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OBJECTIVE: To evaluate general dentists' perceptions, knowledge, and attitudes regarding the provision of dental services to patients with special health care needs (SHCN). METHODS: This cross-sectional descriptive study was conducted at the University Dental Hospital, University of Lahore, Pakistan, from May 2022 to October 2022, using non-probability purposive sampling. The study included house officers, postgraduate residents, and general dental practitioners aged up to 30 years. Self-administered questionnaires were distributed to 220 participants, gathering demographic data and assessing their knowledge, perceptions, and attitudes toward SHCN patients. Data analysis was performed using SPSS version 25. RESULTS: Out of 220 dental professionals, 85 (38.6%) were male and 135 (61.3%) were female. House officers comprised the majority (n=131, 59.5%), followed by postgraduate trainees (n=47, 21.4%) and general dental practitioners (n=42, 19.1%). The mean age of participants was 24.93±2.45 years. A significant portion (n=171; 77.7%) exhibited limited knowledge about SHCN patients, with only 2.7% (n=6) being well-informed. Frequent interactions with SHCN patients were reported by 23.6% (n=52), and 55.5% (n=122) believed there was insufficient experience among dental practitioners in treating these patients. CONCLUSION: The study highlighted a significant knowledge gap and perceived challenges in treating SHCN patients among general dentists. Addressing these issues requires reforms in dental education, including enhanced training and curriculum modifications to improve exposure to and management of SHCN patients.

Aim: To evaluate the average age and primary reason for the first dental visit among patients with special health care needs (SHCN) as well as to examine barriers related to accessing care for children with special health care needs. Methods: This is a cross‐sectional survey that was distributed to caregivers of children with special health care needs (CSHCN). Study data was collected through REDCap, a secure web‐based survey application. Results: A total of 75 caregivers participated in the survey. Only 13% of caregivers reported that their child was less than 1 by the time of their first dental visit. Nearly all reported seeing a pediatric dentist for their first visit (89%) and that it was for a routine exam and cleaning (83%). About one‐third of guardians reported an experience where a dentist was unable to care for their child due to their SHCN (36%). Discussion: It appears that caregivers of CSHCN that participated in this survey have established routine care with a pediatric dentist at an early age. It is important to continue to educate caregivers on the importance of routine care as well as support general dentists in their role of caring for patients with SHCN. [ABSTRACT FROM AUTHOR]

Abstract This study aimed to analyze the profile and level of satisfaction of users served in the dental specialty for patients with special healthcare needs (SHCN), based on the Brazilian Program for Improving Access and Quality (“PMAQ”) of the Centers for Dental Specialties (“CEO”). This observational, quantitative study used a national secondary database in the public domain. Data were analyzed using the chi-squared test with Bonferroni correction, Student’s t-test, and log-linear Poisson regression. Most users of the specialty “SHCN” interviewed were female (74.1% in 2014 and 68.8% in 2018), with a mean age of 41.7 (2014) and 44.9 (2018) years. For every 100 respondents who considered it regular or bad, 171 considered it good, and 199 considered it very good. Regarding satisfaction with the host of the “CEO,” there were differences between the regions of Brazil (Midwest, Northeast, Southeast, and South). There has been an increase in the number of “CEO” that serve users with autism spectrum disorder. Generally, the “CEO” network provides humanized and welcoming services, presenting better performance in the second evaluation cycle, according to user perception.

Aims: This scoping review aimed to document tools designed to identify persons requiring special care dentistry (SCD) and to provide a better understanding of the factors that justify adaptation in the provision of care. Methods: A scoping review methodology was applied. An electronic search was performed in April 2021 using Pubmed and Embase. Additional tools were sought using hand searches and informal professional networking. Results: Ten tools were identified that either predict the complexity of dental management or that retrospectively judge the complexity of care, of which two are as yet unpublished. Some had been developed for a specific population (e.g., patients with Alzheimer's disease, with learning disability, elderly persons) whilst others were applicable for any population (case mix tools). Factors considered included the patient's medical history, ability to cooperate, physical and cognitive autonomy, communication skills, anxiety, need for sedation, oral risk factors, ability to consent and the administrative burden for the dentist. Conclusion: Identifying persons requiring SCD is possible by looking at various factors that influence the provision of dental care. There may be need for adaptation of tools to local circumstances and to the intended usage of the tool at a health services, systems or policy level. [ABSTRACT FROM AUTHOR]

Aims: This systematic review aimed to analyze the influence of educational strategies for oral health care for Persons with disabilities (PwDs) on the technical, ethical, and social training of undergraduate dental students. Methods and results: An extensive search was performed in the following databases: Cochrane, Embase, PubMed, Scopus, Web of Science, LILACS/BBO and OpenGrey database. Observational, nonrandomized, and quantitative comparisons before and after some type of educational strategy in undergraduate dentistry was included. The risk of bias was assessed using the risk of bias in nonrandomized intervention studies (ROBINS‐I) tool. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Nine were included and suggested that a significant improvement was observed in the technical training of undergraduate dental students although there was no consensus on the acquisition of ethical/social competences after the application of educational strategies. The included studies presented a moderate to serious risk of bias, and the certainty of evidence for both, technical and ethical/social evaluative constructs, as very low. Conclusion: Although studies show that awareness regarding PwD significantly increases technical skills in dental students, the evidence is poor due to the high risk of bias and inconsistency observed in both the technical and ethical/social constructs; further studies on this topic are therefore essential. Prospero: (CRD42021288463). [ABSTRACT FROM AUTHOR]

Copyright of RSBO: Revista Sul-Brasileira de Odontologia is the property of UNIVILLE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Health status and health care utilization in people with disabilities are more likely to be poorer than those without disabilities. Previous studies showed that there were gaps in health-related conditions by sociodemographic information and gender but the association between these factors was not explained. This study aims to analyze the relationship between sociodemographic information and the unmet dental care needs of people with disabilities and explore the effect of sex within this relationship. Methods The 2014 national survey on persons with disabilities was used, which separated unmet healthcare needs into medical and dental services. Unweighted samples included 6,824 people with disabilities in total and 6,555 (96.1% of the total, weighted as 6,583) people aged 20 years or older were selected as the study population. Frequency and chi-square tests were conducted to determine differences in the prevalence of unmet dental needs based on socioeconomic information, chronic diseases, and behavioral factors after applying weights. Logistic regressions were performed using an adjusted model with sociodemographic information, chronic diseases, and behavioral variables. All analyses were performed using IBM SPSS Statistics for Windows, version 26 (IBM Corp., Armonk, N.Y., USA). Results Analysis of the sociodemographic factors related to unmet dental care revealed that they were higher in women and the elderly. In the fully adjusted logistic model, most of the sociodemographic information was significantly associated with unmet dental needs. The lowest group was 4.18 times more likely to have unmet dental care needs than the richest group, and females and middle-school graduates were almost twice as likely to experience unmet dental care needs than males and university graduates. Considering the interaction effect of age on unmet dental needs depending on sex differences, the odds ratio decreased for females with every annual increase in both models. Compared with the younger group, the older group showed a lower risk of having unmet dental needs, especially in females. Conclusions The factor most closely related to the unmet dental care needs of disabled people was socioeconomic problems. Its influence also differed by sex and age. Therefore, economic support measures and sexual differences are needed for long-term policy consideration to reduce the unmet dental care needs of disabled people.

Background: Health status and health care utilization in people with disabilities are more likely to be poorer than those without disabilities. Previous studies showed that there were gaps in health-related conditions by sociodemographic information and gender but the association between these factors was not explained. This study aims to analyze the relationship between sociodemographic information and the unmet dental care needs of people with disabilities and explore the effect of sex within this relationship. Methods: The 2014 national survey on persons with disabilities was used, which separated unmet healthcare needs into medical and dental services. Unweighted samples included 6,824 people with disabilities in total and 6,555 (96.1% of the total, weighted as 6,583) people aged 20 years or older were selected as the study population. Frequency and chi-square tests were conducted to determine differences in the prevalence of unmet dental needs based on socioeconomic information, chronic diseases, and behavioral factors after applying weights. Logistic regressions were performed using an adjusted model with sociodemographic information, chronic diseases, and behavioral variables. All analyses were performed using IBM SPSS Statistics for Windows, version 26 (IBM Corp., Armonk, N.Y., USA). Results: Analysis of the sociodemographic factors related to unmet dental care revealed that they were higher in women and the elderly. In the fully adjusted logistic model, most of the sociodemographic information was significantly associated with unmet dental needs. The lowest group was 4.18 times more likely to have unmet dental care needs than the richest group, and females and middle-school graduates were almost twice as likely to experience unmet dental care needs than males and university graduates. Considering the interaction effect of age on unmet dental needs depending on sex differences, the odds ratio decreased for females with every annual increase in both models. Compared with the younger group, the older group showed a lower risk of having unmet dental needs, especially in females. Conclusions: The factor most closely related to the unmet dental care needs of disabled people was socioeconomic problems. Its influence also differed by sex and age. Therefore, economic support measures and sexual differences are needed for long-term policy consideration to reduce the unmet dental care needs of disabled people. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of didactic and clinical training of dental students in treating Persons with Disabilities (PwD) on their self‐perceptions about treating PWD. Methods: A pre‐and postevaluation of a didactic‐clinical educational strategy targeting oral health care of PwD was conducted among fourth‐year undergraduate dental students at a Brazilian dental school. Semi‐structured questionnaires were used to assess the following work environment parameters: technical, organizational, social, ethical, and managerial acumen. Data were analyzed using Fisher's exact and chi‐square tests, with a significance level of 5% (p < 0.05), to verify possible associations between the quantitative variables. A qualitative analysis was conducted through collective subject discourse. Results: Significant differences were found in the self‐perception of students' knowledge and abilities in providing low‐complexity care for PwD before and after the training program (p = 0.025). Students were more confident about managing and organizing the work environment (p = 0.007) and providing humanized care to PwD (p = 0.042) posttraining program. Additionally, a decrease in the feeling of insecurity (p = 0.014) and feelings of pity, fear, or prejudice toward PwD (p < 0.001) were observed posttraining program. Conclusions: Didactic and clinical training interventions for treating PwD improved the work environment of undergraduate dental students in technical, managerial, organizational, and ethical/social dimensions. [ABSTRACT FROM AUTHOR]

Introduction: One of the most underserved populations among dental patients is the people with Neurodevelopmental Disorders (PNDs). This study aimed to explore the barriers to dental care provision for PNDs from the viewpoint of stakeholders in provision in Iran. Methods: We arranged a qualitative study based on an individual in‐depth, semi‐structured interview between October 2019 and February 2020. We interviewed 30 participants using a snowball sampling strategy with three groups: dentists who provided dental care for PNDs, dental public health professionals, and policymakers/managers in dental care provision in Iran. The interviewer used an interview framework based on Levesque's model of patient‐centered access. The main question was: "How do you assess the barriers to the provision of dental services to PNDs in Iran?" The data were analyzed by the qualitative content analysis method described by Graneheim and Lundman. Results: From the 30 interviewees (11 women), there were 11 dentists, nine dental public health professionals, and 10 participants who worked as policymakers/managers. They were aged 35–62 years and had working experience between 4 and 25 years. In the content analysis, 60 meanings units were extracted, and later classified into 14 subthemes, and four main themes. Conclusion: Four main barriers were traced regarding access, financial, competency‐related, and policy‐making aspects. [ABSTRACT FROM AUTHOR]

Aims: Auriculotherapy is a therapeutic method of traditional Chinese Medicine in which a stimulus is exerted on the ear and activates energy channels throughout the body, helping to control anxiety, stress, pain, inflammation, illnesses chronic, and possibly can be used in patient with Arnold Chiari Malformation type II who have painful symptoms that are difficult to resolve. Thus, the aim of this article is to present a case in a patient with Chiari Malformation II where auriculotherapy and effect of laser therapy were performed, to relieve symptoms of agitation, anxiety and healing of self‐mutilation injuries. Case report: Data from medical records were used to collect medical and dental history, complaints and treatments performed. Eight sessions of auriculotherapy and one of laser therapy were carried out in order to heal the lesions. The patient presented lower levels of anxiety, agitation and ceased the habit of self‐mutilation and, consequently, the pain. Conclusions: The use of auriculotherapy led to a considerable improvement in the patient's painful condition and reduced anxiety, also benefiting the interaction with her family members and laser therapy promoted wound healing. [ABSTRACT FROM AUTHOR]

Objective: to investigate the impact of the severity of microcephaly caused by the Zika virus (MCZ) on tooth eruption and orofacial structures of children. Design: This case series study developed the research at the Mens Sana Rehabilitation Center, Arcoverde, Brazil. The study included 27 children diagnosed with MCZ. We performed the data collection in June 2018 through a questionnaire answered by the legal guardians, followed by a clinical examination of the children. The data were analyzed by the Mann–Whitney and Fisher's exact tests (p = 0.05). Results: The final sample was composed of 20 children. Of these, 13 (35.0%) had severe microcephaly, 5 (30.0%) had altered sequence of tooth eruption, 10 (50.0%) had delayed eruption, and the mean number of decayed teeth was 2.3. The most identified orofacial changes were teeth grinding habit (65.0%), difficult chewing (50.0%), and non‐nutritive sucking (50.0%). The Mann–Whitney test showed that the severity of microcephaly did not affect tooth eruption (p = 0.581). The Fisher's exact test showed that the severity of microcephaly was not associated with orofacial changes (p > 0.05). Conclusions: The severity of MCZ does not seem to influence changes in deciduous tooth eruption and the presence of orofacial anomalies. [ABSTRACT FROM AUTHOR]

Purpose: To assess the oral health status of children with Down syndrome (DS) in the United States and evaluate the oral health needs of families with DS. Methods: Among 320 parents who consented to participate, 260 (81.2 percent) surveys were completed. A survey was distributed through the National Down Syndrome Society to parents of children with DS up to age 21 years, which asked questions about children’s general and oral health. Results: Parents who reported that their children had difficulty rinsing and spitting were more likely to report their child’s overall general health as poor (P<0.05). Parents’ frequency of daily toothbrushing was similar to their children’s toothbrushing habits (P<0.05). Conclusions: Dysphagia for children with Down syndrome may negatively impact oral health in addition to general health. Encouraging parental involvement in oral care for children with DS may lower their risk for oral disease. Continued support is needed to ensure dental school education includes training for the treatment and management of patients with DS. [ABSTRACT FROM AUTHOR]

Aims: Sedation and general anesthesia are necessities for the treatment of many individuals within special populations such as those with physical and intellectual disabilities, fear/anxiety, or individuals requiring extensive procedures. This study aims to discover regulatory factors that may be contributing to the limited access to anesthesia services provided by dentist anesthesiologists. Methods and Results: The study included an online survey completed by self‐reported dentist anesthesiologists with 2 or more years of formal anesthesia training. The survey was distributed at the April 2019 American Society of Dentist Anesthesiologists national meeting in Chicago. Participants responded to questions regarding the effect of specific state regulations on decisions to practice in a particular state and how such regulations influenced patient safety and barriers to care. Rules and regulatory restrictions on the mobility of dentist anesthesiologist equipment/supplies and additional state narcotic transportation regulations were deemed statistically significant in failing to improve safety. Requiring airway and sedation training for a facility's provider and staff were not barriers to care. Rules and regulations were not a factor to establishing clinical practice in one state over another state. Conclusion: Individuals and organizations responsible for influencing the regulatory environment of anesthesia services should improve regulations to facilitate the mobility of dentist anesthesiologists. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkiye Klinikleri Journal of Dental Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT Objective: To evaluate the oral health and related factors among people with visual impairment in a municipality in southeastern Brazil. Methods: A cross-sectional and descriptive household study was carried out on a representative sample of people with visual impairments in a medium-sized city in Brazil. A clinical-dental examination was performed (evaluating tooth loss, caries, periodontal health, dental plaque use and need of prosthesis) and a semistructured questionnaire was applied, investigating the socioeconomic conditions (sex, age, marital status, skin color and income) and the use of dental services (reason, time since, and type of service used [private/public] in last dental visit). Descriptive and bivariate analysis were performed to asses the factors related to oral health. Results: The mean age of participants was 65 years (±15.05), with the majority women (70.9%). 53.1% of the interviewees were edentulous, but 58.2% had a good perception of oral health. The blind ones use less public services (p=0.038) and with a lower frequency (p=0.014) than subjects with low vision. Those with less schooling had higher tooth loss and lower periodontal problems (p

Copyright of RGO: Revista Gaúcha de Odontologia is the property of RGO: Revista Gaucha de Odontologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose/Aim: To investigate the frequency of preventive dental care among adults with autism and explore factors associated with receiving regular preventive care. Materials and Methods: De‐identified data was collected from electronic health records of 18‐year‐old or older patients with autism that had at least one preventive dental procedure recorded. The data was then analyzed to describe the frequency of preventive dental procedures provided for this population and investigate what variables are associated with regular care. Results: Sample size was 119, 67% were males, average age was 30.8 years, and 58% had Medicaid. Average BMI was 42.8, the prevalence of diabetes and heart disease were 16% and 34%, respectively, and 86% reported mental health problems. Recreational drug use was 6.8%, alcohol use was 19%, and tobacco use 16%. Xerostomia was reported by 32%, and the average number of medications was 7.2 ± 5.5. The average number of preventive dental visits was 7.9 ± 10.6, and 35% of the patients had at least one preventive dental visit per year. Only number of medications had a statistically significant association with number of preventive dental visits. Conclusions: Only one in every three adults with autism had at least one preventive dental visit per year. [ABSTRACT FROM AUTHOR]

Objective: The aim was to assess craniofacial features through facial anthropometric and lateral cephalometry measurements of individuals with mucopolysaccharidosis (MPS) and compare them with individuals without MPS. Design: Cross-sectional study. Patients: A total of 14 individuals with MPS and 28 non-MPS age- and sex-matched were enrolled in this study. Methods: A clinical facial analysis to evaluate the soft tissues and cephalometric analysis that comprised linear and angular measurements were performed. The calculation of the method error suggested no systematic errors (p >.05). Random errors for linear and angular measurements were low (less than 0.5° and 1.6 mm). Chi-square test and independent t-test were performed. Results: Most individuals with MPS were dolichofacial, presented altered facial proportions with an increased anterior lower facial height (ALFH) and lip incompetence (all p <.05), when compared with non-MPS individuals. Six angular measurements (1s.Na, 1s.NB, FMA, IMPA, AFI, and Po.Or_Go.Me; all p <.05) were significantly increased among individuals with MPS, and two (1s.1i and Ba.N-Ptm.Gn, all p <.05) were significantly decreased among them. Four linear measurements were significantly increased among individuals with MPS (1s-NA, 1i-NB, S-UL, and S-LL; all p <.05) and five (PogN-Perp, Co-A, Co-Gn, Nfa-Nfp, and overbite; all p <.05) were significantly decreased among them. Conclusion: In summary, most individuals with MPS were dolichofacial with increased ALFH. Proclined upper and lower incisors, reduced nasopharyngeal space, and reduced overbite was also noted. [ABSTRACT FROM AUTHOR]

Objective: To verify whether access to information about oral hygiene influenced the practices of caregivers of children with microcephaly caused by Zika virus (ZIKV). Methods: A case series study was developed at the Mens Sana Rehabilitation Center, in the municipality of Arcoverde, Pernambuco, Brazil. The study universe included the mothers of 32 children with microcephaly caused by Zika virus. Data collection took place in June 2018 and was carried out through a structured questionnaire. The variables studied comprised socioeconomic issues, habits, diet, and knowledge about oral hygiene. Fisher's Exact and Pearson's Chi‐square tests were used with a significance level of 5%. Results: Out of 32 individuals eligible to participate in the study, only 27 were selected. Most mothers reported receiving information about oral hygiene from their infants (63.0%). Fisher's Exact and Pearson's Chi‐square tests showed that access to oral hygiene information was associated with mother's education, family income, regular visits to the dentist, frequency of tooth brushing, age at which the infant started brushing, and brushing time (p < 0.05). Conclusion: Access to information about oral hygiene positively influenced the oral health care of mothers with their children with microcephaly caused by ZIKV. [ABSTRACT FROM AUTHOR]

Aims: This manuscript aimed to produce an illustrated booklet of Brazilian sign language (LIBRAS) booklet to facilitate the communication between dentists (and academics) and deaf patients during dental treatment and other healthcare promotion activities. Methods and Results: A literature review was conducted to select signs, symptoms, and diseases related to dentistry expressed in LIBRAS; in addition, photographs were taken to illustrate and produce the booklet. The booklet (in PDF format) was made available on an open‐access website and printed copies were freely distributed at the dental clinics of the Federal University of Pará. Conclusion: Learning of specific LIBRAS is extremely important to guarantee social inclusion and improve dental treatment of deaf patients. [ABSTRACT FROM AUTHOR]

Introduction: Basic and daily oral hygiene care is essential for maintaining oral health in adults with special needs. The caregivers act in this process and need to be understood about the difficulties and the resources they use to deal with this demand. The aim of this qualitative study was to understand the difficulties and strategies of caregivers regarding oral hygiene for adults with special health care needs (SHCN) Methods: Twenty‐one caregivers of adults with SHCN participated in an interview in which the following questions were asked: What are the greatest difficulties in performing oral hygiene for the adult with SHCN you take care? and "How do you overcome these difficulties?" The interviews were recorded and the qualitative data were analyzed using the Discourse of the Collective Subject technique Results: All respondents were female with a mean age of 58.5 years (± 10.8) and the adults with SHCN presented mean age of 30 years (± 18). The greatest difficulty pointed out by caregivers regarding oral hygiene for adults with SHCN was their non‐cooperation to do such activity. Regarding coping strategies, caregivers pointed out several strategies to perform oral hygiene in adults with SHCN, such as supervising their brushing, seek for a qualified dentist to assist with this task, performing oral hygiene during the bath, performing physical restraint, among others Conclusion: The caregivers' perspectives indicate feelings of failure, discomfort, but also the use of creative resources to deal with the task. The results bring up themes that refer to anxieties and are related to technical and dental issues, that could be explored and need to be recognized by the reference oral healthcare team, whose responsibility it is also to work for the empowerment of caregivers. [ABSTRACT FROM AUTHOR]

Background. Providing dental treatment for intellectually disabled patients is usually performed under general anaesthesia. Objectives. This randomised double-blinded parallel clinical trial study aims to evaluate the effect of dexmedetomidine on the blood pressure and recovery conditions of these patients. Methods. Fifty intellectually disabled patients without systemic problems or physical disability were recruited. The anaesthetic regimen included 5 mg.kg-1 of sodium thiopental, 0.8 mg.kg-1 of atracurium, and 1-2 mcg.kg-1 of fentanyl; and 100 mcg.kg-1 .min-1 propofol for maintenance. The intervention group received additional 2 mcg.kg-1 .h-1 dexmedetomidine by infusion. The control group received equal amount of 0.9% saline. Patients’ blood pressure, duration of anaesthesia and recovery, types of dental treatments and agitation levels in recovery were recorded. Results. Systolic blood pressure fluctuated in control group (P = 0.032 between 15 and 30 minutes and P = 0.009 between 45 and 60 minutes), while it did not significantly alter in the intervention group (P = 0.942). The diastolic blood pressure did not significantly change neither in dexmedetomidine (P = 0.094) nor in the control group (P = 0.277). Patients’ agitation levels were significantly lower in dexmedetomidine group at 15 (P = 0.015) and 30 (P = 0.003) minutes post-operatively. The use of dexmedetomidine did not significantly elongate the stay in recovery (P = 0.194). Conclusions. Dexmedetomidine can be used to stabilise intra-operative blood pressure and to decrease post-operative agitation without lengthening recovery time. [ABSTRACT FROM AUTHOR]

Oral health is a very important aspect of general health, especially for vulnerable groups such as children with special healthcare needs. It is important to provide appropriate oral care in order to promote quality of life and good health for everyone, especially for children with special healthcare needs. Method: We reviewed the recent literature to collect knowledge regarding the delivery of quality oral care to children with special healthcare needs. We also explored some of the treatment management options that could address the needs of these children when attending dental clinics. Result: Unfortunately, we noted significant inequalities with issues related to oral health among those children. This situation often results in limitations to the activities of daily living for these children. There is therefore a need for much-needed advancements and refinements in oral healthcare to address the needs of children who have special healthcare needs. Conclusions: Providing children with special healthcare needs with high-quality dental care may necessitate active liaisons with healthcare facilitators and will require work across professions to make certain that these children's oral health is also prioritized. Coordinated efforts by dental professionals are needed to provide dental health education and preventive interventions for these children. [ABSTRACT FROM AUTHOR]

Background: Children with disabilities generally face poorer oral health outcomes compared with their non-disabled peers due to a range of factors including inadequate oral hygiene, infrequent dental visits and systemic barriers in accessing care., Aim: This ethnographic study explored the perspectives of caregivers and professionals to identify the ways that children with disabilities are included in oral health., Design: A purposive sample of 10 caregivers, all mothers with disabled children aged 9-15 years, five healthcare providers and five educators in Saudi Arabia, participated. Data collection used participant observation and semi-structured in-depth interviews. Data were analysed using reflexive thematic analysis., Results: The findings suggest that mothers lacked a supportive environment to develop their skills and knowledge about oral health care, preventing them from including their children in oral health. Inaccessible services added to the exclusion of both mothers and children. Some dental professionals exhibited poor communication skills and discriminatory attitudes towards the children and problematising mothers. Educators tended to discuss disabled children in terms of inability, displaying a deficit approach to impairment., Conclusions: The evidence suggests the exclusion of mothers from oral health. This has an impact on how they enable their children. Recommendations include adopting a social model of disability in dental education and policies in Saudi Arabia to address inequalities. Provision of support, education and focusing on societal barriers moves towards inclusion rather than conceptualising disability as an individual problem., (© 2024 BSPD, IAPD and John Wiley & Sons Ltd.)

Introduction: Individuals with intellectual and developmental disabilities (IDDs) face numerous challenges in accessing dental care. Despite difficulties, more evidence exploring difficulties among this cohort in India is needed. This study aims to conduct a scoping review of articles published in India exploring access to dental care among individuals with IDD., Method: We followed the Arksey O'Malley framework for scoping reviews and the PRISMA guidelines for reporting studies. Findings were analyzed based on Levesque's framework for access., Results: Seventeen articles were collated from five databases. The perceived need for dental care was low, and dental visits were mainly need-based and infrequent. Knowledge regarding dental care did not translate to dental visits. Patient-related barriers were cost, transportation difficulties, fear, lack of dentist skills, patient behavior, and cooperation. From the providers' perspective, most dentists were willing to treat but noted infrastructural and knowledge-based limitations., Conclusion: Access to dental care was limited due to infrastructure constraints and a lack of dentist training. Caregivers and individuals with IDD did not prioritize dental health, faced communication barriers, and were afraid of dental procedures. It is important to improve preventive dental care and raise awareness among caregivers of individuals with IDD in India. Training dentists and incorporating special care dentistry into the standard dental curriculum will improve access., (© 2024 The Author(s). Special Care in Dentistry published by Special Care Dentistry Association and Wiley Periodicals LLC.)

Background: This systematic review investigates barriers and enablers to dental care utilization by disabled children. Given the high global prevalence of disabilities in children, coupled with poor oral hygiene and a 45% rate of dental caries in this group, developing inclusive oral health strategies is critical. The review aims to synthesize literature on factors affecting oral healthcare improvement for disabled children, identifying barriers, facilitators and knowledge gaps., Methods: The review was conducted following the Joanna Briggs Institute's methods and reported according to PRISMA guidelines. A comprehensive search spanned multiple databases, considering perspectives from carers, parents, dentists and health professionals. The focus was on studies involving children up to age 17 with disabilities, as defined by WHO, using dental care services. Exclusions included non-qualitative studies, populations over 18 and nondisabled children. There were no restrictions on publication date or language. Thematic synthesis of the studies extracted themes related to barriers and enablers in oral healthcare for disabled children., Results: Thematic synthesis identified five overarching themes: stigma, communication issues, professional development, oral health education and medical-dental collaboration. Facilitators included enhancing accessibility and availability of dental care through a holistic approach, improving dental care facility environments and ensuring skilled dental care providers., Discussion: The review underscores the importance of interprofessional collaboration, improved parent/caregiver education and specialized dental facilities to support children with disabilities. It identifies key barriers and facilitators in dental care, including challenging stereotypes, improving communication between providers and parents, enhancing holistic training and addressing gaps in oral health education and integrated healthcare systems., Conclusion: Addressing the complex dynamics of dental care for disabled children is essential for developing inclusive and effective preventive and therapeutic strategies. This review highlights the need for tailored approaches and enhanced support systems to improve oral health outcomes in this vulnerable population., Patient and Public Contribution: The members of the family support department, Middle East and North Africa (MENA) Organization for Rare Disease and Disability who provided the disability voice and contributed to providing input to the review protocol., (© 2024 The Author(s). Health Expectations published by John Wiley & Sons Ltd.)

Background: We investigated the factors associated with regular dental check-ups among adults with intellectual disabilities in Japan, with the aim of increasing the attendance rate of regular dental check-ups, which are important for maintaining the oral health of persons with intellectual disabilities., Methods: A questionnaire survey focused on oral health was conducted with 971 adults with intellectual disabilities in Japan. The survey included questions related to disability diagnosis, severity of intellectual disability, residence type, and several oral-health factors, including proxy-reported number of teeth, presence of a family dentist, frequency of regular dental check-ups, tooth-brushing habits, and availability of a dental hygienist at a facility. Logistic regression analysis was used to determine the association between regular dental check-ups (dependent variable) and independent variables. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated., Results: In a multivariate analysis, sex, diagnosis of disability, severity of intellectual disability, residence type, and the presence of a family dentist were significantly associated with regular dental check-ups. The ORs for nonregular dental check-ups were significantly higher for adults with Down syndrome, those with mild disability, and those living at home with family; the respective mean ORs (95% CIs) were 2.3 (1.2-4.4), 3.3 (1.3-8.4), and 1.8 (1.1-3.0). The absence of a family dentist had a particularly strong association with a lack of regular dental check-ups, with a mean OR (95% CI) of 15.0 (8.7-26.0)., Conclusions: Regular dental check-ups among adults with intellectual disabilities in Japan were associated with sex, diagnosis of disability, severity of disability, type of residence, and the presence of a family dentist., Competing Interests: Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Dental care accessibility is subject to a dentist's qualification, practice and intention to treat patients, regardless of whether those patients have special healthcare needs (SCN) and should receive treatment in a dental setting. This multicentre study aimed to evaluate the characteristics of patients with SCN, their access to dental care and behaviour towards dental care from their caregiver's perspective. In addition, the perspective of dental care providers who care for patients with SCN and the factors affecting the provision of treatment was also appraised. The Eastern Province of Saudi Arabia served as the site of this cross-sectional study from 1 February 2020 to 31 January 2022. Caregivers of 272 patients with SCN, regardless of age and gender, were recruited in the study. The caregiver's proforma sought information on the demographic characteristics, type of disability, cooperation, medical history, occupation of the parent and patient's behaviour towards oral hygiene and dental healthcare. The second proforma had the dental care provider's perspective about the common disabilities, factors that affect the decision to provide treatment, difficulties patients face in getting their dental treatment and, from the dentist's experience, recommendations to improve the access to dental care for patients with SCN. Statistical analysis was carried out by using SPSS version 22.0. The demographic features, caregiver's perception about oral healthcare accessibility and dental professional's point of view were presented as frequencies and percentages. Chi-square test was applied to compare the proportions. The majority of the caregivers were satisfied with the dental service providers (91.9%) for their patients with SCN. The dental care provider's survey results indicated a shortage of dentists (54.7%) in the region and other factors that pose challenges to special care, like the severity of the disability of patients with SCN (50%), family structure (46.7%), treatment cost (35.6%) and transportation (32.8%). Patients with SCN in Saudi Arabia had a high appraisal of access to dental care and were very satisfied with dental treatment results. However, the presence of a dental care provider in the same rehabilitation centre was a major concern. The severity of the disability and the patient's cooperation were the major factors that may have affected the decision of the dental care provider., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Tarek Ezzeldin et al.)

Purpose: To assess oral hygiene, gingivitis, and the association between them for adolescents with cystic fibrosis (CF) compared to nonCF controls. Methods: This was a cross-sectional study of adolescents with CF aged 12 to 17 years (n=27), compared to two non-CF control groups: Medicaid-enrolled adolescents with special health care needs (ASHCN; n=60) and healthy Medicaid-enrolled adolescents (n=185). Dental plaque was a proxy for oral hygiene, and gingival bleeding was a proxy for gingivitis. This study employed confounder-adjusted binomial logistic regression to compare outcomes between adolescents with CF and controls. Results: After adjusting for confounders, adolescents with CF had significantly poorer oral hygiene than controls (CF versus ASHCN odds ratio [OR] = 2.9, 95 percent confidence interval [95% CI] = 2.0 to 4.4, P<0.001; CF versus healthy OR = 1.7, 95% CI=1.3 to 2.2, P<0.001), but there was no significant difference in gingivitis (CF versus ASHCN OR=1.3, 95% CI=0.87 to 1.9, P=0.21; CF versus healthy OR = 0.80, 95% CI=0.60 to 0.99, P=0.04). Poor oral hygiene was significantly associated with gingivitis for all adolescents (CF OR=1.2, 95% CI=1.1 to 1.4, P<0.001; ASHCN OR = 1.8, 95% CI=1.6 to 2.0, P<0.001; healthy OR = 1.2, 95% CI=1.1 to 1.3, P<0.001). Conclusions: Adolescents with CF had poorer oral hygiene than non-CF controls but similar levels of gingivitis. Future efforts should identify factors that protect adolescents with CF from gingivitis.

Purpose: To assess existing knowledge of anesthesia and perioperative information needs/preferences in parents (parent, caregiver) of patients with special health care needs (SHCN) undergoing general anesthesia (GA) for dental procedures, and analyze the relations between caregiver anesthesia knowledge, health literacy level, and preoperative anxiety. Methods: Parents of patients with SHCN requiring GA for dental treatment completed an online survey with closed- and open-ended items assessing preferences and interest in perioperative information and educational resources, anesthesia knowledge, anxiety, and health literacy. Pearson product-moment correlation coefficients and descriptive statistics were used to summarize the findings. Results: Fifty-two parents completed the survey. Over two-thirds of the sample identified as having "high information" perioperative requirements, 42.3 percent of respondents exhibited elevated levels of perioperative anxiety, and 67.4 percent had adequate health literacy levels that were positively associated with anesthesia knowledge. Ratings of importance and interest in learning more about GA for dental treatment were high. Facilitating increased caregiver involvement before, during, and after surgery was the highest-rated resource format. Conclusions: Parents of patients with special health care needs are generally interested in receiving more information and resources about general anesthesia for dental treatment. Identified gaps in anesthesia knowledge and preferences for content and format of resources can be used to inform the development of tailored educational resources for families regarding perioperative management to ensure that parents have a complete understanding of their patients' anesthetic management and surgical care.

Purpose: To evaluate the accuracy and consistency of chatbots in answering questions related to special needs dentistry. Methods: Nine publicly accessible chatbots, including Google Bard, ChatGPT 4, ChatGPT 3.5, Llama, Sage, Claude 2 100k, Claude-instant, Claude-instant-100k, and Google PaLM, were evaluated on their ability to answer a set of 25 true/false questions related to special needs dentistry and 15 questions for syndrome diagnosis based on their oral manifestations. Each chatbot was asked independently three times at a three-week interval from November to December 2023, and the responses were evaluated by dental professionals. The Wilcoxon exact test was used to compare accuracy rates among the chatbots while Cronbach's alpha was utilized to measure the consistency of the chatbots' responses. Results: Chatbots had an average accuracy of 55??4 percent in answering all questions, 37±6 percent in diagnosis, and 67±8 percent in answering true/false questions. No significant difference (P>0.05) in the accuracy proportion was detected between any pairwise chatbot comparison. All chatbots demonstrated acceptable reliability (Cronbach's alpha greater than 0.7), with Claude instant having the highest reliability of 0.93. Conclusion: Chatbots exhibit acceptable consistency in responding to questions related to special needs dentistry and better accuracy in responding to true/false questions than diagnostic questions. The clinical relevance is not fully established at this stage, but it may become a useful tool in the future.

The aim of this systematic review was to update an existing review on the management of dental caries lesions in patients with disabilities so as to provide an up-to-date summary of the evidence. Randomized clinical trials and cohort studies related to preventive and restorative programmes for dental caries among people requiring special care, published in English, Spanish, Portuguese, French and German languages from February 1st 2011 to April 1st 2022, were retrieved from three databases (“updated review”). From the 1,105 titles identified using the search topic “Caries AND Disability”, 17 papers informed in the analyses: 6 referring to caries preventive strategies and 11 related to restorative care strategies. Most of these studies targeted children and adults with intellectual/physical disability, although preventive and therapeutic strategies were also reported for frail older adults and onchohematological patients. Fluorides in tablets, gels or varnishes forms and the use of xylitol as a sugar substitute were reported as effective approach to prevent the onset of caries in high-risk groups. Minimally intervention treatment options such as the Hall technique, the ART approach and the use of SDF for arresting caries, were deemed suitable and effective strategies for treating existing lesions in-office. In conclusion, in the past decade (2011–2022) an increased number of articles reported strategies to prevent and manage caries among people requiring special care. Although an array of preventive and therapeutic strategies for dental caries exists, more and better-quality clinical evidence is needed to offer guidance to inform policy and practice for special care dentistry.

It is known that the oral health status of people with intellectual disabilities (IDs) is likely to be compromised as compared with the general population. Until recently, the trend of oral hygiene among the adult population with intellectual disabilities in Brunei Darussalam had yet to be studied. Thus, the aim of this study was to determine the oral hygiene practices, oral health knowledge and dental appointment patterns among the adult population with IDs in Brunei Darussalam. A cross-sectional study was conducted at different service providers in Brunei Darussalam for adults with IDs. An easy-to-read questionnaire was distributed to the participants. The responses of the questionnaire for IDs were analyzed. A total of 34 participants were recruited. It was found that all participants were practicing their daily oral hygiene routine. In terms of dental visits, more than half visit the dentist at least once a year. The majority of the participants agreed that visiting the dentist every 6 months was essential. This study showed that adults with IDs in Brunei Darussalam were aware of the importance of oral health and were maintaining their daily oral hygiene, although not with the ideal method. It is important for clinicians to not only educate the individuals with IDs but also their carer(s) when it comes to oral health knowledge, as carers play a key role in the oral health of the people under their care. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the barriers to access and oral health care faced by children and adolescents with Cerebral Palsy (CP) according to their motor impairment through the perception of caregivers. Material and Methods: A case series study was carried out at three health institutions in Pernambuco, Brazil. The study sample consisted of 94 caregivers of 5-to-18-year-old patients with CP, according to GMFCS (The Gross Motor Function Classification System). Data were collected using a semi-structured form to evaluate the barriers to access and analyzed statistically by the chi-square and Fisher exact tests, adopting a 5% level of significance. In addition, binary logistic regression was performed to determine the weight of the variables in explaining the outcome variable. Results: There were major difficulties involving transportation (p=0.04) and structural accessibility to dental services (p

This systematic review evaluates published evidence on oral hygiene interventions conducted in Alzheimer's disease (AD) patients. PubMed, Embase, Cochrane Library, CINAHL, Dentistry & Oral Sciences Source, and Web of Science were searched for articles published up to 19 April 2021. The main outcomes of interest were the Plaque index score (PI), oral health knowledge of participants or their caregivers, and behaviors and attitudes towards oral hygiene. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Institutes of Health. The study was conducted under PROSPERO registration code CRD42021247733. Two studies met the inclusion criteria. One was a pre-post study conducted in Brazil, and the other was a prospective cohort study carried out in China. The sample sizes of these studies were 29 and 168, respectively. Both studies were carried out in institutionalized patients and presented a significant loss to follow-up. The PI and gingival index scores both improved after the application of the respective interventions, yet the differing methodologies used precluded further comparisons. The studies were deemed to be of good and regular quality, respectively. Despite the need for more comprehensive interventions to ensure a better oral health status and a higher quality of life for AD patients, an alarming lack of studies have been conducted in this population. [ABSTRACT FROM AUTHOR]

Background: Children with hearing and speech impairment are one of the important groups deprived of good oral health due to communication barriers. The chance of acquiring minimal information can significantly affect their personal as well as oral health. Aim: The present study was conducted to assess the oral health status among hearing and speech-impaired children in Erode. Materials and Methods: This cross-sectional descriptive study was conducted among hearing and speech-impaired children aged 7–14 years attending special schools at Erode, Tamil Nadu. A structured questionnaire written in vernacular language (Tamil) was used to obtain information on demographic details and oral hygiene practices. Then, oral examination was carried out and findings were recorded in the WHO Oral Health Assessment Form for Children, 2013. Descriptive statistics and Chi-square test were used for statistical analysis. Results: A total of 75 children were examined including 46 males (61%) and 29 females (39%). The common dental diseases found in the children were dental caries (65%) and gingival bleeding (47%). Most of the children (76%) required prompt treatment. Intervention urgency is higher among those children who have not visited a dentist before. Conclusion: The present study population has extensive dental treatment needs owing to communication difficulties and underutilization of dental care. The dental professionals along with the school authorities and voluntary agencies should reorganize the preventive as well as curative dental services so as to benefit the hearing and speech-impaired children.

Amal Alfaraj,1 Hassan S Halawany,2 Muntasar T Al-Hinai,3 Abid H Al-Badr,2 Marwa Alalshaikh,4 Khalifa S Al-Khalifa5 1Prosthodontics Residency Program, Department of Prosthodontics, School of Dentistry, Indiana University, Indianapolis, IN, USA; 2Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia; 3Dental and Maxillofacial Surgery Department, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Sultanate of Oman; 4Periodontics Fellowship Program, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 5Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Amal AlfarajProsthodontics Residency Program, Department of Prosthodontics, School of Dentistry, Indiana University, Indianapolis, IN, USAEmail asalfara@iu.eduObjective: Access to dental care is a key factor influencing oral health outcomes. Individuals with special healthcare needs are at risk of not having access to dental care services which they need to maintain their oral health. This study assessed the magnitude of this problem and identified barriers responsible for the difficulties in accessing dental care in Qatif, Saudi Arabia, as reported by caregivers of individuals with special healthcare needs.Methods: This cross-sectional study collected data using a self-administered survey questionnaire from caregivers of individuals with special healthcare needs across 11 centers (eight special needs centers and three schools) in Qatif, Eastern Province of Saudi Arabia, between February and April 2019.Results: A total of 186 caregivers participated in the study, 102 (54.8%) of whom reported difficulties in getting access to dental care. The key barriers included lack of time on the part of caregivers (60.8%), unsuitable clinic environment (53.9%), difficulties with transportation (51.9%), medical/health status of the individual with special healthcare needs (51.0%), and geographically distant dental clinics (51.0%). Caregiver demographics (age, gender, and educational level) had no significant influence on the difficulties reported by caregivers in getting access to dental care for individuals with special healthcare needs (p> 0.05).Conclusion: A large proportion of caregivers in Qatif, Saudi Arabia, experience difficulties with access to dental care services for individuals with special healthcare needs. The most common barriers are physical accessibility of dental facilities (for individuals with special healthcare needs), affordability, and lack of skills and knowledge of dental care providers.Keywords: health services accessibility, dental care for disabled, caregivers, Saudi Arabia

Abstract Background To explore the profile of patients and treatment delivered at specialist referral centres for individuals with special needs. Methods A cross-sectional audit was conducted of the health records of all patients with appointments at two of Australia’s largest referral centres for patients with special needs, the Integrated Special Needs Department at the Royal Dental Hospital of Melbourne and the Special Needs Unit at the Adelaide Dental Hospital, for the month of August 2015. Results The profile of patients treated at these specialist units demonstrates the diversity of individuals with additional health care needs that general dentists feel require specialised oral health care. The Adelaide-based clinic had a greater proportion of complex medical patients in comparison to those treated in Melbourne who were more likely to have a disability or psychiatric condition and were less likely to be able to self-consent for treatment. Interestingly, despite similar workforce personnel numbers, there were approximately twice as many appointments at the Special Needs Unit in Adelaide than the Integrated Special Needs Department in Melbourne during the study period which may have reflected differences in workforce composition with a greater use of dental auxiliaries at the Adelaide clinic. Conclusions The results of this study provide an initial profile of patients with special needs referred for specialist care in Australia. However, the differences in patient profiles between the two units require further investigation into the possible influence of service provision models and barriers to access of care for individuals with special needs and to ensure equitable access to health care.

This study aimed to answer the following question: What is the proportion of acceptance reported by parents toward pediatric behavior guidance techniques (BGTs)? Observational studies that evaluated parental acceptance of BGTs during pediatric dental visits among parents of non-special health care need (non-SHCN) and SHCN children were included. A search of the Cochrane Library, Latin American and Caribbean Health Sciences (LILACS), MedLine/PubMed, PsycINFO, Scopus, and Web of Science databases, in addition to gray literature, was performed until October 2021. The Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies was used for quality assessment. The certainty of evidence was assessed using the Recommendation, Assessment, Development, and Evaluation (Grade). Fifty-three studies with 4868 participants were included, and 42 were retained for the random-effects proportion meta-analysis. The methodological quality varied from low to high. The agreement with the BGTs varied from 85.6% (95%CI: 77.5-92.1; p < 0.001; I2 = 93.6%; 16 studies; n = 1399) for tell-show-do to 25.7% (95%CI: 17.8-34.4; p < 0.001; I2 = 90.4%; 12 studies; n = 1129) for passive protective stabilization among non-SHCN children's parents; meanwhile, among the parents of SHCN children, it varied from 89.1% (95%CI: 56.1-99.7; p < 0.001; I2 = 95.7%; 3 studies; n = 454) for tell-show-do to 29.1% (95%CI: 11.8-50.0; p = 0.001; I2 = 84.8%; 3 studies; n = 263) for general anesthesia. The effect estimates varied greatly, as substantial heterogeneity across studies was observed, thus limiting the confidence in the results. Parents were more likely to agree with basic BGTs over advanced BGTs, with very low certainty of evidence. Dentists should discuss BGT options with parents. Protocol registration: PROSPERO CRD42018103834. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the barriers to access and oral health care faced by children and adolescents with Cerebral Palsy (CP) according to their motor impairment through the perception of caregivers. Material and Methods: A case series study was carried out at three health institutions in Pernambuco, Brazil. The study sample consisted of 94 caregivers of 5-to-18-year-old patients with CP, according to GMFCS (The Gross Motor Function Classification System). Data were collected using a semi-structured form to evaluate the barriers to access and analyzed statistically by the chi-square and Fisher exact tests, adopting a 5% level of significance. In addition, binary logistic regression was performed to determine the weight of the variables in explaining the outcome variable. Results: There were major difficulties involving transportation (p=0.04) and structural accessibility to dental services (p<0.01) among children and adolescents with severe CP. In addition, the more severe the CP, the greater the difficulty of accessibility (OR=4.09,) and the lower the income (OR=8.80), the greater the motor impairment. Conclusion: Despite the availability of access to dental services, low-income families have more severe CP patients, contributing to the daily difficulties already faced by them in oral health care. [ABSTRACT FROM AUTHOR]

This article discusses the issues of at-home care and associated difficulties, as well as possibilities of providing dental care to people with disabilities. It covers the legal basis of visiting patients by a dentist and orders regulating dental care. It also describes the documents that a patient must have before calling a dentist.

Background: Children with disabilities experience poorer oral health and frequently have complex needs. The accessibility of oral health care services for children with disabilities is crucial for promoting oral health and overall well-being. This study aimed to systematically review the literature to identify the barriers and facilitators to oral health care services for children with disabilities, and to propose priority research areas for the planning and provision of dental services to meet their needs., Methods: This was a mixed methods systematic review. Multiple databases searched included MEDLINE, Scopus, PsycINFO, EMBASE, and CINAHL. The search strategy included Medical Subject Heading (MeSH) terms related to children, disabilities, and access to oral health. Eligibility criteria focused on studies about children with disabilities, discussing the accessibility of oral health care., Results: Using Levesque's framework for access identified barriers such as professional unwillingness, fear of the dentist, cost of treatment, and inadequate dental facilities. Facilitators of access offered insight into strategies for improving access to oral health care for children with disabilities., Conclusion: There is a positive benefit to using Levesque's framework of access or other established frameworks to carry out research on oral healthcare access, or implementations of dental public health interventions in order to identify gaps, enhance awareness and promote better oral health practices. The evidence suggests that including people with disabilities in co-developing service provision improves accessibility, alongside using tailored approaches and interventions which promote understanding of the importance of dental care and increases awareness for professionals, caregivers and children with disabilities., Trial Registration: Protocol has been registered online on the PROSPERO database with an ID CRD42023433172 on June 9, 2023., (© 2024. The Author(s).)

Background: Oral health is essential for overall well-being and can significantly improve quality of life. However, people with special health care needs (SHCN) often face challenges in accessing dental services. This study aimed to systematically review all available evidence on the oral and dental service utilization determinants among these individuals. Based on the findings, we also explore strategies to increase their access to dental care., Method: This study is a systematic review of reviews based on the PRISMA 2020. Six databases were systematically searched including PubMed, Web of Science, Scopus, Embase, ProQuest, and Cochrane Library. Related keywords were applied up to 30 October 2023. This study includes all systematic, scoping, and rapid reviews written in English that examine the factors affecting dental service use among SHCNs. Microsoft Power BI was used for descriptive quantitative analysis, and MAXQDA version 10 was applied for qualitative thematic analysis., Results: The number of 2238 articles were retrieved based on the search strategy. After excluding duplications and appraising the eligibility, 7 articles were included. An examination of these 7 articles shows that they were all carried out from 2016 to 2022. Of these, 42% were systematic reviews, 42% used a scoping method, and one study (14%) was a rapid review. According to the thematic analysis, there were five main themes concerning determinants of oral and dental utilization of SHCN: "Financial considerations," "Patient-Provider Relationship," "Accessibility and Availability of Services," "Patient Factors," and "Quality of Care." Additionally, regarding strategies for improving utilization, three main themes emerged: "Education and Training," "Service Improvement," and "Policy Solutions., Conclusion: This study delves into the intricate challenges SHCNs face in accessing dental services, highlighting the imperative for comprehensive interventions addressing supply and demand. Supply-oriented measures encompass dentist education, implementing financial policies for affordable services, and integrating dental care into primary healthcare systems. On the demand side, strategies revolve around empowering patients and caregivers and enhancing cultural inclusivity. Despite sustained efforts, current utilization rates fall short of optimal levels. Thus, effective strategic planning by policymakers and healthcare leaders is paramount to bolster dental service utilization among SHCNs, thereby enhancing their overall well-being., (© 2024. The Author(s).)

Oral health is an essential component of overall health for all individuals. The oral health of children and youth with developmental disabilities (CYDD) involves unique characteristics and needs of which pediatricians and pediatric clinicians can be aware. Risk for oral disease in CYDD is multifactorial and includes underlying medical conditions, medications, and ability to participate in preventive oral health care and treatment, and lack of access to providers is common for this population despite being eligible for Medicaid. Pediatric clinicians are uniquely positioned to support the oral health needs of CYDD and their families through the medical home. This clinical report aims to inform pediatric clinicians about the unique oral health needs of CYDD. It provides guidance on assessing caries risk and periodontal status using structured screening instruments; understanding dental trauma, the role of diet and caries risk, trauma prevention, and malocclusion; and providing anticipatory guidance on oral hygiene that includes tooth brushing, use of fluoridated toothpaste, assessing community water fluoridation, advocating for a dental home by 1 year of age, and transition to adult dental care as part of adolescent health care. It also highlights special considerations for dental treatment rendered under sedation or general anesthesia that CYDD may need. Pediatric clinicians can help reduce risk of CYDD developing dental disease by understanding the unique needs of their patients and their barriers to accessing oral health care in their community, communicating with the child's dental home, and advocating for safe and accessible dental procedures., (Copyright © 2024 by the American Academy of Pediatrics.)

Purpose: To assess children's OHRQoL and associated factors among a sample of children with special needs in Riyadh, Saudi Arabia., Materials and Methods: A sample of 6- to 12-year-old children was obtained using convenience sampling from rehabilitation centers. Data were collected through a questionnaire and dental examination. The questionnaire included items related to the children's and their families' characteristics, oral health-related quality of life scales (Parental-Caregivers Perceptions Questionnaire [P-CPQ] and Family Impact Scale [FIS]), perceived health status, and dental care utilisation. Clinical examination was performed by a trained and calibrated dentist. The data were analysed using SPSS; descriptive and inferential data analyses were also performed using SPSS., Results: The mean P-CPQ was 1.10 ± 0.74, and the mean FIS was 1.39 ± 0.88. There was a statistically significant correlation between P-CPQ and caries (r = 0.36, p = 0.02). After controlling for confounders, caries was associated with poor P-CPQ (B = 0.06, p = 0.024). Compared to low-income families, higher-income families had better P-CPQ (4000-8000 SAR: B = -1.36, p = 0.001)., Conclusion: Poor oral health-related quality of life in Saudi children is associated with caries and low income. Preventive measures addressing social determinants are vital to control caries and promote oral health in children with special health-care needs.

Background: This retrospective clinical study was undertaken to comparatively evaluate the number of restorative treatments, endodontic treatments, and tooth extractions performed for patients under general anesthesia due to dental anxiety or special needs between 2015 and 2022 and to examine the pain, bleeding, nausea, and vomiting data of those patients., Methods: In total, 1165 patients underwent dental treatment under general anesthesia in the faculty hospital. Those under the age of 15 and with no endodontic procedure planned (n = 918) were excluded, followed by those with incomplete data (n = 25) and those without endodontic treatment (n = 25). Patients who underwent at least one endodontic treatment were finally included in the study (n = 184). Patients were divided into two groups: healthy and with special needs. Dental treatments were recorded as endodontic, restorative, and teeth extractions. Endodontic treatments were classified according to the tooth type (premolar, molar, and incisors). The composite restorations were classified as anterior, occlusal (O), occluso-distal (OD) or occluso-mesial (OM), and mesio-occluso-distal (MOD) restorations and patients' post-treatment pain, nausea, vomiting, and bleeding were recorded. The data were analyzed statistically., Results: Among the 184 patients included in the study, 70 (38%) were healthy, and 114 (62%) had special needs. Postoperative bleeding was observed more in patients with special needs (χ 2  = 4.189, p < 0.05), whereas pain was observed more in healthy patients (U = 2922.00, p < 0.05). While the number of anterior, O, and MOD restorations was higher in patients with special needs, the number of OD or OM restorations was higher in healthy patients (χ 2  = 74.877, p < 0.05)., Conclusions: Patients with special needs undergo a greater number of restorative treatments compared to control patients, which may be associated with the inadequate oral hygiene care of such patients. However, restorative treatment is mostly indicated for such patients in our faculty hospital, which may indicate that a conservative approach is taken. Additionally, the finding that postoperative bleeding was more severe in this group of patients compared to the control group in this study may emphasize the need to consider more possible complications after general anesthesia in these patients., (© 2024. The Author(s).)

Introduction/background: Oral health care for children with special health-care needs (CSHCN) is often overlooked despite a substantial global population with disabilities or special needs. This scoping review delves into the challenges dentists face in delivering oral health care to CSHCN., Methodology: The scoping review was conducted as per the guidelines of PRISMA-ScR with a search strategy based on the population, intervention, comparison, and outcome (PICO) framework of the research question. The databases searched were PUBMED, Google Scholar, and EBSCOhost. Articles published within 20 years and in the English language were included in the study., Results: The review included 20 studies and highlighted several significant barriers encountered by dentists when providing oral health care for CSHCN. They included inadequate training among dentists in managing special needs patients, the time-intensive nature of oral procedures for this population, and the unpredictable behaviors exhibited by CSHCN during dental visits., Conclusion: The findings underscore the crucial need to address the challenges dentists face in delivering oral health care to CSHCN., (Copyright © 2024 Copyright: © 2024 Journal of Indian Society of Pedodontics and Preventive Dentistry.)