RESUMO
INTRODUCTION: In Hungary, dental care and prevention for mentally disabled individuals are becoming increasingly challenging. Currently, there are 100,000 intellectually disabled individuals in the country who require "special medical care". OBJECTIVE: The objective of this study was to develop and modify a relatively simple preventive procedure, adjusted to the mental capabilities of the patients, and implement it within a selected group. The study aimed to assess the results after 3 and 6 months, respectively, and to compare them with the international literature. METHOD: The preventive procedure was introduced to 49 patients admitted to the institute of Csömör Nursing Home and Daycare Institute of the Foundation for Equal Opportunities. To ensure the accuracy of the data, the patients were examined separately by 3 doctors. The program began with dental care training for both patients and nursing staff. The periodontal examinations were carried out by the team's periodontologist. The patients were checked after 3 and 6 months, respectively, and the data were recorded. RESULTS: No changes were registered in terms of the DMF-T index during this short period of time, therefore we applied the restorative index. However, a significant improvement was observed in the periodontal condition. DISCUSSION: The preventive procedure proved to be effective, considering the fact that all patients had periodontal problems due to neglected oral hygiene. As there was a significant improvement in the periodontal condition, an improvement of the DMF-T index dentition of the patients can also be expected in the future. CONCLUSION: Enhanced oral hygiene (advancing towards "normal oral hygiene" from the neglected oral hygiene of the patients) can bring about considerable improvement in the case of patients needing special medical care. To attain positive results, a proper approach and regular motivation are essential for both patients and caregivers. Orv Hetil. 2023; 164(37): 1456-1461.
Assuntos
Pessoas com Deficiência , Doenças Periodontais , Pessoas com Deficiência Mental , Humanos , Academias e Institutos , Hospitalização , Assistência OdontológicaRESUMO
Összefoglaló. Bevezetés: Magyarországon 100 000 olyan értelmi sérült él, akik speciális ellátásra szorulnak. Elozoleg beszámoltunk az akut fogászati ellátás eredményeirol és problémáiról. Ahhoz azonban, hogy a teljes fogászati rehabilitáció felé lépéseket lehessen tenni, ismerni kell az ilyen betegek fogászati állapotát. Célkituzés: Statisztikailag releváns, nagyobb beteganyagon felmérni az értelmi sérült betegek fogászati állapotát, összehasonlítva mind az orvosi rehabilitációs kezelésben részesülo betegek (foleg testi fogyatékosok), mind az általános populáció adataival. Módszer: A fogászati állapot felmérésére két betegcsoport állt rendelkezésünkre. Összesen 325 beteg statusát rögzítettük. A vizsgáltakat 3 csoportba osztottuk: enyhe (36), közepes (247) és súlyos (42) értelmi sérültek. Az értelmi sérült betegek fogászati állapotát DMF-T-indexszel mértük, és összehasonlítottuk az orvosi rehabilitációs kezelésben részesülo betegek és az általános populáció adataival is. Eredmények: A 325 szellemi sérült össz-DMF-T-indexének átlaga ± szórás: 11,04 ± 7,35; a carieses fogak számának átlaga: D = 3,66 ± 4,61; a hiányzó fogak számának átlaga: M = 5,22 ± 5,74. A fogmegtartó kezelés minimális volt: átlag F = 2,16 ± 3,12. Azoknak az értelmi sérülteknek, akik intézetben élnek, rosszabb a fogazati állapotuk, mint azoknak, akik családban vannak. Következtetések: Az eredményekbol látszik, hogy az értelmi sérültek fogai elhanyagoltabbak, mint a normálpopuláció esetében. A DMF-T-index önmagában nem tükrözi ezeket a magállapításokat, csak akkor, ha szétbontva vizsgáljuk az adatokat. Orv Hetil. 2021; 162(42): 1698-1702. INTRODUCTION: There are 100,000 mentally disabled individuals in Hungary requiring special care. Previously, we reported the results and problems of acute dental care. However, in order to take the appropriate measures toward holistic dental rehabilitation, clarity regarding the condition of those mentally disabled individuals is necessary. OBJECTIVE: To measure the dental health of mentally disabled individuals based on a large sample of patients, to compare the results with both differently-abled (i.e., primarily physically disabled) individuals and the general population. METHODS: There were two available patient cohorts for the measurement of dental health. With the two cohorts combined, we recorded data about 325 patients. We split the patients into three groups: mild (36), medium (247), and severe (42) mental disability. We used DMF-T index to measure dental health status, and compared the results with those of physically disabled and the general population. RESULTS: The mean ± deviation of DMF-T index of the disabled patients was 11.04 ± 7.35; the mean of decayed teeth: D = 3.66 ± 4.61; the missing teeth: M = 5.22 ± 5.74; the filled teeth: F = 2.16 ± 3.12. Mentally disabled patients living in institutions showed worse dental health than those living with families. CONCLUSIONS: The results show that the teeth of mentally disabled patients are more neglected than those of the general population. The DMF-T index does not mirror these conclusions unless we examine each data set separately. Orv Hetil. 2021; 162(42): 1698-1702.
Assuntos
Pessoas com Deficiência Mental , Humanos , HungriaRESUMO
Introduction: Dental care for mentally disabled people poses a growing challenge for healthcare. In Hungary, the number of mentally disabled people needing special dental care is ca. 100 000. Aim: The aim of our retrospective analysis is to provide a summary of the demographic data and the treatment outcomes of patients with mental disorders treated at the Department of the Oral and Maxillofacial Surgery of the Semmelweis University in the past five years. Method: Dental care for patients with a severe level of mental disability can be carried out in general anaesthesia only. At Semmelweis University, in the Oral and Maxillofacial Department, 1717 mentally disabled adults received dental care during the past five years. (Patients included people with a mild, medium or severe level of mental disability, patients with Down's syndrome, autism, epilepsy or panic disorder.) Results: The single biggest achievement seems to be the fact that the issue of acute dental care and oral surgery has basically been settled. A workable relationship has been forged with foundations and organizations dealing with the problems of these patients. It has been realized, however, that in the case of mentally disabled patients there is an enormous need for prevention and ongoing care. Conclusions: Up to now no survey has been carried out in Hungary with the aim of objectively revealing the dental care needs of these patients. Internationally, however, several surveys have been published. It can be stated on the basis of these that both caries frequency and the presence of parodontal diseases increase in correlation with age and the level of disability. Oral hygiene is insufficient, patients or their caretakers do not get proper information, only a few of them receive adequate training and they are not motivated to keep up oral health. Dental care, except for tending acute cases, is not satisfactory. For the sake of prevention, cooperation is needed with non-governmental organizations, foundations, special education teachers and psychiatrists specialized in this field. Orv Hetil. 2019; 160(35): 1380-1386.
