 2005; 32:684-90. [PMID: 15882231 DOI: 10.1111/j.1600-051x.2005.00737.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The periodontal conditions and the subgingival microflora of children, adolescents and young adults (8-28 years old) with Down syndrome were investigated in the present cross-sectional study and compared with those of healthy individuals and subjects with cerebral palsy. MATERIAL AND METHODS Seventy Down syndrome patients, 121 age-matched healthy individuals and 76 patients with cerebral palsy participated in the present study. Full-mouth recordings of clinical parameters (probing depth, probing attachment level, bleeding on probing, hygiene index) and the community periodontal index of treatment needs were assessed and subgingival plaque samples were taken from the Ramfjord teeth and analysed for 14 species using "checkerboard" DNA-DNA hybridization. RESULTS Clinical indices of periodontal inflammation and treatment needs were statistically significant higher among Down syndrome patients compared with the other two groups (ANOVA, p=0.000). Important periodontal pathogens colonize these subjects earlier and at higher levels (chi-squared test, p=0.000). DISCUSSION Down syndrome patients display more severe periodontal destruction earlier, and heavier colonization with periodontal pathogens compared with age-matched healthy individuals and patients with cerebral palsy.
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Affiliation(s)
- D Sakellari
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Greece.
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Abstract
Special needs populations such as the mentally disabled or developmentally disabled present a unique challenge for the dental professionals providing dental treatment. Among those challenges is oral health promotion through primary prevention of dental caries and periodontal disease. There are many barriers to adequate oral care for these special needs patients that include cost, physical limitations, low levels of perceived need and lack of dental knowledge by residents and staff, if the person resides in an institution. Primary prevention to maintain oral comfort and function for these patients is a priority to support their quality of life. Typical oral health problems of these patients include hyposalivation, root-surface caries, poor oral hygiene, a high prevalence of periodontal disease and dental caries. The purpose of this paper is to review information for the inclusion of xylitol in primary preventive regimens as an adjunct for the prevention of oral diseases for special needs patients.
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Affiliation(s)
- Dinah H Kitchens
- Department of Periodontics, Endodontics and Dental Hygiene, University of Louisville School of Dentistry, Louisville, KY, USA.
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Sasaki Y, Sumi Y, Miyazaki Y, Hamachi T, Nakata M. Periodontal management of an adolescent with Down's syndrome--a case report. Int J Paediatr Dent 2004; 14:127-35. [PMID: 15005701 DOI: 10.1111/j.1365-263x.2004.00529.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A case of periodontitis in a young adolescent Japanese girl with Down's syndrome is presented in this report. The patient received a monthly preventive course of dental care consisting of mechanical plaque control and oral hygiene instruction. After 2.5 years she recovered from progression of periodontal disease both clinically and microbiologically. The importance of clinical care for periodontitis in Down's syndrome patients is discussed.
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Affiliation(s)
- Y Sasaki
- Section of Pediatric Dentistry and Section of Preventive Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan.
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Trulsson U, Klingberg G. Living with a child with a severe orofacial handicap: experiences from the perspectives of parents. Eur J Oral Sci 2003; 111:19-25. [PMID: 12558804 DOI: 10.1034/j.1600-0722.2003.00001.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Orofacial functions include competences/abilities such as eating, breathing, speech/language, mimicry, as well as oral health, and disturbances are common in children with rare disorders. To describe parental experiences of orofacial function and needs in children with rare disorders, in-depth interviews focusing on orofacial function were carried out with 14 parents. Interviews were transcribed verbatim and analysed in open, axial (theoretical) and selective coding processes according to Grounded Theory. Two core categories emerged from data in the analysis: 'the vulnerable family' and 'support perceived from others'. The data indicated the importance of a balance between these two core categories: the strain caused by living in a family with a child with a severe disability/handicap, and the availability of perceived support from caregivers and significant others. This balance was necessary for the parents in developing self-reliance and in reconciling themselves to their life situations. Parents described orofacial dysfunction in terms of feeding and communication problems, needs for orthodontic treatment to reduce risk of trauma or improve chewing, and drooling. Oral health issues such as dental caries and gingivitis were not mentioned. Five aspects of good professional attitude were recognized: respect, involvement, continuity, knowledge, and availability.
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Bosch JJ. Health maintenance throughout the life span for individuals with Down syndrome. JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS 2003; 15:5-17. [PMID: 12613408 DOI: 10.1111/j.1745-7599.2003.tb00248.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE To describe the routine health maintenance needs of individuals with Down syndrome who have specialized health needs associated with the multi-system impact of the diagnosis. DATA SOURCES Review of scientific literature including peer-reviewed articles, books, and online resources. CONCLUSION In addition to the routine health maintenance needs of all persons, those with Down syndrome have specialized needs. Failure to address these specific health maintenance concerns may lead to misdiagnoses and failure to reach the highest level of function possible. IMPLICATIONS FOR PRACTICE Patients with Down syndrome who have legitimate, treatable diagnoses may be misdiagnosed as having behavior problems or dementia. Failure to identify abnormalities such as cardiac problems or sleep apnea may shorten life and interfere with ability to live life to the fullest.
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Affiliation(s)
- Joni Jacobsen Bosch
- Center for Disabilities and Development, University of Iowa Hospitals and Clinics, USA.
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Lustig JP, Yanko R, Zilberman U. Use of dental implants in patients with Down syndrome: a case report. SPECIAL CARE IN DENTISTRY 2002; 22:201-4. [PMID: 12580359 DOI: 10.1111/j.1754-4505.2002.tb00271.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Down syndrome is caused by trisomy of the 21st chromosome and is associated with well-described physical and systemic problems. Most people with Down syndrome have some degree of mental retardation as well as malformation of head and neck. Oral structures that are commonly affected include the tongue (macroglossia), abnormalities in the number and shape of teeth, and poor quality (osteoporotic-like) of alveolar bone and jaw. These oral malformations as well as a tendency toward poor cooperation in the dental office contribute to the belief among dentists that people with Down syndrome are not good candidates for oral rehabilitation with dental implants. This article describes the use of dental implants in the oral rehabilitation of a 16-year-old boy with Down syndrome. Although more experience is needed before dental implants can be considered a suitable option during oral rehabilitation in people with Down syndrome, this case report shows a promising beginning.
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Affiliation(s)
- Joseph P Lustig
- Dental Clinic for Medically Compromised Patients, Barzilai Medical Center, Ashkelon, Israel
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Abstracts. Br Dent J 2001. [DOI: 10.1038/sj.bdj.4801065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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