Assessment of oral health status of children with epilepsy: A retrospective cohort study

Sociodemographic factors associated with the level of knowledge about management of epileptic patients in Peruvian dental students: a cross-sectional study under a multivariable analysis

BACKGROUND

Epilepsy is a chronic neurological disease that could indirectly affect oral health, and it is necessary for dentists to be familiar with the specific needs of patients with epilepsy. Therefore, aim of the present study was to assess the factors associated with the level of knowledge about management of epileptic patients in Peruvian dental students.

METHODS

This analytical, observational, cross-sectional and prospective study assessed 312 dental students from a Peruvian university during February to April 2022. A validated questionnaire of 20 closed multiple-choice questions was used to measure the level of knowledge about dental management in epileptic patients. A logit model was used to assess the influence of variables: gender, age, year of study, marital status, place of origin and area of residence, with the level of knowledge in dental students considering a significance level of p < 0.05.

RESULTS

Of the total, 28.8%, 36.2% and 34.9% had a poor, fair and good level of knowledge, respectively, about the dental treatment of epileptic patients. On the other hand, it was observed that being a woman (OR = 0.44, CI 0.26-0.75) and being a third year student (OR = 0.39, CI 0.21-0.74) and fourth year student (OR = 0.43, CI 0.23-0.89) constituted a protective factor against poor knowledge about the dental management of epileptic patients, while being from the capital city constituted a risk factor. Finally, age, marital status and the students' area of residence were not considered influential factors (p > 0.05).

CONCLUSION

Most of the students showed a poor and fair level of knowledge about the dental management of epileptic patients, with gender, academic year and place of origin being influential factors. It is advisable that authorities and teachers in the dental profession organize recurrent training programs on the care of patients with chronic diseases requiring special attention, since knowing general concepts, pharmacological management and dental care of epileptic patients will allow future dentists to develop competencies to improve and implement good quality care protocols for this group of patients.

Assessment of dental caries in children with organic lesions of the nervous system using ICDAS II criteria

Studies of the dental status of children with cerebral palsy (CP) indicate a high prevalence and intensity of damage to the hard tissues of the teeth. The risk of developing dental diseases is known to increase significantly as the severity of neurological symptoms increase. The purpose of the study was to assess the incidence of dental caries using the International Caries Detection and Assessment System (ICDAS II) criteria in children with organic diseases of the nervous system depending on the severity of motor impairment. A number of 122 children (mean age 8.8±3.7 years) with spastic forms of cerebral palsy were examined. They were divided into groups according to the Gross Motor Function Classification System – Expanded & Revised (GMFCS-ER). All patients underwent a neurological examination, and the state of dental caries was determined using the ICDAS II criteria. In children with cerebral palsy, lesions of the occlusal surfaces of the teeth predominate, lesions of the proximal surfaces appeared to be three times less, but more than three times higher than in healthy children. Higher intensity of the carious process and the frequency of deep cavities are observed in children with cerebral palsy with severe motor impairment, according to GMFCS-ER. Establishing the features of caries development in children with cerebral palsy depending on the severity of neurological symptoms according to the ICDAS II system is an essential factor in determining the direction of preventive measures that should be taken for this group of children.

The Oral Health Inequities between Special Needs Children and Normal Children in Asia: A Systematic Review and Meta-Analysis

This meta-analysis aimed to analyze the oral health inequalities among special needs children during 2004-2019 in Asia to reveal the importance and the needs of establishing integrated and equitable special needs dentistry care system in Indonesia. PubMed, Scopus, Cochrane Library, Web of Science, and Wiley Online Library were systematically searched for full-text observational studies published from 1 January 2004 to 15 January 2020, in English in Asia. Studies that included children under 18 years of age with special needs and compared them to healthy controls were selected. Study quality was assessed using the Joanna Briggs Institute 2017 Critical Appraisal Checklist. Risk of bias was assessed using the ROBINS-E tool. The decayed, missing, and filled permanent teeth (DMFT) index indicated that special needs children who suffer from intellectual disability or autism spectrum disorder had significantly more caries than normal children (p < 0.001). The special needs children who had more caries than normal children lived in countries that had a high average DMFT value among 12 years old children (p < 0.001), and these two variables showed a positive correlation in meta-regression analysis (p < 0.001). Having an integrated and equitable care system and elevating children's oral health are important to maintain special needs children's oral health.

The relationship between special needs and dental trauma. A systematic review and meta-analysis

BACKGROUND/AIMS

Understanding the risk factors for dental injuries is essential to develop prevention strategies. The aim of this study was to perform a systematic review and meta-analysis to determine whether people with special needs (SN) have a higher incidence of traumatic dental injury (TDI).

MATERIALS AND METHODS

Electronic searches were performed with no language or date restrictions in the following databases: PubMed, Lilacs, BBO, Scopus, Web of Science, Cochrane Library and Open Gray. According to the PECOS strategy, observational studies that investigated subjects with and without SN and its association with TDI episodes were included. Quality assessment and bias control were carried out according to Fowkes and Fulton guidelines. A meta-analysis was performed by sub-grouping studies according to the type of SN, with the odds ratio (OR) also being calculated (P ≤ .05). The evidence was quality tested using the GRADE approach.

RESULTS

After titles and abstracts were examined, and full texts were read, 28 studies were included in the qualitative synthesis and 27 in the meta-analysis. Three studies were classified with high methodological quality and the others had methodological problems. No associations were determined between TDI and autism spectrum disorder, epilepsy and mental disability (OR 1.12 [0.70, 1.78], OR 1.28 [0.13, 12.27] and OR 1.04 [0.20, 5.35], respectively, P > .05). A positive association (P < .05) was found between TDI and hyperactivity disorder, cerebral palsy, 21 trisomy, various conditions of SN and in pooled results (OR 2.67 [1.22, 5.87], OR 1.89 [1.06, 3.37], OR 6.18 [2.24, 17.05], OR 1.69 [1.18, 2.41], OR 1.61 [1.16; 2.22], respectively).The certainty of evidence ranged from very low to low.

CONCLUSIONS

In general, people with SN had a higher chance of having TDI with very low certainty of evidence. People with ADHD and cerebral palsy had a higher chance of TDI.