[Enamel defects in tuberous sclerosis: hard facts of diagnostic importance]. / Glazuurdefecten bij tubereuze sclerose: harde feiten van diagnostische betekenis.

Tuberous sclerosis is a complex syndrome. Recognition of the disease can be very difficult because of its incomplete forms. In this article a new symptom of possibly great diagnostic value is discussed, namely the presence of enamel defects in patients with tuberous sclerosis. For a clear understanding and correct interpretation of enamel defects in general, the role of the odontogenesis, the amelogenesis and the different types of developmental disturbances is explained. A review is given of all published investigations concerning the presence of enamel defects in tuberous sclerosis. The conclusion is that the enamel defects may be of great importance for an early diagnosis as well as for a possible revise of the penetrance and mutation rate of the disease.

[Caries control for the handicapped]. / Preventie van cariës bij gehandicapten.

Many systemic diseases, disabling conditions and medical treatment may reduce the caries resistance of the patient. Some factors and conditions that might influence caries susceptibility and caries activity especially in the handicapped are discussed. The actual caries risk of a patient decides on the type and the intensity of preventive measures. Caries control in particular for mentally retarded and cerebral palsied patients is described.

[Psycho-social aspects of dental care for the handicapped. An investigation into dental care for handicapped children living at home]. / Psychosociale aspecten vna tandhelekundige zorg voor gehandicapten. Onderzoek naar de tandheelkundige verzorging van thuisverblijvende gehandicapte kinderen.

An investigation was carried out to determine those factors that play a decisive part in dental care for handicapped children living at home. Data were obtained by interviews with parents of 32 mentally retarded and cerebral palsied children, 20 attendants, 48 general dental practitioners and 19 dental hygienists in two districts in The Netherlands. The dental health of 21 children was clinically examined. Parents experienced many problems in maintenance of oral hygiene as well as in finding a dentist for their child. They perceived drooling, halitosis and oral-facial malfunctions as the most important oral problems. Poor levels of oral hygiene were found in the handicapped children and the normative treatment needs were high. Dentists and dental hygienists shrank from treating disabled patients mainly because of inadequate knowledge and training. The results of this study were discussed in the context of planning dental health care for the handicapped.

Enamel defects associated with tuberous sclerosis. A clinical and scanning-electron-microscope study.

The clinical and scanning-electron-microscope appearances of enamel defects in six patients with tuberous sclerosis are described. The pit-shaped enamel defects seem to be pathognomonic of the disease. The detection may be an important help in the early diagnosis of this complex syndrome.