[Difficulties in dental health care for the disabled]. / Difficultés de prise en charge de la santé bucco-dentaire des personnes en situation de handicap.

Upper Normandy has several disadvantages in terms of access to dental health care for disabled people: an insufficient medical population, a lack of dental schools and dental care networks.A cross-sectional epidemiological investigation, using a questionnaire form, was carried out between November 2014 and February 2015 with a cohort of dentists in this region.The topics on this form focused firstly on accessibility and compliance with standards of dental offices and the influencing factors which are hampering their accessibility implementation, and secondly on the oral care of disabled patients by practitioners of this region : the impact of incentives, influencing factors which are complicating the dental care and the usage of private and public structures.If the care of disability concerns most practitioners, an apprehension is observed in the adaptation of these doctors' treatment protocols for these specific patients. The expectations of dentists concerning disability are multiple : the creation of specific care networks, better coordination of medical and social actors, and specific training programs concerning the dental care of disabled patients.

Safety of day surgery for patients with special needs.

BACKGROUND: The objective of this study was to assess the safety and quality of day care management for dental surgery under general anaesthesia in a population with special needs and to compare the results with a control population. METHODS: A retrospective observational cohort study was performed. The study population included all patients who had day care dental surgery under general anaesthesia for one year. The primary endpoint was the rate of unscheduled admission, which was defined as the unplanned need to maintain a hospital stay on the evening of the surgical procedure. Secondary endpoints included occurrence of complications during the perioperative period (either anaesthesia or surgery related) on the day of surgery (D0) and on day 1 and satisfaction of patients or their relatives. RESULTS: Data from 138 patients (70 with special needs and 68 controls) were analysed. In both groups, patients were young (mean age 33 years ± 14 in each group). Special needs were mainly related to autism (34%), cerebral palsy (19%), intellectual disability (19%) and Down syndrome (10 %). Surgical procedures were more extensive in the control group. There was 1 unscheduled admission in the special needs group and 3 in the control group (RR 0.32, 95% CI [0.03; 3.04]). There was no difference in the rate of complications. CONCLUSION: In our cohort, day care management for dental surgery under general anaesthesia is safe and effective for patients with special needs.

Needs in screening cardiovascular parameters during dental care in the elderly.

AIMS: The aim of this study was to compare physiological reactivity during oral care between elderly and young subjects. MATERIALS AND METHODS: Heart rate (HR), systolic and diastolic blood pressure (SBP and DBP) and blood oxygen saturation (SPO2) were recorded seven times during two consecutive dental impression sessions in 31 complete denture wearers (aged 60.7+/-11.44 yrs) and 31 young subjects (aged 21.8+/-1.5 yrs). Subjects also reported pain and anxiety on a visual analogue scale. RESULTS: In the group of young subjects, SBP and DBP increased after the first impression and remained unchanged after the second. In the group of elderly persons, SBP and DBP increased significantly during both first and second dental impressions. Intergroup comparisons showed a longer-term relative increase in SBP and DBP in the group of elderly subjects. CONCLUSIONS: These results emphasize the need to screen cardiovascular parameters during dental care in elderly subjects.