Special Care in Dentistry最新文献

Purpose/objectives: A precordial stethoscope (PS) is essential for ensuring clear breath sounds during open airway sedations. However, a traditional PS limits the ability of new users to simultaneously listen to heart and lung sounds alongside experienced practitioners, hindering their learning and development. Bluetooth speaker systems allow for multiple providers but amplify all noise. An artificial intelligence (AI) PS has the potential to selectively reduce ambient noise, allowing multiple providers to monitor concurrently and provides a visual representation of the sound waves. The study looks at the benefits of AI PS in teaching in the dental setting.

Methods: A questionnaire was created to compare the new AI PS to a conventional PS during intravenous moderate sedation in a dental clinic setting.

Results: Sixteen individuals involved in sedations (four dental attendings, seven dental residents, and five dental assistants), were polled with a 100% response rate. 75% of participants agreed that clarity was improved using the AI PS and 81.25% of participants agreed that breath sounds and loudness were improved using the AI PS. 93.75% reported the AI PS was beneficial in allowing attendees to concurrently monitor a sedation case alongside dental residents. 100% of assistants reported that the AI PS benefited from their participation in sedation cases.

Conclusion: As technology advances, it is important that we as providers continue to evolve and consider implementing AI to improve our ability to monitor patients and enhance educational experiences for dental resident trainees.

Aim: West syndrome is characterized by a triad of infantile spasms, arrested psychomotor development, and pronounced paroxysmal electroencephalogram (EEG) abnormalities, notably hypsarrhythmia. This case report aims to discuss the various considerations and strategies for the dental management of a child with West syndrome.

Method and result: This report focuses on a case of a 5-year-old girl diagnosed with West Syndrome who presented for her first dental visit with complaints of pain and swelling in the right posterior tooth region for the past three weeks. Due to frequent seizure episodes, neuropsychomotor delay, and multiple dental treatment needs, comprehensive full-mouth rehabilitation was performed under general anesthesia.

Conclusion: Awareness of syndromes like West syndrome equips dentists to better manage children with complex conditions. Additionally, parental counselling and early preventive measures can significantly reduce the added burden of dental diseases in these patients.

Aims: To assess oral health, treatment burden, mortality risk, and demographics in elders with care-resistant behaviors (CRB) in nursing homes (NH) and compare them with those without CRB.

Methods and results: 503 participants from eight NH who received dental treatment through a mobile dental clinic were included. Their medical and dental records were screened regarding oral/dental health, treatment history, general health, demographics, and CRB. Statistical analysis was performed to show correlations between CRB and the measured parameters. Data were verified for normal distribution; a point-biserial correlation model was used (95% CI: α = 0.05). No correlation was found between CRB and Decayed Missing Filled Teeth (DMF-T) (r_pb = -0.061, p = .177), as well as periodontal status (r_pb = 0.004, p = .946). A negative correlation was observed between CRB and the required number of treatment procedures (r_pb = -0.181, p < .0001), time (r_pb = -0.118, p = .010), and costs (r_pb = -0.100, p = .028). Sex predilection for men regarding CRB was evident (r_pb = -0.155, p = .01). No correlation appeared between CRB and vital status (r_pb = -0.41, p = .355).

Conclusion: Oral health seems to be similar in institutionalized elders with or without CRB. Treatment burden was not elevated, but even reduced in elders with CRB, evincing that few/no treatment procedures were performed in those elders. CRB demonstrated a sex predilection for men. An association between CRB and increased mortality was not evident.

This study aimed to clarify the factors influencing picky eating in children with disabilities based on the hypothesis that primary disease or oral function is involved in picky eating. The subjects were 242 children aged 3-6 years receiving outpatient feeding therapy at our clinic. The subjects' general and oral conditions and picky eating were assessed by their medical recodes. Resultingly, 79 children showed picky eating. Using logistic regression analysis, associated factors of picky eating were primary disease (p = .04), nutritional methods (p = .01), and oral hypersensitivity (p = .04). The relationship with the primary disease suggests the influence of the characteristics of the primary disease. The relationship with oral hypersensitivity may be attributed to avoiding certain sensations. Additionally, the study revealed that the subjects employed tube feeding to compensate for reduced nutritional intake due to picky eating. This study indicated that primary disease and nutritional method as general conditions and oral hypersensitivity as an oral function were possible factors for picky eating. Picky eating was found to occur at varying frequencies depending on the underlying primary disease, especially when the child struggled to tolerate different sensations experienced during meals.

Background: The invisibility of the transgender population within official records, combined with other socio-economic factors, impacts oral health status among transgender people. Hence, our systematic review and meta-analysis aim to generate a pooled estimate of the oral health status of the transgender community in India.

Material and methods: A systematic search was performed across four databases. The studies included a quantitative research design conducted in India and involved self-identified transgender individuals. The pooled prevalence was determined at a 95% confidence interval (CI). Q-statistics and the I² test were utilized to evaluate the source of heterogeneity. Leave-one-out analysis and Baujat plots were used to detect outliers within the studies. A Doi plot and LFK index were employed to assess the publication bias.

Results: A total of 12 studies comprising 1566 transgender participants were included. The pooled prevalence of toothbrush use among transgenders in India was found at 83% (95% CI: 0.73-0.91), smoking = 12% (CI: 0.03-0.26), smokeless tobacco = 53% (CI = 0.38-0.68), dental caries = 78% (CI: 67%-88%), calculus = 65% (CI: 0.4-0.86), and bleeding 18% (CI:0.08-0.32).

Conclusion: Oral health disparities among Indian transgender individuals are evident in the low toothbrush usage, an elevated prevalence of tobacco use, and dental disorders such as calculus, cavities, and bleeding. Tailored dental health programs that include inclusive healthcare services and awareness are essential.

Prospero registration: CRD42023468872.

Introduction: This study aims to evaluate parental acceptance of dental treatment with silver diamine fluoride (SDF) in children with cerebral palsy (CP).

Methods: The present study is a case-control study with 80 children in the age range of 6-11 years. Group I consisted of children diagnosed with CP and Group II consisted of children without any Special Health Care Needs and systemic conditions. Preoperative and postoperative behavior assessment was done using Frankl's behavior Rating Scale. 38 % SDF application was done in any one primary molar with occlusal dentinal caries. A well-designed validated structured questionnaire with 10 questions was developed to assess the parental acceptance of dental treatment with SDF. The questionnaire comprised 10 close-ended questions with subdivisions on socio-demographic details, the reason for the previous and current dental visit, and acceptance of dental treatment with SDF. The data were analyzed using SPSS (version 26, IBM, Chicago, USA). Continuous variables were expressed as mean ± standard deviation (M ± SD). Categorical variables were expressed as frequency (n) and percentage (%). The chi-square test was used for qualitative analysis. The level of significance was set at 5%.

Results: The number of children showing positive behavior on Frankl's behavior Rating Scale increased from 55% to 70% after dental treatment with SDF and this difference was statistically significant in Group I (p-value < 0.001). 87.5% of parents in Group I had accepted the discoloration caused after dental treatment with SDF compared to 80% in Group II. In Group I, 95% of parents agreed strongly, while in Group II, 82.5% agreed strongly that SDF can be done on un-cooperative and special health care needs children. This difference in agreement seen between parents of Group I and Group II was found to be statistically significant (p-value = 0.02). Also, the acceptance of SDF was found to be higher in parents who were educationally more qualified in Group I. This difference in the acceptance level of SDF seen based on the educational status of parents was statistically significant (p-value < 0.001).

Conclusion: Parental acceptance of SDF for dental treatment was higher in Group I (children with CP) as a greater number of parents accepted dental treatment despite discoloration with the modality being noninvasive and less time-consuming. Improved behavior rating was observed among children in both groups after dental treatment with SDF.

Aim: Presurgical Nasoalveolar molding (PNAM) is a technique used for cleft lip and palate patients prior to cheiloplasty. However, concerns exist regarding its negative impact on maxillary arch growth.This study aimed to assess the effect of selective trimming in NAM on maxillary arch growth in patients with unilateral cleft lip palate.

Methodology: The retrospective observational study analyzed the study casts of 30 patients before and after undergoing nasoalveolar molding treatment. Study casts which were repositories of the institute were analyzed and segregated as Group A: NAM given with selective trimming of the appliance, and Group B: NAM without selective trimming of the appliance. Pre and post-treatment casts were assessed digitally at L-L' (Intercleft segment width), C-C' (Intercanine width), T-T' (Alveolar arch width), L-TT' (Alveolar arch length from major cleft segment), and L'-TT' (Alveolar arch length from minor cleft segment) RESULTS: A notable significant difference between Group A's and B's mean Alveolar arch width and Intercleft segment width was seen. Whereas parameters such as intercanine width, and alveolar arch length as functions from major and minor segments showed no significant variance.

Conclusion: Although NAM has been known to affect the growth of the maxillary arch, this study proposes that techniques such as selective trimming can help counteract this drawback.

Objectives: Gerontological education and intergenerational contact are proven strategies for effectively combating ageism. In this context, this study investigates the association between gerontological education, intergenerational contact, and ageism among dental students.

Methods: Gerontological education from students' perspective, intergenerational contact, and ageism were assessed using a questionnaire containing sociodemographical aspects and an ageism scale (ASDS-Braz). The sample included students enrolled in the final year of dental programs at three public universities in southern Brazil. A multilevel Poisson regression was conducted to assess factors associated with ASDS-Braz scores.

Results: A modest correlation was identified between dental schools in terms of reducing ageism, and a weak correlation was found between self-reported race and ageism. Notably, statistically significant findings were observed across family relationship with older individuals: students who reported having a poor relationship with older adults in their families presented 45% higher ageism scores than did those with an excellent relationship.

Conclusion: The results suggested that while some gerontological education was reported by the participants, it may not be sufficient to prepare dental students to provide effective oral healthcare to older adults and to reduce ageism among them. Additionally, reinforcing positive aspects of intergenerational relationships may be an additional strategy in combating ageism within this population.

Background: Autism Spectrum Disorders (ASD) encompass a range of conditions characterized by difficulties in social interaction and communication. Managing dental treatment for children with autism presents challenges due to their reluctance to interact with dentists, which can be as high as 65%.

Objectives: This prospective non-randomized study, conducted at the Kazakh-Russian Medical University from January 15, 2023, to June 20, 2023, aimed to assess the efficacy of air abrasion caries treatment (AAbCT) compared to the standard method.

Intervention: The intervention involved applying air abrasion (AAb) treatment without anesthesia using aluminum oxide powder in the AAbCT group, while the control group received cavity preparation with local anesthesia.

Results: In this study, it was noted that the AAb method of tooth preparation was not different in efficacy from the traditional method for a population of children with autism, and could be used without anesthesia. A greater willingness to cooperate was noted (p = .0372).

Conclusion: The AAb is an effective and safe treatment for children with ASD. Further studies needed to investigate its efficacy and safety in combination with behavioral interventions.

Objective: To assess the impact of treatment with orthodontic aligners (OA) on oral health-related quality of life (OHRQoL) in patients with trisomy 21 (T21) compared to non-syndromic patients.

Materials and methods: The sample consisted of 30 patients, both sexes, aged between 11 and 35 years, divided into two groups: T21 (n = 10, patients with T21, treated prospectively) and CONTROL (n = 20, control group, non-syndromic patients, from the Orthodontic Laboratory of UNOPAR). In both groups, patients were treated with Invisalign orthodontic aligners (Align Technology), following the same treatment parameters. Participants, assisted by their caregivers, when necessary, answered Oral Health Impact Profile (OHIP-14) instrument and the patient's guardians answered the Oral Health Scale for People with Down's syndrome (OHDS) instrument, before (T0) and after 30 (T1), 180 (T2), and 365 (T3) days from the start of treatment. Friedman tests with Bonferroni correction and Mann-Whitney tests were used (p < .05).

Results: For the OHDS instrument, it was observed that for the eating and communication domains and an overall score, the treatment with OA positively impacted the lives of T21 patients (p < .05). Regarding the OHIP-14 instrument, the intragroup evaluation showed that in the CONTROL group, there was no significant difference between the evaluated times; while for the T21 group, there was a significant positive impact (p < .05).

Conclusion: The results showed that the treatment with aligners positively impacted the OHRQoL of T21 patients, and these results were perceived by caregivers, mainly in relation to issues related to eating and communication.