Abordagem odontológica em pacientes com diabetes mellitus tipo 1 / Dental management in patients with diabetes mellitus type 1

Objetivos: Abordar, por meio de revisão de literatura, as manifestações bucais predominantes e as precauções que devem ser tomadas para o tratamentoodontológico de crianças com diabetesmellitus tipo 1. Fontes pesquisadas: Artigos advindos de base de dados (Bireme e PubMed) relacionados à diabetes mellitus tipo 1 e ao tratamentoodontológico. Síntese dos dados: Após arevisão da literatura, destaca-se a presença de várias manifestações bucais em crianças com diabetes mellitus tipo 1. Além disso, torna-se evidente que o tratamento destes pacientes deve ser interdisciplinar, já que o controle glicêmico, obtido por meio da reeducação alimentar e aplicações regulares de insulina, proporcionarão à criança diabética melhoria da qualidade de vida e melhores chances de sucesso ao tratamento odontológico, uma vez que em crianças com glicemia controlada ocorre redução de alterações bucais, como xerostomia, periodontite, gengivite, cárie dental e infecçõesoportunistas. Também se ressaltam os cuidados que devem ser tomados no atendimento odontológico destas crianças, para que recebam um tratamento odontológico seguro, efetivo e voltado para suas reais necessidades. Conclusão: Crianças diabéticas devem receber atenção odontológica criteriosa, visto que estão mais sujeitas a xerostomia, periodontite, gengivite, cárie dental e infecções oportunistas, principalmente quando a glicemia nãoestá bem controlada. A identificação destas alterações bucais pelo cirurgião-dentista pode indicar essa condição e um encaminhamento ao médico responsável deve ser realizado. Durante o atendimento desses pacientes no consultório odontológico, cuidados como antibioticoterapia profilática, horário das consultas, dieta, tratamento de complicações bucais e monitoramento do controle glicêmico devem ser tomados.

Objectives: To discuss, through a literature review, the predominant oral manifestations and emphasizedthe precautions to be taken by the dental treatment of children with type 1 diabetes mellitus. Researched sources: Papers from the database (Bireme and PubMed) related to type 1 diabetes and dental treatment. Data source: After review of the literature, there is the presence of several oral manifestations in children with type 1 diabetes mellitus. Furthermore, it becomes clear that their treatment must be interdisciplinary,since the glycemic control achieved through diet and regular applications of insulin will providebetter quality of life for diabetic children and improvechances of dental treatment success. In children with controlled glicemy, there is a decline of some oral manifestations such as dry mouth, periodontitis, gingivitis, dental caries and opportunistic infections. Also itis emphasized that care must be taken in the dental care of these children to receive dental treatment safe, effective and focused on their real needs. Conclusion: Diabetic children should receive dental care judiciously, since they are more susceptible to dry mouth, periodontitis, gingivitis, dental caries and opportunistic infections, especially when glicemy is not well controlled. The identification of these oral diseases by the dentist may suggest this condition and referral to a medical treatment should be performed. During treatment of these patients in the dental office, precautions as use of prophylactic antibiotics, appointment hour, diet, treatment of oral complications and monitoring of glycemic control should be taken.

Oral findings and dental treatment in a child with West syndrome.

West syndrome (WS) is a rare, severe form of epilepsy that typically manifests early in infancy. It is considered a malignant condition that combines episodes of spasms that occur in clusters (infantile spasm), hypsarrhythmia on the electroencephalogram, and neuropsychomotor delay. Although WS has been widely investigated from a medical standpoint, few reports have focused on the oral findings in patients with this syndrome. This article reports the case history of a 7-year-old child diagnosed with WS. The major clinical features were generalized tooth wear and gingival enlargement, altered chronology and sequence of dental eruption, primary canine cusp-to-cusp relationship, ectopic dental eruption, and mildly arched palate. Multiple white spot lesions were also observed, possibly associated with poor oral hygiene, due to a fermentable carbohydrate-rich diet, and continuous use of sugar-containing medications. Dental care management of patients with special needs is discussed and the dental treatment for this child with WS is described.