Special Care in Dentistry最新文献

Introduction: As of 2020, about 21% of adults in the United States have a diagnosable mental health disorder, excluding substance use and developmental disorders. Depression, predicted by the WHO to be the leading cause of disease burden by 2030, is linked to various systemic conditions and has been associated with poor oral health. Both behavioral factors, like poor dental hygiene and irregular visits, and biological mechanisms, such as changes in salivary immunity, contribute to this connection, which impacts overall well-being and quality of life. This systematic review aims include: (1) Does tooth loss affect depression? (2) Does oral pain, such as that experienced during chewing and speaking, impact depression? (3) Does oral functionality, including chewing and speaking, influence depression? (4) Does overall oral health affect depression?

Methods: We conducted a systematic search of PubMed, EBSCO host, Medline, and Google Scholar databases from January 2000 to June 2024 using relevant keywords. Studies examining the impact of oral health parameters (tooth loss, oral pain, oral functionality, overall oral health) on depression were included. Articles were included if (1) full text manuscripts in English were available, (2) the study described the association of oral health and depression, and (3) the independent value was an oral related factor and the dependent value was depression. The following were excluded from our analysis: (1) any articles where oral factors were not the independent value, (2) systematic reviews, (3) case reports, and (4) duplicate studies among our databases. Thirty-one studies met the inclusion criteria.

Results: Tooth loss, oral pain, and impaired oral functionality were consistently associated with increased depressive symptoms across the included studies. Greater tooth loss was linked to higher odds of both onset and progression of depression. Oral pain exacerbated depressive symptoms, while difficulties in chewing or speaking were associated with elevated risks of depression.

Conclusion: There is a bidirectional relationship between oral health and depression, highlighting the urgent need for comprehensive public health initiatives. Integrating oral health assessments into routine medical care, and developing targeted interventions are crucial steps to mitigate the impact of poor oral health on mental health outcomes.

Aim: This matched case-control study aimed to investigate the prevalence of traumatic dental injuries (TDI) and its impact on oral health-related quality of life (OHRQoL) in hearing and/or visually impaired children attending government special schools in Eastern India.

Methods: A two-step cluster analysis was performed to define cases and controls based on the Parental-Caregivers Perceptions Questionnaire (PCP-Q) scores from the 228 parent/guardian responses. The cases included children with a higher negative impact on OHRQoL (89 subjects), whereas the controls were those with a lower negative impact on OHRQoL (139 subjects). Groups were matched for age and gender and researchers were blinded to case/control status. Binary logistic regression was performed.

Results: The prevalence of TDI among the study subjects was 24.12%. Compared to subjects in the control group (16.5%), a significantly higher proportion of cases (36%) reported a history of TDI. Children with TDI had considerably higher OHRQoL scores across all P-CPQ sub-scales. Falls were the most common cause of TDI, primarily at home or school and none received treatment.

Conclusion: TDI significantly impacts OHRQoL in these children. Lack of treatment highlights the need for caregiver awareness and improved dental access for children with special needs. Further research with larger samples and specialized OHRQoL tools is recommended.

Aims: Limited data exist on the effectiveness of oral health preventive programs in children with Neurodevelopmental Disorders (NDD). The aim of this study was to evaluate the effectiveness of an individualized preventive oral health program for preschool children with NDD at a rehabilitation center, over a two years period.

Methods and results: In this study, 102 preschool children with NDD were assessed for caries (dmft), oral hygiene status (Green & Vermillion Index) and presence of developmental dental defects. An individualized preventive program was applied based on caries risk and children were followed for two years. Effectiveness of the program was assessed for caries and dental plaque change and explanatory individual factors were used in multivariate models. After two years prospective, dmft increased significantly from 1.1 (SD = 2.7) to 2.04 (SD = 3.6), while GVPI was reduced significantly from 1.8 (SD = 0.9) to 1.4 (SD = 0.9). Children in the moderate and high-risk groups missed significantly more follow-ups compared to the low caries risk group (p < .001) while older maternal age (OR = 1.38, 95%CI = 1.057-1.808) and consumption of more than three sugary snacks/day (OR = 0.005, 95%CI = 0-0.0794) were significantly correlated with dental caries.

Conclusion: The individualized preventive program for preschool children with NDD was effective in improving oral hygiene but not dental caries status.

Introduction: Older adults in Ghana have been disproportionately affected by oral health issues such as caries and periodontitis. This situation calls for comprehensive attention within health and healthcare policies, due to the established connections between oral health and other aspects of health and well-being in high-income countries, including physical and mental health. However, there is a significant gap in the literature when it comes to exploring the association of oral health with physical and mental health in resource-constrained settings like Ghana.

Methods: To address this void, we collected a cross-sectional sample comprising older adults aged 60 and above (n = 1073) and analyzed self-rated health measures to investigate the relationship between oral health and general and mental health in Ghana.

Results: The results of our logistic regression analysis revealed a significant association: older adults who reported poor oral health were more likely to rate their general (OR = 5.10; p < .001) and mental health (OR = 4.78, p < .001) as poor, compared to those with good oral health, even after accounting for demographic and socioeconomic variables.

Conclusions: Based on these findings, we discuss the policy implications of our findings, especially in the context of advancing Sustainable Development Goal 3 in Ghana and other resource-constrained settings.

Aim: The aim of this study was to evaluate outpatient and inpatient dental care for patients with disabilities from 2014 to 2023.

Material and methods: A time series analysis was carried out with data from Brazil's public healthcare system, considering the outpatient productivity of Special Needs Dentistry specialists and hospitalizations (inpatient admissions) of patients with disabilities for dental procedures, both normalized to every 100,000 inhabitants (incidence). The significance level was set at 5%.

Results: In the last 10 years, 22,420,859 procedures were carried out and 89,380 hospitalizations were approved. Trend analysis showed no significant temporal variation in the incidence of both variables. Regarding the procedures, the majority were low-complexity (82.1%, p < .001) and clinical (71.2%, p < .001). Periodontal (19.9%) and restorative (19.5%) procedures were the most frequent. Considering the hospitalizations, almost (R$) 40 million was allocated, and the majority were classified as elective (71.9%, p = .002) and of short duration (less than a day).

Conclusion: Dental care for patients with disabilities presented patterns related to the types of procedures, complexity and circumstance, in addition to not showing significant temporal variation over the last 10 years.

Introduction: Medication-associated osteonecrosis of the jaws (MRONJ) is characterized by the presence of exposed bone or an intraoral or extraoral fistula in the maxillofacial region in patients with a history of treatment with anti-resorptive and anti-angiogenic drugs, such as monoclonal antibodies, and without a history of radiotherapy or metastatic diseases in the area.

Objective: The aim of this study is to report a case of a pathological mandibular fracture in an area of MRONJ in a patient diagnosed with Crohn's disease treated with infliximab.

Case report: A 53-year-old male patient, an active smoker for 35 years, diagnosed with Crohn's disease, undergoing intravenous administration of infliximab 300 mg for 1 year and 3 months, with no previous history of anti-angiogenic or anti-resorptive medication, presenting with an extraoral fistula in the submandibular region for 4 months, with painful symptoms, diagnosed as MRONJ. He was initially treated conservatively, using antimicrobial photodynamic therapy (aPDT), antibiotic therapy, and the PENTO protocol. However, the patient evolved with a pathological fracture in the mandibular parasymphysis, requiring surgical reconstruction.

Final considerations: Pathological fracture of the mandible is a complication of MRONJ that compromises the patient's quality of life. The management of patients with MRONJ is complex and challenging.

Aim: This study aimed to compare the effectiveness of two visual pedagogy methods, video modeling and educational posters, on improving tooth-brushing autonomy in 10-12-year-old children with mild autism.

Methods: Sixty-four autistic children were randomly assigned to either the video or poster groups using the Rand function in Excel. Toothbrushing skills were divided into five stages: preparation, buccal, occlusal, lingual surfaces, and the end. These five stages comprised a total of 20 steps, with each step scored from 1 (not done at all) to 5 (done independently). The final score was calculated by averaging the scores of the five stages. The FONES method of toothbrushing was used for training. Follow-up assessments were conducted after 1 and 3 months. The data were analyzed using SPSS V26, including t-tests, Mann-Whitney U tests, and repeated-measures ANOVA.

Results: After 3 months, there were significant improvements in autonomy scores for both groups, with the video group showing greater benefits (4.37 ± 0.43) compared to the poster group (4.11 ± 0.49) (p = .03), with an effect size of η² = .07.

Conclusion: Both video and poster methods were effective in improving tooth-brushing skills, but video modeling was associated with a higher total autonomy score.