Orofacial myofunctional therapy associated with the use of the stimulating palatal plate in children with trisomy 21: case studies

Individuals with trisomy 21 may have muscle hypotonia of the speech articulation organs, an enlarged protruding tongue positioned on the floor of the mouth, and a lack of lip closure. The stimulating palatal plate is an intraoral appliance that, associated with myofunctional therapy, aims to improve these children's habitual lip and tongue posture. This study aimed to present the cases of four male children with trisomy 21, with a mean age of 6.7 and a standard deviation of 7.8 months, who used the stimulating palatal plate in association with myofunctional therapy. The children used the plate for 6 months and did exercises based on the orofacial regulation therapy, and their parents received instructions on feeding them and removing deleterious oral habits. In the first session and at the end of the treatment, each child's face was video-recorded for 5 minutes at rest, and two researchers analyzed independently their habitual tongue and lip posture. Participants who began the treatment earlier and had the most severe postural changes had greater tongue and lip posture improvement.

Access to oral health care services for individuals with rare genetic diseases affecting skeletal development

OBJECTIVE

To identify factors associated with oral health care services for individuals with and without rare genetic diseases.

MATERIALS AND METHOD

A cross-sectional study was undertaken, with 140 individuals paired by sex and age (70 with rare genetic diseases and 70 without), aged between 3 and 27 years, and their parents. The sample was selected from two reference hospitals for patients with rare genetic diseases in southeastern Brazil. The parents completed a questionnaire on individual aspects and their child's medical/dental history. Participants who did and did not suffer from rare genetic diseases were examined for dental caries, malocclusion, dental anomalies, and oral hygiene. The theoretical model Directed Acyclic Graphs (DAG) was used to identify possible confounding variables in the association between rare diseases and access to dental care. Descriptive analyses and non-matched and matched logistic regression models (p < 0.05) were carried out.

RESULTS

The chance of individuals without rare genetic disease having access to oral health care service was 5.32 times higher (95% CI 2.35-12.01) than those with such conditions. Individuals who had not suffered upper respiratory tract infections had a 3.16 times greater chance of being in the group with access to oral health care service (95% CI 1.45-6.90).

CONCLUSION

Individuals with no rare genetic diseases and no history of upper respiratory tract infections had a greater chance of belonging to the group of individuals with access to a dental service. Individuals with rare genetic diseases have less access to oral health care.

Oral health of Brazilian individuals with mucopolyssaccaridosis

PURPOSE

This study described and compared the oral characteristics of Brazilian individuals with mucopolysaccharidosis (MPS) and without MPS.

METHODS

A cross-sectional study was performed with 29 individuals with MPS and 29 without MPS and their parents/guardians. The individuals were aged between 3 and 21 years and attended at two hospitals in Belo Horizonte, southeastern Brazil. The dental characteristics were evaluated by clinical examination of dental caries, gingivitis, malocclusion, dental anomalies and developmental defects of enamel. The parents/guardians answered a questionnaire about the sociodemographic and behavioural aspects of their children. The study was approved by the Research Ethics Committee of the Federal University of Minas Gerais.

RESULTS

The average age of the individuals was 13.9 years (± 7.2). The majority were male (58.6%), had black/brown skin (70.7%) and were from favored economic class (89.7%). Dental caries, gingivitis, malocclusion and dental anomalies were more prevalent in the MPS group (p < 0.05).

CONCLUSION

The individuals with MPS had a higher prevalence of oral diseases and dental anomalies than the group without MPS.

Oral health-related quality of life of young people with mucopolysaccharidosis: a paired cross-sectional study

The purpose of the present study was to compare the perceptions of the parents/ caregivers of young people with and without Mucopolysaccharidosis (MPS) with regards to their oral health-related quality of life (OHRQoL). A cross-sectional study was conducted with 29 individuals with MPS and 29 normotypic individuals aged three to 21 years and their parents/caregivers. All parents/caregivers of young people with MPS in follow-up at two reference hospitals in the city of Belo Horizonte, southeastern Brazil, were invited to participate in the study. Individuals without MPS were recruited from the pediatric clinics of both hospitals. Parents/caregivers answered a structured questionnaire addressing the sociodemographic characteristics, behavioral habits and medical and dental history of the children as well as the Brazilian short-form version of the Parental-Caregiver (P-CPQ). The individuals with and without MPS were examined for malocclusion, dental caries and oral hygiene by an examiner who had undergone training and calibration exercises. Mean age of the subjects was 12.1 years (± 4.2). Comparing total P-CPQ scores and scores on the oral symptoms, functional limitations and wellbeing domains, the parents/caregivers individuos with MPS reported a statistically significant greater negative impact on OS domain than their counterparts. Regarding the clinical variables, malocclusion was also associated a greater negative impact on OHRQoL of young people with MPS when compared to those of young people without MPS. Our findings show the great negative impact caused by the malocclusion of young people with MPS.