Special Care in Dentistry最新文献

Cardiovascular disease is the leading cause of morbidity and mortality worldwide, making it inevitable that dentists will encounter patients with this condition. A thorough understanding of the medical and surgical management of these patients is essential to ensure safe and effective delivery of dental care. A comprehensive preoperative evaluation, optimal perioperative tissue management, and thorough review of postoperative instructions are each critical in reducing the risk of postoperative bleeding and avoiding medical complications when rendering dental services. Additionally, the need for antibiotic prophylaxis and current recommendations for pre-surgical dental intervention will be discussed. This review aims to help elucidate the current guidelines and existing literature, providing insight into best practices for managing this common, yet complex, patient population.

Aims: Myiasis can be particularly debilitating in pediatric patients with neurological impairments, as communication challenges in expressing symptoms may delay diagnosis and appropriate treatment. We report a case of palatal myiasis in a young Latin American patient with neurological deficits.

Methods and results: A 16-year-old female with a history of severe meningitis, which resulted in neurological sequelae including spastic paralysis and epilepsy, presented with an oral lesion in the buccal cavity and episodes of fever. Upon admission, she was diagnosed with bacterial pneumonia, multiple foci of myiasis in the hard and soft palate, and dyspnea caused by larval migration to the oropharyngeal region. Larvae were manually removed, and the patient was treated with intravenous ceftriaxone, clindamycin, and ivermectin. Nitrofurazone paste was also applied topically. Four days later, surgical debridement was performed to remove necrotic mucosa from the palate. No further larvae were detected, and the patient's condition stabilized. The patient has been under follow-up for 1 year.

Conclusion: Severe palatal myiasis is a rare condition that demands prompt diagnosis and a multidisciplinary approach. This case highlights the complexity of managing myiasis in patients with physical and cognitive disabilities, especially in unfavorable socioeconomic conditions.

People with special health care needs and caregivers alike cite dentistry as among the most inaccessible primary health care services. As the population of people living with disabilities increases, there is both a moral and demographic imperative to improve dental education to better serve these patients. It is a significant challenge for many dental schools to provide the breadth and depth of clinical experiences required to produce dentists competent in treating this patient population. Community-based clinical education could provide additional clinical training opportunities in special needs dentistry and represent a potential solution to existing barriers in dental education.

Aims: Individuals with complex medical and social needs often face barriers to health care, leading to poor health outcomes. The Nurse Practitioner-Dentist Integrated Practice Model (NPD Model) integrates a nurse practitioner (NP) within the dental team to enhance chronic disease management, improve access to care, and support interdisciplinary collaboration. This study evaluates a dental school pilot program's clinical and financial impact.

Results: We first examine a case study illustrating the NPD Model's positive impacts on a patient with diabetes and periodontal disease. We also analyze data from patient primary care visits between September 2023 and April 2024 to understand patient demographics, patterns of primary care utilization, clinical outcomes, and financial sustainability. Our results support our hypothesis that the NPD Model facilitates comprehensive, person-centered health care by an interdisciplinary provider team and is especially impactful for individuals with complex medical and social needs; it is also economically feasible in an academic dental setting.

Conclusion: The NPD Model enhances patient-centered care for medically complex individuals by integrating medical and dental services. The NPD Model holds significant potential to be extrapolated to other dental and medical settings, including hospital-based primary care clinics and emergency rooms.

Introduction: Despite the high vulnerabilities of sex workers to poor oral health, there is a substantial global gap in comprehensive evidence regarding their oral health status, reflecting a broader neglect of their oral healthcare needs in public health discourse. In light of this, our systematic review seeks to synthesize and consolidate current global research on the oral health status of sex workers, highlighting the prevalence of oral disorders among the group.

Methods: A search method was developed to find papers indexed in three electronic databases. Studies addressing the oral health of adult sex workers, whether female, male, or LGBTQ+, were considered. The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS). The findings from the included research were synthesized and provided in a narrative format.

Results: Out of 4185 studies, 11 were included in the analysis. Four studies found that the prevalence of oral lesions among sex workers ranged between 8.14% and 81.35%. Oral sexually transmitted infections (OSTIs) were identified, including human papillomavirus (HPV), chlamydia trachomatis, and Neisseria gonorrhoeae. Furthermore, half of the sex workers were reported to use substances, including alcohol, cigarettes, and tobacco. A high frequency of dental cavities and poor periodontal health was also reported.

Conclusion: The most prevalent oral health conditions among sex workers include oral lesions, dental caries, periodontitis, and oral STIs. Substance abuse, notably smoking in various forms, is also extremely widespread. Designing and implementing tailored health interventions addressing substance abuse, stress management, good oral health, and hygiene practices, as well as training dental professionals on the use of inclusive language in clinical settings, are critical to encouraging sex workers to seek help for oral health issues, thereby improving their oral health outcomes.

Introduction: Video-based learning has emerged as a powerful tool to overcome the well-documented limitations of traditional lectures. Hence, the aim of this study was to investigate the impact of the implementation of a video animation on academic performance and student's opinion.

Methods: A video animation on biological mechanisms behind the link between periodontitis and its treatment with atherosclerosis and diabetes was projected in addition to the traditional lecture to 46 4th-year undergraduate dental students enrolled in the 2024-2025 academic course at the University of Santiago de Compostela. A multiple-choice test including eight questions was delivered to assess student's knowledge after the lesson. Also, student´s perception on the use of this video animation was evaluated by the User Experience Questionnaire.

Results: The video animation tested in this study shows excellent results in terms of attractiveness, perspicuity, efficiency and dependability. Good results are observed for stimulation and novelty. Almost 3/4 of undergraduate dental students obtained very good or outstanding marks in the test.

Conclusions: The use of a video animation to explain biological mechanisms underlying the link between periodontitis and systemic diseases appears to be a helpful tool for undergraduate dental students.

Moebius syndrome is a rare congenital disorder of unknown etiology. It is characterized by non-progressive paralysis of the facial and abducens cranial nerves due to atrophy of their nuclei, often accompanied by malformations in the upper and lower limbs. This report aims to highlight the critical role of hospital dentistry in managing a 6-year-old patient with Moebius syndrome. The patient was on mechanical ventilation via tracheostomy following a cardiorespiratory arrest at birth and has been hospitalized in a long-term care institution. Feeding and medication were administered via gastrostomy, and she was under a regimen of phenobarbital, phenytoin, and benzodiazepines for epilepsy control. Dental follow-up, initiated at birth, included monthly bed visits and medical team consultations. Key interventions included extraction of deciduous teeth to prevent bronchopulmonary aspiration, management of sialorrhea using scopolamine and botulinum toxin, selective wear of deciduous canines to mitigate self-mutilation, and monitoring drug-induced gingival hyperplasia. This case underscores the essential role of dental care in maintaining oral health, preventing complications such as respiratory infections, and enhancing the quality of life for syndromic patients under prolonged mechanical ventilation.

Introduction: Conducting Dental examination in children with autism is challenging due to the limitation in cooperativeness that is caused by impairment of communication, social interaction, and sensory sensitivities.

Aims: This study aims to provide evidence base for the structural-visual approach in reducing uncooperativeness behavior to dental care in children with autism spectrum disorder (ASD).

Methods: Searches were conducted in the electronic databases PubMed, PsycINFO, and Cochrane from inception to October 2021 (CRD42022383409). Randomized controlled trials (RCTs), non-RCTs, and pre/post-test and qualitative studies that conducting visual pedagogy and visual learning methods were included. The quality of evidence was assessed with Cochrane Collaboration's Risk of Bias Tool for RCTs, Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) for non-RCTs, and Critical Appraisal Skill Program (CASP) for qualitative studies.

Results: The initial search identified 270 studies, and 256 remained after removing duplicates. After screening titles and abstracts, 62 studies were remained for full-text assessed, and finally 13 eligible studies were selected for reviews. The studies analyzed various structural-visual interventions, participants, study design, countries, and outcomes.

Conclusion: The structural-visual approach could reduce uncooperative behavior in children with ASD. Future study should investigate the wide range of age and varied behavior approach as the evidence-based of the clinical management.