Special Care in Dentistry最新文献

Introduction: Globally, around 3.5 billion people are affected by oral disease, with individuals with disabilities being more affected due to physical and cognitive limitations. They rely on their parents or caregivers to maintain their oral health.

Aim: To develop and validate educational videos for promoting oral health through a YouTube channel for the parents/caregivers of children with cerebral palsy (CP).

Methodology: The preparation of the script/storyboard was based on scientific articles addressing oral health promotion. The content was divided into eighteen videos, which were validated by a panel of experts.

Results: All the items in the script board content scored CVR greater than 0.80, and videos were considered valid. The Cohen's kappa for all the questions for the audiovisual content ranges between 0.86 and 1.00, showing strong agreement (κ > 0.80) among the content experts.

Conclusion: The developed educational videos demonstrated strong content validity scores, indicating their potential to significantly enhance oral health knowledge among parents and caregivers of children with CP.

Background: Visually impaired individuals face significant challenges in maintaining oral hygiene due to reliance on visual cues. Conventional oral health education (OHE) often fails to address their needs, leading to disparities in oral health outcomes. The aim of this study was to assess and compare the effectiveness of three customized oral health education strategies-Audio only (Group 1), Audio + Braille (Group 2), and Audio + Tactile Model (Group 3)-on oral health Knowledge, Attitude, Practice (KAP), and clinical oral hygiene status among institutionalized visually impaired individuals in Lucknow, India.

Methods: A prospective cluster randomized controlled trial was conducted across two institutions, enrolling 180 visually impaired individuals aged ≥ 7 years. Of these, 15 were excluded based on eligibility criteria. The remaining 165 participants were randomly allocated into three intervention groups (55 participants per group). During follow-up, 5 participants from each group were lost, resulting in a final analysis of 150 participants (n = 50 per group). Each group received structured OHE via a designated modality, reinforced at 30, 60, and 90 days. Pre- and post-intervention assessments included Knowledge, Attitude, and Practice (KAP) scores and clinical parameters-Debris Index (OHI-S) and Gingival Index (GI). Data were analyzed using repeated measures ANOVA, Tukey's HSD, paired t-tests, one-way ANOVA, Chi-square tests, and Pearson's correlation.

Results: All groups showed significant improvement post-intervention (p < 0.001), with the Audio + Braille group achieving the greatest gains in knowledge (26%-100%), attitude/practice (36.5%-68.4%), and clinical outcomes (Debris Index: 2.23 to 0.43; GI: 1.09 to 0.22). Repeated measures ANOVA and post hoc analysis confirmed Group 2's superiority across all parameters. Strong inverse correlations between behavior scores and clinical indices emerged over time (r > -0.85), highlighting the impact of behavior change on oral health.

Conclusion: Multisensory OHE strategies, especially Audio + Braille, were most effective in improving oral health knowledge and hygiene status. Integration of such sensory-adapted educational models into public health programs may enhance oral health equity among visually impaired populations.

Trial registration: CTRI/2024/10/093533.

Background: Intranasal sedation (INS) administration has gained popularity in dentistry. It is noninvasive, painless, and an easy-to-use drug delivery route. With the growing interest in INS, there is a need for a comprehensive review to assess its safety and efficacy and to explore the limitations in the existing literature.

Aims: This scoping review aimed to evaluate the effectiveness of INS in the dental setting.

Methods: This scoping review followed the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. Ovid MEDLINE, Google Scholar, ClinicalTrials.gov, PROSPERO, and Cochrane Library were used to retrieve related articles.

Results: The search process identified 1666 articles. Of these, 1594 were excluded, and 72 were independently assessed for eligibility. In the end, 48 articles with various types of studies were selected, including RCTs, clinical trials, pilot studies, case reports/series, retrospective, and prospective studies. The findings are presented narratively using text and tables.

Conclusion: This scoping review found that INS is an effective type of conscious sedation (CS) for dental procedures that could overcome some of the disadvantages of other CS techniques and general anesthesia. However, an interventional comparative matched study is needed to determine if INS can be effective alone without using other types of CS, and if a combination of drugs is required, or if a single drug can be effective and safe.

Aims: Oral membranous substances in tube-fed patients undergo temporal morphological changes, increasing the risk of asphyxiation. While xerostomia is hypothesized to influence these alterations, its precise relationship with oral wetness and specific morphological stages remains unclear. This study aimed to investigate oral wetness as an indicator of xerostomia and predictor of membranous substance formation.

Methods and results: This study included 18 older tube-fed patients. Following initial oral care, comprising tooth surface and oral mucosa cleaning, we measured tongue dorsum wetness at 3, 6, 12, 24, and 48 h post-care. Concurrent visual examinations assessed the presence and morphology of palatal membranous substances, categorizing them into four types: none, mucous, viscous, and dry. We analyzed the relationships between morphology, wetness, and elapsed time. Oral wetness levels varied significantly across morphological types (p < 0.001), with dry membranous substances exhibiting the lowest wetness values. Membranous substance morphology significantly correlated with elapsed time (r = 0.513, p < 0.001) and oral wetness (r = -0.390, p < 0.001).

Conclusions: Both temporal progression and xerostomia significantly contribute to the formation and morphological evolution of membranous substances. Timely implementation of oral care and moisturization appears crucial for preventing membranous substance formation and mitigating the associated risks.

Background: Thalidomide embryopathy is a disorder associated with a wide range of congenital anomalies, including limb deformities, craniofacial abnormalities, and neurological impairments. Facial hyperalgesia and dental anxiety represent significant barriers to the safe and effective management of invasive dental procedures.

Case presentation: We report a 62-year-old woman with thalidomide embryopathy, bilateral upper limb agenesis, and pronounced facial hyperalgesia, scheduled for guided bone regeneration (GBR) as part of implant-supported prosthetic treatment. Given her heightened pain sensitivity and severe dental phobia, local anesthesia alone was considered inadequate.

Management and outcome: Ultrasound-guided nerve block (USG-NB) targeting the maxillary nerve and intravenous sedation were employed. This strategy provided targeted regional anesthesia and effective anxiolysis, enabling safe and comfortable perioperative management. The procedure was completed uneventfully. The patient reported no pain during or after the procedure, and no postoperative adverse events were observed.

Conclusion: This case illustrates the utility of USG-NB in managing complex dental procedures in patients with congenital disorders or pain hypersensitivity, offering insights for anesthetic management in comparable clinical situations.

Objective: This study aims to evaluate the 6-month effects of an applied oral hygiene education program delivered through home visits for children with special needs in Istanbul. Additionally, the study seeks to establish an individualized oral health monitoring program and promote non-cariogenic dietary habits.

Methods and results: The study included 279 children with special needs aged 1-8 years. Participants' oral hygiene practices, dietary habits, and dental health status were compared before and after the education program. Plaque levels were assessed using the Silness-Löe Plaque Index, and Streptococcus mutans (S. mutans) levels were measured using the Saliva-Check Mutans test kit. After the intervention, the proportion of children brushing twice daily increased from 13.8% to 33% (p < 0.05), while the percentage of children with moderate plaque levels decreased from 40.1% to 26.5%. Additionally, the proportion of children with S. mutans levels exceeding 10⁵ CFU/mL decreased significantly from 91.3% to 68.0% (p < 0.005).

Conclusion: Individualized oral hygiene education was found to be effective in improving oral health in children with special needs. Significant reductions in plaque levels and S. mutans concentrations were observed, along with increased parental awareness. Future multidimensional educational programs incorporating home visits may play a crucial role in maintaining long-term oral hygiene habits in children with special needs.

Introduction: GAPO syndrome (#230740) is a rare autosomal recessive disorder characterized by growth retardation, alopecia, pseudoanodontia, and optic malformations, hence the acronym GAPO. The presence of both dentitions in the ridge leads to abnormally thick alveolar ridges, which are thought to hinder full denture fabrication and placement. This article aims to report the success of full dentures in two cases with GAPO syndrome with no surgical intervention, and we include observations from the follow-ups.

Subjects and methods: Patients diagnosed with GAPO syndrome and confirmed by molecular testing were recruited from the outpatient clinic for oral rehabilitation.

Results: The study included 3 patients, 1 male (patient 1) and 2 females (patients 2 and 3). Patient 3 failed to appear for the delivery session of her denture. The dentures of patients 1 and 2 had very good retention at the delivery sessions, and it was further enhanced during the follow-ups.

Conclusion: The undercuts present due to the ridge ballooning in GAPO patients were retentive to classical dentures. The unexpected normal muscular tone aided the retention as well. GAPO patients are compliant and motivated to be dentally rehabilitated.

Hematological conditions such as anemia, hemophilia, von Willebrand disease, leukemia, and multiple myeloma can lead to various oral manifestations, including delayed wound healing, mucosal ulcers, and increased bleeding risk. This review article outlines the implications of anticoagulant and antiplatelet therapies on dental procedures, highlighting the need for careful risk assessment and management strategies. The article emphasizes the importance of understanding these disorders for dental professionals to provide safe and effective care. The review also provides insights into diagnostic criteria for hematological disorders, and the collaborative approach required between dentists and hematologists. By addressing these critical aspects, the article aims to guide dental practitioners in enhancing patient outcomes while managing the complexities associated with bleeding problems.