Bridging oral and systemic health in children with Prader-Willi syndrome: Case reports and dental treatment recommendations

2021 ◽  
Vol 17 ◽  
Author(s):  
Jaclyn Vu ◽  
Priyanshi Ritwik
Keyword(s):  
General Anesthesia ◽  
Dental Treatment ◽  
Case Reports ◽  
Dental Health ◽  
Neurodevelopmental Disorder ◽  
Prader Willi Syndrome ◽  
Treatment Needs ◽  
Obstructive Sleep ◽  
Dental Rehabilitation ◽  
Systemic Problems

Background: Prader-Willi Syndrome (PWS) is a complex neurodevelopmental disorder caused by gene alterations on chromosome 15q11-q13 resulting in hyperphagia and neuroendocrine deficits. A comprehensive guide for dental treatment for PWS is lacking despite numerous case reports. The objective of this report and review was to develop a problem-focused list of the interrelationship between oral and systemic parameters of PWS and enable dentists in anticipating the unique treatment needs of children and individuals with PWS. Methods: Four pediatric patients with PWS presenting to an academic dental clinic were evaluated. A literature review spanning the last twenty years was performed to identify the pathophsyiological impact of systemic problems on dental health and treatment. Results: The four cases along with cases from literature were used to enumerate salient oro-dental and systemic features influencing treatment decisions in dentistry. They formed the basis for collective recommendations and precautions for rendering dental treatment in patients with PWS. Conclusion: Sedation for dental treatment is contraindicated due to obesity (BMI over 95th percentile), hypotonia, obstructive sleep apnea (OSA) and respiratory limitations (restricted ventilation due to weight on thoracic cage). Prolonged recovery from general anesthesia, OSA and temperature dysregulation necessitate extended monitoring after dental rehabilitation under general anesthesia. Orthopedic problems and respiratory limitations exclude protective stabilization. Xerostomia and acidic saliva necessitate recommendations for oral rehydrating products. Periodontal assessment is necessary due to poor oral hygiene and diabetes mellitus. Early establishment of a dental home and risk-based frequency of dental care should address caries prevention and restorative needs.

A Case Of Prader-Willi Syndrome With Behavioural Disturbances: A Successful Multidisciplinary Management Approach

2020 ◽  
Vol 5 (1) ◽  
pp. 83
Author(s):  
Nor Jannah Nasution Raduan ◽  
Mohd Razali Salleh ◽  
Norharlina Bahar ◽  
Mohd Faiz Md Tahir ◽  
Najwa Hanim Md Rosli
Keyword(s):  
Neurodevelopmental Disorder ◽  
Pressure Control ◽  
Family Therapist ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Management Approach ◽  
Adolescent Psychiatrist ◽  
Prader Willi Syndrome ◽  
Obstructive Sleep ◽  
Genetically Determined

Prader-Willi Syndrome (PWS) is a genetically determined neurodevelopmental disorder occurring in 1 in 15,000 births. PWS is a rare case in Malaysia and a successful approach to its management has not been well reported here. We present a case of a 13-year-old boy with Prader-Willi Syndrome with prominent behavioural disturbances characterised by temper tantrums, compulsive food intake, stubbornness, stealing and impulsivity further complicated by underlying morbid obesity, poorly controlled type 2 diabetes mellitus, hypertension, dyslipidaemia, obstructive sleep apnoea syndrome and intellectual disability. Multidisciplinary approach involving child and adolescent psychiatrist, occupational therapist, counsellor, family therapist, endocrinologist and dietician has shown to improve the patient’s weight, glucose and blood pressure control and most importantly the behavioural disturbances.

scholarly journals Special Care Dentistry in a Patient with Prader–Willi Syndrome through the Use of Atraumatic Restorative Treatment under General Anesthesia

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Caio Vinícius Gonçalves Roman-Torres ◽  
Sérgio Takashi Kussaba ◽  
Yasmin Comoti Vita Bantim ◽  
Roberta de Barros Antunes Almeida de Oliveira
Keyword(s):  
General Anesthesia ◽  
Dental Treatment ◽  
Atraumatic Restorative Treatment ◽  
Prader Willi Syndrome ◽  
Genetic Origin ◽  
Restorative Treatment ◽  
Single Section ◽  
History Of ◽  
Grade Ii

Prader–Willi syndrome described in 1956 has a genetic origin, affecting both genders, varying in presence and intensity from individual to individual. A precocious diagnosis, before the manifestation of symptoms, has brought some improvement in the quality of life of the carriers in the last years. The objective of this case report was to describe the treatment realized in a 3-year-old boy who presented grade II obesity, difficulty of locomotion, hypotonia, and history of cardiopathy. A dental treatment under general anesthesia was defined, allowing an oral adequation in a single section, in which it was planned the extraction of the element 74 and atraumatic restorative treatment (ART) technique in the other teeth. The precocious intervention in this 3-year-old patient by the therapy realized with ART under general anesthesia was done with success, avoiding unnecessary extractions, preserving dental elements, and maintaining the oral cavity in adequate function.

scholarly journals Sanjad-Sakati Syndrome Dental Management: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Hisham Y. El Batawi
Keyword(s):  
Health Education ◽  
General Anesthesia ◽  
Dietary Habits ◽  
Dental Treatment ◽  
Dental Health ◽  
Genetic Disorder ◽  
Growth Failure ◽  
Dental Tissues ◽  
Dental Management ◽  
Nutritional Needs

Sanjad-Sakati syndrome (SSS) is a rare genetic disorder with autosomal recessive pattern of inheritance characterized by hypoparathyroidism, sever growth failure, mental retardation, susceptibility to chest infection, and dentofacial anomalies. A child with SSS was referred to the dental departmentseeking dental help for sever dental caries which was attributed to his dietary habits and quality of dental tissues. Full restorative rehabilitation was done under general anesthesia. Two years later, the child presented with recurrent caries affecting uncrowned teeth. High carries recurrence rate was blamed for the nutritional habits endorsed by the parents. Only steel crowned teeth survived such hostile oral environment which suggested shifting of treatment strategy towards full coverage restorations instead of classical cavity preparations and fillings during a second attempt for dental treatment under general anesthesia and for the dental treatment of two cousins of the same child. The author recommends effective health education for parents including the nature of their child’s genetic disorder, nutritional needs, and dental health education to improve the life style of such children.

HEMOFILIJA A IR B SERGANČIŲ LIETUVOS VAIKŲ BURNOS SVEIKATA IR JĄ LEMIANTYS VEIKSNIAI

2015 ◽  
Vol 25 (1) ◽  
pp. 66-71
Author(s):  
Rūta Žaliūnienė ◽  
Jolanta Aleksejūnienė ◽  
Vilma Brukienė ◽  
Vytautė Pečiulienė
Keyword(s):  
Dietary Habits ◽  
Dental Treatment ◽  
Dental Health ◽  
Economic Status ◽  
Study Groups ◽  
Salivary Flow ◽  
Caries Experience ◽  
Healthy Children ◽  
Treatment Needs ◽  
Increased Risk

Patients with haemophilia often face difficulties in accessing primary dental care: they are at increased risk of spontaneous gum bleeding and significant bleeding from invasive dental procedures. Other of the known barriers is lack of confidence in the ability of dentists to manage patients with haemophilia. The aim of this study was to examine the dental health and its determinants in Lithuanian children with haemophilia and to compare these findings to the general population. Materials and methods. Two study groups were formed: a group of cases, children with haemophilia aged between 4-17 years and a group of controls, randomly selected healthy subjects matched for gender, age and place of residense. The Quantitative Plaque Percent Index (P% index), caries related microflora, stimulated salivary flow rate and buffer capacity, dmf(t), DMF(t) scores were calculated and analyzed. Dietary habits, frequency of tooth brushing, educational and economic level of the parents and type of haemophilia were determined by a questionnaire. Results. Data were collected from 57 children among which 27 were children with haemophilia and 30 healthy controls. Children with haemophilia had lower overall caries experience and less unmet dental treatment needs in deciduous dentitions as compared to their healthy counterparts, but were no differences between the study groups in permanent dentitions. Higher bacteriological counts were found in controls than in study group. Healthy children were from higher socio-economic status families than children with haemophilia. Conclusions. Better dental health was observed in children with haemophilia in deciduos teeth as compared to healthy children. In permanent dentitions overall caries experience and unmet dental treatment needs did not differ between cases and controls.

scholarly journals Socioeconomic and family influences on dental treatment needs among Brazilian underprivileged schoolchildren participating in a dental health program

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Cristina Martins Lisboa ◽  
Janice Simpson de Paula ◽  
Glaucia Maria Bovi Ambrosano ◽  
Antonio Carlos Pereira ◽  
Marcelo de Castro Meneghim ◽  
...  
Keyword(s):  
Health Program ◽  
Dental Treatment ◽  
Dental Health ◽  
Family Influences ◽  
Treatment Needs

scholarly journals Epidemiology of Dental Caries among Adults in a Rural Area in India

2012 ◽  
Vol 13 (3) ◽  
pp. 382-388 ◽  
Author(s):  
Ami M Maru ◽  
Sena Narendran
Keyword(s):  
Oral Health ◽  
Dental Caries ◽  
Rural Area ◽  
General Health ◽  
Dental Treatment ◽  
Dental Health ◽  
Oral Health Status ◽  
Caries Experience ◽  
Structured Interviews ◽  
Treatment Needs

ABSTRACT Background Data on epidemiology of dental caries of adults in rural India appear to be sparse. Objective The purpose of the study was to assess the oral health status and dental treatment needs of a rural Indian population. Materials and methods The study population consisted of 189 volunteer subjects with a mean age of 34.9 ± 14.2 years and 54% males. Decayed, missing due to caries and filled teeth (DMFT) and tooth surfaces (DMFS) assessed the dental caries experience. Structured interviews collected data on perception of health including oral health, oral hygiene practices and snacking habits. Results While only 38.1% perceived themselves to be in good or very good dental health, nearly 85% felt the same about general health. The most common sugar exposure was sweetened tea; 75% consumed the beverage at least once a day. More than 80% of the subjects had untreated caries with mean DMFT and DMFS scores of 5.1 ± 3.9 and 13.8 ± 17.8, which lacked any gender differences. Dental treatment needs ranged from 16.9% two-surface fillings to 60.8% one-surface fillings; 23.8% crowns or bridges and 37.6% extractions. Those who perceived themselves to be in better oral health had significantly lower DMFT (4.0 ± 3.2 vs 5.9 ± 4.1) and DMFS (8.4 ± 11.7 vs 17.1 ± 20.0) scores (p < 0.05). A similar trend was observed between perception of general health and DMFT (4.8 ± 3.4 vs 7.0 ± 5.6) and DMFS (11.9 ± 13.7 vs 24.1 ± 30.7) scores. Conclusion Results indicate high levels of dental caries as well as dental treatment needs among the study participants. How to cite this article Maru AM, Narendran S. Epidemiology of Dental Caries among Adults in a Rural Area in India. J Contemp Dent Pract 2012;13(3):382-388.

scholarly journals Pediatric Dental Surgery Under General Anesthesia: Uncooperative Children

2018 ◽  
Vol 65 (4) ◽  
pp. 225-230 ◽  
Author(s):  
Robert L. Campbell ◽  
Navin S. Shetty ◽  
Kaavya S. Shetty ◽  
Herbert L. Pope ◽  
Jeffrey R. Campbell
Keyword(s):  
General Anesthesia ◽  
Recovery Time ◽  
Pediatric Patients ◽  
Dental Treatment ◽  
Age Groups ◽  
Pulmonary Complications ◽  
Dental Practice ◽  
Dental Surgery ◽  
Dental Rehabilitation ◽  
Sedative Agents

Dental treatment of young pediatric patients can be confounded by lack of cooperation for dental rehabilitation procedures and even examination and/or radiographs. With the recent US Food and Drug Administration warning applied to many anesthetic/sedative agents for children less than 3 years old, a retrospective review of general anesthesia (GA) cases from 1 private pediatric dental practice was studied for age, gender, body mass index, anesthetic duration, airway management used, extent of dental surgical treatment, recovery time, and cardiac/pulmonary complications. For the 2016 calendar year, 351 consecutive GA cases were identified with patients aged 2–13 years. Of these, 336 underwent nasal endotracheal intubation. Forty-six of 351 patients (13%) were younger than 3 years. Median anesthesia duration was approximately 1.7 hours for all age groups. Dental treatment consisting of 8–9 teeth including crowns, fillings, and extractions was most frequently encountered. One hundred sixty-eight patients (48%), however, required care for 10–18 teeth. There were no episodes of significant oxygen desaturation. The overall complication rate was 1.1%, with 2 cases of postextubation croup, 1 case of mild intraoperative bronchospasm, and 1 case of intraoperative bradycardia. Complications did not correlate with children being overweight or obese.

Intra Operative Use of Anti Emetic Drugs for Children Undergoing Full Dental Rehabilitation under General Anesthesia. A Double Blind Randomized Clinical Trial

2016 ◽  
Vol 40 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Hisham Y El Batawi ◽  
Ahmed A Shorrab
Keyword(s):  
Clinical Trial ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Postoperative Nausea And Vomiting ◽  
Control Group ◽  
Double Blind ◽  
Dental Procedures ◽  
Dental Staff ◽  
Significant Difference ◽  
Dental Rehabilitation

Background: Postoperative Nausea and Vomiting (PONV) is a common complication following dental treatment under general anesthesia (DGA) that may lead to unplanned hospitalization, increased costs and dissatisfaction of parents. Aim: To investigate the incidence of Postoperative Vomiting (POV) on children who underwent dental rehabilitation under general anesthesia and to compare possible preventive effect of Dexamethasone and Ondansetron on occurrences of POV. Study design: A double blind randomized parallel clinical trial was carried out on 352 ASA I children who underwent DGA in a private Saudi hospital in Jeddah. Children were allocated randomly to four groups. Group D of 91 children, received Dexamethasone PONV prophylaxis, group O of 87 children received Ondansetron, group DO of 93 children received combination of the two drugs and group C the control group of 81 children. The three groups were investigated by blinded dental staff for POV episodes, number of times analgesia was needed and post anesthesia care unit time (PACUT). Results: There was a no significant difference between the two drugs on POV. There was a significant difference in POV between control group and groups D, O, and DO. There was significant reduction in need for analgesia in the Dexamethasone groups. The three groups, which had PONV prophylaxis, showed significant reduction in PACUT compared to control group. Conclusions: Antiemetic drugs are useful adjuncts in DGA. Some dental procedures may have higher emetic potential than others. The type of dental procedures done is to be considered when deciding the drug profile in children undergoing DGA.

Opinion of the Polish Paediatric Dentistry Association (PTSD), Section of Paediatric Dentistry of the Polish Dental Association, Polish Branch of Alliance for a Cavity-Free Future (ACFF) and the National Consultant in Paediatric Dentistry concerning preventive dental recommendations for patients with disabilities

2018 ◽  
Vol 23 (1) ◽  
Author(s):  
Karolina Gerreth ◽  
Dorota Olczak-Kowalczyk ◽  
Maria Borysewicz-Lewicka
Keyword(s):  
Dental Caries ◽  
Dental Treatment ◽  
Dental Health ◽  
Paediatric Dentistry ◽  
World Health ◽  
World Population ◽  
Treatment Needs ◽  
The World ◽  
Health Organization

The problem of treatment of patients with special health needs resulting from the presence of deficits in intellectual, motor or sensory functions, also in dentistry, has not been comprehensively solved. According to the World Health Organization (WHO), about 15% of the world population has some form of disability. Patients with disabilities are considered to have greater dental treatment needs in comparison to healthy individuals. High incidence and intensity of dental caries as well as frequent gum diseases are observed in this environment. Often the situation is related, among other, to the presence of systemic diseases and the treatment used, limitations in shaping proper dental health behaviors, insufficient knowledge of parents about oral health or barriers in access to dental care. The development of recommendations for parents/caregivers as well as medical staff is required to improve the health of these patients and quality of their life. The document contains information on the etiology and epidemiology of dental caries in patients with disabilities but also prophylactic recommendations for this population of patients and their parents/caregivers and dentists.

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