Avaliação das condições periodontais e de higiene bucal em escolares com transtornos neuropsicomotores
Evaluation of periodontal conditions and oral hygiene in school children with neuropsychomotor disorders
Nasiloski, Karen Silva; Silveira, Ethieli Rodrigues da; César Neto, João Batista; Schardosim, Lisandrea Rocha
Resumo
Introdução: A doença cárie e as alterações periodontais são problemas frequentemente encontrados em pacientes com deficiência. Objetivo: Avaliar as condições periodontais e de higiene bucal em escolares com deficiência neuropsicomotora matriculados em um centro de reabilitação. Método: A pesquisa envolveu entrevista com os responsáveis e exame clínico do escolar, para registro do índice de placa e do índice de sangramento. Após o exame, foi realizada profilaxia profissional, orientação de higiene bucal e esclarecimento de dúvidas. Os dados foram observados por meio de estatística descritiva. Resultado: A amostra foi constituída por 41 escolares com deficiência neuropsicomotora, com idades entre sete e 14 anos, sendo 20 do sexo feminino (48,8%) e 21 do sexo masculino (51,2%), e com idade média de 10,8 anos. A maioria dos pacientes tinha a figura da mãe como principal cuidador (85%). Observou-se que 71% dos escolares necessitavam de ajuda para realizar a higiene bucal e quase 40% dos cuidadores apresentavam dificuldade para realizá-la, principalmente pelo fato de o paciente “não abrir a boca”. Quase a totalidade dos escolares não usava fio dental. Constatou-se, ainda, que 87,2% apresentaram sangramento gengival à sondagem e que, em 84,7%, verificou-se índice de placa maior ou igual a ‘2’. Conclusão: Concluiu-se que os escolares com deficiência neuropsicomotora incluídos neste estudo apresentaram condições periodontais e de higiene bucal insatisfatórias, demonstrando a necessidade de serem instituídas ações preventivas focadas na orientação aos pacientes e cuidadores, para a efetividade da higiene bucal.
Palavras-chave
Abstract
Introduction: Caries and periodontal disease are problems frequently affecting patients with disabilities. Objective: In this study we aim to evaluate the periodontal conditions and the oral hygiene in students with neuropsychomotor disorders enrolled in a rehabilitation center. Method: Data collect was based in interview with the responsible and the scholar’s clinical exam to register the plaque index and the bleeding index. After the clinical exam were performed professional prophylaxis, oral hygiene orientation and explanation of doubts. Result: The sample consisted of 41 students with neuropsychomotor disabilities, with ages among 7 and 14 years, 20 females (48.8%) and 21 males (51.2%) with a mean age of 10.8 years. Most patients had the figure of the mother as primary caregiver (85%). It was observed that 71% of students need help in performing oral hygiene and nearly 40% of caregivers had difficulty doing it, in most of the cases because the patient “did not open his mouth”. Almost the totality of the students doesn’t use dental floss. It was also found that 87.2% had gingival bleeding and 84.7% had the plaque index greater or equal to 2. Conclusion: It was concluded that disabled students included in this study had bad periodontal conditions and poor oral hygiene. It shows the need of preventive programs to guide themselves and the caregivers, seeking for effectiveness of oral hygiene.
Keywords
References
1. Sacchetto MSLS, Andrade NS, Brito MHSF, Lira DMMP, Barros SLLV. Evaluation of oral health in patients with mental disorders attended at the clinic of oral diagnosis of a public university. Rev Odontol UNESP. 2013 Set-Out;42(5):344-9. http://dx.doi.org/10.1590/S1807-25772013000500005.
2. Gardens SJ, Krishna M, Vellappally S, Alzoman H, Halawany HS, Abraham NB, et al. Oral health survey of 6-12-year-old children with disabilities attending special schools in Chennai, India. Int J Paediatr Dent. 2014 Nov;24(6):424-33. http://dx.doi.org/10.1111/ipd.12088. PMid:24372860
3. Moursi AM, Fernandez JB, Daronch M, Zee L, Jones CL. Nutrition and oral health considerations in children with special health care needs: implications for oral health care providers. Pediatr Dent. 2010 Jul-Ago;32(4):333-42. PMid:20836954.
4. Oliva L. Oral hygiene in the special needs classroom. NASN Sch Nurse. 2013 Nov;28(6):281-3. http://dx.doi.org/10.1177/1942602X13506751. PMid:24392505
5. Lewis CW. Dental care and children with special health care needs: a population-based perspective. Acad Pediatr. 2009 Nov-Dez;9(6):420-6. http://dx.doi.org/10.1016/j.acap.2009.09.005. PMid:19945077
6. Campos CC, Frazão BB, Saddi GL, Morais LA, Ferreira MG, Setúbal PCO, et al. Manual prático para o atendimento odontológico de pacientes com necessidades especiais. 2. ed. Goiânia: Universidade Federal de Goiânia; 2009.
7. Avenali L, Guerra F, Cipriano L, Corridore D, Ottolenghi L. Disabled patients and oral health in Rome, Italy: long-term evaluation of educational initiatives. Ann Stomatol (Roma). 2011 Mar;2(3-4):25-30. PMid:22545186.
8. Carvalho EMC, Araújo RPC. A saúde bucal em portadores de transtornos mentais e comportamentais. Pesq Bras Odontoped Clin Integr. 2004 Jan-Abr;4(1):65-75.
9. Uemura ST, Ramos L, Esposito D, Uemura AS, Boccia MF, Mugayar LRF. Motivação e educação odontológica em pacientes especial. RGO – Rev Gaúcha Odontol. 2004 Abr-Jun;52(2):91-100.
10. Campanaro M, Huebner CE, Davis BE. Facilitators and barriers to twice daily tooth brushing among children with special health care needs. Spec Care Dentist. 2014 Jul-Ago;34(4):185-92. http://dx.doi.org/10.1111/scd.12057. PMid:24252060
11. Nahar SG, Hossain MA, Howlader MB, Ahmed A. Oral health status of disabled children. Bangladesh Med Res Counc Bull. 2010 Ago;36(2):61-3. PMid:21473203.
12. Löe H, Silness J. Periodontal disease in pregnancy.I. Prevalence and severity. Acta Odontol Scand. 1963 Dez;21(6):533-51. http://dx.doi.org/10.3109/00016356309011240. PMid:14121956
13. Löe H. The gingival index, the plaque index and the retention index system. J Periodontol. 1967 Nov-Dez;38(6):610-6. http://dx.doi.org/10.1902/jop.1967.38.6.610. PMid:5237684
14. Ameer N, Palaparthi R, Neerudu M, Palakuru SK, Singam HR, Durvasula S. Oral hygiene and periodontal status of teenagers with special needs in the district of Nalgonda, India. J Indian Soc Periodontol. 2012 Jul;16(3):421-5. http://dx.doi.org/10.4103/0972-124X.100923. PMid:23162340
15. Trentin MS, Silva SO, Linden MSS. Prevalence of periodontal disease in special needs patients at APAE-PF/RS and the effect of local prevention programs. Braz J Oral Sci. 2010; 9(4):475-80.
16. Menchaca MHR, Alanis TMG, Silva RG. Guía para el cuidado de la salud oral en pacientes con necesidad de cuidados especiales de salud en México. Rev ADM. 2011; 68(5):222-8.
17. Bhandary S, Shetty V, Hegde AM, Rai K. Knowledge of care providers regarding the oral health care of visually impaired children. J Clin Pediatr Dent. 2013; 37(4):385-9. PMid:24046987.
18. Ahmad MS, Jindal MK, Khan S, Hashmi SH. Oral health knowledge, oral hygiene status and dental caries prevalence among visually impaired students in residential institute of Aligarh. J Dent Oral Hygiene. 2009; 2(1):22-6.
19. Stiefel DJ. Dental care considerations for disabled adults. Spec Care Dentist. 2002; 22(3 Suppl):26S-39S. PMid:12375745.
20. Blevins JY. Oral health care for hospitalized children. Pediatr Nurs. 2011 Set-Out;37(5):229-35, quiz 236. PMid:22132567.
21. Fisher K. Is there anything to smile about? A review of oral care for individuals with intellectual and developmental disabilities. Nurs Res Pract. 2012; 2012:860692. PMid:22548164.
22. Silva APR, Gomide MR. Análise da higiene oral, ocorrência de cáries e padrões alimentares de um grupo de pacientes especiais. J Bras Clín Odontol Integr Saúde Bucal Coletiva. 2006;1-5.
23. Cericato GO, Fernandes APS. Implicações da deficiência visual na capacidade de controle de placa bacteriana e perda dentária. RFO. 2008; 13(2):17-21.
24. Carvalho EMC, Araujo RPC, Correa AP. Perfil periodontal de portadores de transtorno mental e comportamental assistidos no Hospital Juliano Moreira – Bahia. Rev Fac Odontol Univ Fed Bahia. 2001; 22(1):26-44.
25. Avasthi K, Bansal K, Mittal M, Marwaha M. Oral health status of sensory impaired children in Delhi and Gurgaon. International Journal of Dental Clinics. 2011; 3(2):21-3.
26. Azrina AN, Norzuliza G, Saub R. Oral hygiene practices among the visually impaired adolescents. Annal Dent Univ Malaya. 2007; 14:1-6.
27. Peixoto ITA, Rocha CT, Fernandes PM. Auxiliary devices for management of special needs patients during in-office dental treatment or at-home oral care. Int J Dent. 2010; 9(2):85-9.
28. Ferguson FS, Cinotti D. Home oral health practice: the foundation for desensitization and dental care for special needs. Dent Clin North Am. 2009 Abr;53(2):375-87, xi. http://dx.doi.org/10.1016/j.cden.2008.12.009. PMid:19269405
29. Aguiar SMHCA, Alves Rezende MCR. Dental care for cerebral palsy patients using auxiliary resources to inhibit pathological tonic reflexes. Arch Health Invest. 2013; 2(4):39-44.
30. Parizotto SPCOL, Ruschel HC, Rodrigues CRD, Mosele GTN. Eficácia de duas técnicas de utilização de fio dental e sua associação com a ocorrência de traumatismo gengival em crianças. Pesqui Bras Odontopediatria Clín Integr. 2009; 9(1):19-23. http://dx.doi.org/10.4034/1519.0501.2009.0091.0004.
31. Al-Shammari KF, Al-Ansari JM, Al-Khabbaz AK, Dashti A, Honkala EJ. Self-reported oral hygiene habits and oral health problems of Kuwaiti adults. Med Princ Pract. 2007; 16(1):15-21. http://dx.doi.org/10.1159/000096134. PMid:17159358
32. Shyama M, Honkala S, Al-Mutawa SA, Honkala E. Oral health-related quality of life among parents and teachers of disabled schoolchildren in Kuwait. Med Princ Pract. 2013; 22(3):285-90. http://dx.doi.org/10.1159/000345213. PMid:23171756
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email