Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry
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Scleroderma is a connective tissue disorder of excess collagen production characterized by intense fibrosis of the skin, with internal organ involvement. A wide range of oral sequelae-including microstomia, oral mucosal/gingival fibrosis, xerostomia, and mandibular bone resorption-complicates maintenance of oral health and dental treatment. The literature is reviewed, and two cases are presented.
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As the population ages, with increased retention of the natural dentition, there will be a greater responsibility for dental professionals to maintain the oral health of medically, behaviorally, cognitively, and physically impaired adults. Oral sedatives and nitrous oxide analgesia are frequently and successfully used for dental treatments in these patients. However, many compromised older adults cannot safely tolerate dental treatment with these sedative techniques in an outpatient setting. This paper describes the use of general anesthesia in a hospital environment, coordinated with medical and anesthesia specialists, that is a viable, safe, and effective treatment tool for providing comprehensive dental and oral surgical treatment for the older patient.
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Clinical Trial Controlled Clinical Trial
Incidence of oral complications and application of a preventive protocol in children with acute leukemia.
This prospective, controlled study was designed to assess the effectiveness of a preventive oral protocol in children receiving antineoplastic treatment for acute lymphoblastic leukemia (ALL). During a 13-month period, 96 children from one to 16 years of age with a diagnosis of ALL were evaluated. When the study was initiated, 60 patients already undergoing chemotherapy received palliative treatment for complications (Group I). ⋯ We found a significant improvement in oral hygiene (p = 0.001) and a significant decrease in the incidence of mucositis grade 2 (p = 0.0013) and oral candidiasis (p = 0.009) in the Group II children. These findings show that the systematic application of a preventive protocol significantly reduces the incidence of oral complications. The results of this study identify a need to include a pediatric dentist in a multidisciplinary team which provides oral care for cancer patients.
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Review Case Reports
Aspiration of a primary tooth in a patient with a tracheostomy.
Aspiration of a foreign object is uncommon in a patient with a tracheostomy. The following case history describes the consequences of failure to diagnose an aspirated object and how the aspiration of an exfoliated tooth can occur despite the presence of a tracheostomy tube. Dentists play an important role in preventing foreign body aspiration in debilitated patients.
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This paper is a case report of a 10-year-old girl with focal dermal hypoplasia (FDH) who presented for dental care. She displayed many of the well-documented oral features associated with this syndrome. Additionally, she had taurodontism of a permanent mandibular molar. Although taurodontism affected only one tooth in this patient, the presentation of taurodontism with FDH has not been reported previously.