RESUMO
Os indivíduos portadores de necessidades especiais são mencionados na história há muitos séculos. Atualmente, no Brasil, existem grupos isolados que prestam atendimento odontológico a estes pacientes. Baseado na literatura, o objetivo deste trabalho é possibilitar ao cirurgião-dentista um maior conhecimento sobre o atendimento odontológico a pacientes com necessidades especiais - principalmente, aos portadores de síndrome de Down, paralisia cerebral e deficiências audiovisuais - e a necessidade de anestesia geral. Como conclusão, foi possível constatar que, antes de iniciar o atendimento odontológico a essa população, é essencial ter uma visão ampla e completa do paciente especial, reconhecer a etiologia das deficiências e proporcionar, além de níveis elevados de saúde bucal, dignidade e melhor qualidade de vida.
Individuals with special needs are mentioned in history for many centuries. Currently in Brazil, there are isolated groups who provide dental care to these patients. Based on the literature, the objective of this work is to enable the dentist a better understanding of dental care to patients with special needs - especially to people with Down Syndrome, cerebral palsy and audiovisual disabilities - and the need for general anesthesia. It was concluded that, before starting dental care to this population, it is essential to have a comprehensive and complete view of the particular patient; recognizing the etiology of disabilities and provide high levels of oral health, dignity and quality of life.
RESUMO
Periodontal disease is a chronic multifactor pathology, characterized by the progressive destruction of the dental structures support tissues. Patients with some type of disability have a higher predisposition to develop periodontal disease, due to bad hygiene, product of their motor and psychological deficiencies, and to their systemic alterations that difficult the defense against periodontopathogenic microorganisms. The purpose of this study was to evaluate and compare the periodontal status of a group of children with special needs, and a control group. 47 patients with mental retardation and Down syndrome from three special education centers, and 31 healthy patients of ages ranging from 6 to 15 years, were dentally evaluated, to determine their plaque index, gingival index, and the presence of calculus. After gathering the data and tabulating the results, a 1.08 plaque index was determined, and a gingival index of 1.03, corresponding to a mild gingivitis in the study group. On the other hand, on the group of regular patients, there was a 1.08 PI and a 0.96 GI. Calculus percentage was similar on both groups. However, a large percentage of children with mild gingival inflammation was observed in the group of special patients (53.19 percent,) compared to the control group (29 percent).
La enfermedad periodontal es una patología crónica y multifactorial donde ocurre una progresiva destrucción de los tejidos de soporte de las estructuras dentales. El desarrollo de la enfermedad periodontal está dado inicialmente por la presencia de placa dental que aunado a factores inmunológicos, hormonales y celulares conllevan a un desarrollo más rápido o agresivo. Los pacientes que presentan algún tipo de discapacidad, tienen una predisposición mayor a desarrollar enfermedad periodontal debido a la mala higiene por sus deficiencias motoras y psíquicas y a sus alteraciones sistémicas que dificultan la defensa ante los microorganismos periodontopatógenos. El propósito de este estudio fue evaluar y comparar el estatus periodontal de un grupo de niños con necesidades especiales y un grupo control. 47 pacientes con Retardo mental y Síndrome de Down pertenecientes a tres centros de educación especial y 31 pacientes sanos con edades comprendidas entre 6 y 15 años fueron evaluados odontológicamente, determinándose el índice de placa, el índice gingival y la presencia de cálculo. Posterior a la obtención y tabulación de los resultados, se determinó un índice de placa de 1.08 que se corresponde con la presencia de una placa adherida leve y un índice gingival de 1.03 que se corresponde con una gingivitis leve en el grupo de estudio. Por el contrario, en el grupo de pacientes regulares se obtuvo 1.08 de IP y 0.96 de IG. El porcentaje de cálculo fue similar en ambos grupos, 48.94 por ciento en el grupo de estudio y 45.16 por ciento en el grupo sano. Sin embargo, se observó un alto porcentaje de niños con inflamación gingival moderada en el grupo de pacientes especiales (53.19 por ciento) comparado con el grupo control (29 por ciento).
Assuntos
Humanos , Masculino , Adolescente , Feminino , Criança , Índice de Placa Dentária , Pessoas com Deficiência , Doenças Periodontais , Índice Periodontal , Estudos de Casos e Controles , Estudos Transversais , Cálculos Dentários , Crianças com Deficiência , Síndrome de Down , Deficiência Intelectual , Saúde Bucal , VenezuelaRESUMO
Access to oral health care for vulnerable populations is one of the concerns addressed by the U.S. Health Resources and Services Administration HIV/AIDS Bureau's Community-Based Dental Partnership Program (CBDPP). The program introduces dental students and residents at several dental schools to care for vulnerable patients through didactic and clinical work in community-based dental settings. This study of the dental students and residents in this program answered three questions: 1) What are their HIV knowledge, attitudes, and behaviors? 2) How has participation in the CBDPP impacted their knowledge, attitudes, and behaviors? 3) Has the intervention affected their work placement decisions and attitudes after graduation, particularly with respect to treating people living with HIV and other underserved populations? A total of 305 first- through fourth-year dental students and first- and second-year residents at five dental schools across the United States completed surveys before and after a community-based rotation and following graduation. Response rates at each of the five schools ranged from 82.4 to 100 percent. The results showed an increase in the participants' knowledge and positive attitudes regarding treatment for patients with HIV and other vulnerable populations post-rotation compared to pre-rotation. Results after graduation found that most respondents were practicing in private settings or in academic institutions as residents but were willing to treat a diverse patient population. These findings support the role of training programs, such as the CBDPP, for expanding the dental workforce to treating vulnerable populations including people living with HIV/AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida/psicologia , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Relações Comunidade-Instituição , Educação em Odontologia , Infecções por HIV/psicologia , Intenção , Estudantes de Odontologia/psicologia , Escolha da Profissão , Odontologia Comunitária/educação , Assistência Odontológica para Doentes Crônicos , Acessibilidade aos Serviços de Saúde , Humanos , Internato e Residência , Preceptoria , Prática Privada , Estados Unidos , United States Health Resources and Services Administration , Populações VulneráveisRESUMO
O medo é o principal obstáculo para o atendimento odontológico seguro e de sucesso. A utilização da sedação inalatória vem se mostrando eficaz para o controle de comportamento destes pacientes. Entretanto, no Brasil, ainda poucos cirurgiões-dentistas são habilitados e lançam mão desta ferramenta. O objetivo deste relato é demonstrar um caso de paciente odontofóbico atendido com sucesso através da sedação inalatória. Esta técnica é eficaz para o tratamento odontológico de pacientes odontofóbicos, permitindo a colaboração do paciente e diminuindo os riscos de emergências médicas.
The fear is the main obstacle to a safe and successful dental care. The use of inhalation sedation has proved effective for controlling behavior of these patients. However, in Brazil, yet few dentists are enabled, and lay hold of this tool. The objective of this report is to demonstrate a case of odontophobia patient treated successfully by inhalation sedation. This technique is effective for dental treatment of odontophobic patients, allowing the patients collaboration and decreasing the risk of medical emergencies.
Assuntos
Inalação , Assistência Odontológica , Ansiedade ao Tratamento Odontológico , Pessoas com Deficiência , Medo , Óxido Nitroso , TerapêuticaRESUMO
BACKGROUND: This work aimed to access the profile of cleft lip and palate patients of a sub-population in Mid-West Brazil. MATERIALS & METHODS: Research was carried out through a cross-sectional study at the Craniofacial Rehabilitation Center of the University General Hospital of the University of Cuiabá, Mato Grosso, Brazil. Variables related to oral cleft type, gender, race, age and presence or absence of associated congenital anomalies or syndromes were analyzed. RESULTS: 313 patients treated at the institution from 2004 to 2007 were recruited. There were 54% male and 46% female patients with the mean age of 11.4 years. Cleft lip and palate was the most prevalent alteration in 49.6% of cases. Caucasians were the most affected in 54.6% of cases. 6.4% of patients had other anomalies or syndromes associated with cleft. CONCLUSION: More comprehensive surveys should be conducted in order to supply the lack of data on the occurrence and determinants of oral clefts in this region. How to cite this article:Cuozzo FD, Espinosa MM, Serafim da Silva KT, Martins de Barros YB, Bandeca MC, Aranha AM, Borges AH, Volpato LE. Cleft lip and palate in a Brazilian subpopulation. J Int Oral Health 2013; 5(4):15-20.
RESUMO
The psychology in Dentistry is a great challenge for the clinicians during the care of their patients. The conditioning of a patient to achieve a behavior meeting the professionals needs for developing a procedure within the quality standards is necessary. When this conditioning focuses on the child patients the challenge is even greater because the child will use all ways to make difficult the action of the clinician due to fear or discomfort. The ability of the dentist to condition the patient will be directly proportional to the training and theoretical knowledge acquired. Considering the Patients with Special Needs (PSN), this training should be differentiated because there is the physical, cognitive, and the previous dental/medical history in addition to the psychological and emotional difficulties. The aim of this study was to evaluate the profile of the patient to be conditioned satisfactorily and which conditioning techniques would be more efficient to ambulatory dental care of PSN. Thirty patients, both genders, aged from 20 months to 11 years-old who were enrolled at the ambulatory treatment of NEAPE were observed. It was concluded that when there is the cognitive development of the individual, they are able to be conditioned for the ambulatory care; the use of auxiliary methods is important in the conditioning for the ambulatory care of the individuals; the syndromic patients had the best results for the conditioning aiming to the ambulatory care; there was a significant improvement in the behavior of individuals between the first and last appointments.
A psicologia em odontologia é um grande desafio para os profissionais no atendimento clínico de seus pacientes. Condicionar um paciente para que este tenha um comportamento condizente com as necessidades do profissional para o desenvolvimento de um procedimento dentro dos padrões de qualidade torna-se necessário. Quando este condicionamento tem como foco o paciente infantil este desafio é extremamente exarcebado, pois a criança usará de todos os meios para que dificulte a ação do profissional, ou por medo ou desconforto. O destreza do profissional em condicionar o paciente será diretamente proporcional ao treinamento e conhecimento teórico por ele adquirido. Com os Pacientes Portadores de Necessidades Especiais (PNE) este treinamento deverá ser diferenciado pois além das dificuldades psicológicas e emocionais temos as limitações físicas, cognitivas e com sua história médica/odontológica pregressa. A proposta deste trabalho foi avaliar que perfil de paciente pode ser condicionado de modo satisfatório e quais técnicas de condicionamento são mais eficazes para o tratamento odontológico em ambulatório de PNE. Foram observados 30 pacientes, de ambos os sexos, com idade entre 20 meses a 11 anos, que freqüentavam o ambulatório do NEAPE. Concluímos que: quando existe um desenvolvimento cognitivo do individuo, os indivíduos são passiveis de serem condicionados para o atendimento ambulatorial; o uso de métodos auxiliares é importante no condicionamento para o atendimento ambulatorial dos indivíduos; os pacientes sindrômicos foram os de melhor resultados no condicionamento para atendimento ambulatorial; existiu melhoria significante no comportamento dos indivíduos entre a primeira e ultima sessão de atendimento.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Odontologia , Pessoas com Deficiência , Odontopediatria , PsicologiaRESUMO
O objetivo deste estudo foi avaliar o perfil dos pacientes com deficiência atendidos no projeto de extensão "Conquistando Saúde: atendimento a pacientes com necessidades especiais" do Curso de Odontologia da Universidade Luterana do Brasil - Campus Canoas / RS, no período de 2001 a 2006. A coleta dos dados foi feita a partir dos prontuários dos pacientes atendidos no referido período. Observou-se um equilíbrio entre os pacientes do sexo masculino e feminino, uma maior procura ao serviço por pacientes jovens, procedentes de Canoas e com distúrbios neurológicos. Aproximadamente 80% dos pacientes apresentavam experiência de cárie. A partir dos resultados obtidos sugere-se o estabelecimento de políticas públicas de promoção de saúde e reorientação de serviços odontológicos que facilitem o acesso e a utilização por indivíduos com deficiências.
The objective of this study was to evaluate the profile of patients with disabilities served by the extension project "Conquering Health: serving patients with special needs" in the School of Dentistry Lutheran University of Brazil - Canoas Campus/RS, from 2001 to 2006. The data was collected from patients's charts. A similar number of male and female patients, a higher prevalence of young patients, coming from Canoas and with neurological disorders was observed. Approximately 80% of the patients with disabilities presented caries. The results obtained suggest the establishment of public policies on health promotion and reorientation of dental services that facilitate access and use by individuals with disabilities.
Assuntos
Humanos , Masculino , Feminino , Assistência Odontológica , Perfil de Saúde , Pessoas com DeficiênciaRESUMO
Objetivo: A proposta deste estudo foi avaliar o tratamento odontológico de pacientes com necessidades especiais sob anestesia geral. Material e método: Foram selecionados prontuários de pacientes assistidos no período de 2006 a 2007, cujos tratamentos foram realizados em centro cirúrgico e registrados os seguintes dados: gênero, idade, condição médica do paciente, risco anestésico (classificação conforme American Society of Anesthesiology- ASA) e os procedimentos odontológicos. Foram analisados 144 prontuários, entretanto 25 foram excluídos, totalizando 119. Resultado: Em relação ao gênero, observou-se que 56,30% eram do gênero masculino e 43,70% do feminino. Quanto à idade, houve maior prevalência de pacientes na faixa etária de 21 a 30 anos (30,25%). A paralisia cerebral (48,74%) e deficiência mental (25,21%) foram as condições médicas mais frequentes, seguidas das síndromes (10,09%), autismo (4,20%) e transtornos psiquiátricos (3,36%). A maioria dos pacientes (98,32%) foi classificada como ASA II. Nos 119 prontuários constatou-se que: em 92 pacientes (77,31%) foram realizadas 501 restaurações; em 89 (74,79%) 602 extrações; em 69 (57,83%) raspagem supra / subgengival; em 37 (31,09%) 100 selantes de fossas e fissuras; em 2 (1,68%) 4 pulpotomias; em 1 (0,84%) 1 pulpectomia, e em 1 (0,84%) gengivectomia. As consultas de revisão para manutenção preventiva foram realizadas principalmente em ambulatório (83,10%). Conclusão: Os resultados mostraram que há uma grande demanda de tratamento cirúrgico-restaurador nos pacientes especiais evidenciando a necessidade de uma prática baseada em promoção de saúde bucal.
Objective: The purpose of this study was to evaluate the dental treatment of patients with special needs under general anesthesia. Material and method: Dental records of patients whose treatments had been performed in surgical center between 2006 and 2007 were selected, and the following data were registered: gender, age, medical conditions, anesthetic risk (classification of the American Society of Anesthesiology -ASA) and dental procedures. 144 dental records were analyzed, but 25 were excluded, totalizing 119. Result: Concerning to the gender, it was noticed that 56.30% were male and 43.70% female. Related to the age, it was observed a higher prevalence of patients of 21 to 30 years old (30.25%). The cerebral palsy (48.74%) and developmental disability (25.21%) were the most frequent medical conditions, followed by the syndromes (10.09%), autism spectrum disorders (4.20%) and psychiatric illness (3.36%). The majority of the patients (98.32%) was classified as ASA II. In the 119 dental records it was noticed that: in 92 patients (77.31%) 501 dental restorations were performed; in 89 (74.79%) 602 dental extractions; in 69 (57.83%) supra/subgingival scalling; in 37 (31.09%) 100 pit and fissure sealants; in 2 (1.68%) 4 pulpotomies; in 1 (0.84%) 1 pulpectomy and in 1 (0.84%) gengivectomy. The follow up appointments were carried out mainly in an ambulatory setting (83.10%). Conclusion: The results showed that there is a great demand for surgical and restorative treatment for patients with special needs, thus evidencing the need of a practice based on oral health promotion.
Assuntos
Transtorno Autístico , Paralisia Cerebral , Assistência Odontológica para a Pessoa com Deficiência , Análise de Dados , Transtornos Mentais , Anestesia Geral , Pessoas com DeficiênciaRESUMO
The purposes of this study were to investigate radiographically the dental and maxillomandibular in patients with neuropsychomotor disorders and determine the role of panoramic radiographs for quantitative and qualitative analyses of dental alterations. A total of 322 panoramic radiographs from 190 males and 132 females aged 4 to 57 years were obtained from the files of the Center for Care to Patients with Special Needs (CAPE; Dental School, University of São Paulo) and subdivided into syndromes, special needs, neurological, neuromuscular or cerebral disorders, and sequels of diseases. 32 percent of dental alterations were in tooth position, with 69 percent of this group associated with tooth rotation. The mandible accounted for 54.62 percent of alterations. The male gender (55.85 percent) and the permanent dentition (78.7 percent) were most affected. Panoramic radiographs were proved to be well suited for quantitative evaluation of dental anomalies of epidemiological nature. Panoramic radiographs are important diagnostic resources when applied to patients with special needs because of the difficulty to place intraoral films and held them correctly positioned during the radiographic technique.