Incidence of oral health in paediatric patients with disabilities: sensory disorders and autism spectrum disorder. Systematic review II

Introduction: We are currently witnessing an increase in the number of disabled patients, creating the need for knowledge of each of the pathologies and of the different oral and dental conditions they present, in order to achieve efficient management and treatment. Objectives: To analyse the existing scientific literature on the oral conditions of children with autism spectrum disorder (ASD) and children with sensory deficits (SD), in comparison with the healthy child population. Material and Method: The bibliographic search was carried out in Pubmed/Medline, Scopus and Cochrane Library and included articles taking a sample of children between 0 and 18 years of age diagnosed with the abovementioned disorders and including at least one of the following oral hygiene conditions - oral hygiene, dental caries, malocclusion, oral habits, dental trauma, and gingival-periodontal status - comparing them with a healthy population. Results: A total of 10 articles were obtained for autism spectrum disorder and six for sensory deficits. Conclusions: Of all the variables studied, only the state of oral, gingival and/or periodontal hygiene can be considered worse in patients with ASD and SD, although we believe a larger number of research studies is needed to corroborate these results

The influence of crossbite in early development of mandibular bone asymmetries in paediatric patients

All authors agree that posterior crossbite is a malocclusion that affects mandibular growth and may lead to skeletal asymmetry but there are few data on which age these modifications are easily quantifiable. For this study, the researchers used x-ray records of 217 children between 6 and 9 years of age, in the mixed dentition stage and with unilateral posterior crossbite. All the horizontal variables were traced and evaluated by the principal researcher, using the tpsDig version 2 computer program. Subsequently, a descriptive and statistical analysis was carried out, using the SPSS 17.0 for Windows program. After analysing the vertical mandibular traces on the x-rays, the researchers found, in all cases, quantifiable differences between the crossbite side and the non-crossbite side. The differences between horizontal variables were statistically significant (p<0.005) for the entire sample (H3-H4), in the group of boys (H3-H4) and in the 7-year old age group (H1-H2 and H3-H4). Differences were observed in the size of the horizontal measures between the crossbite side and the non-crossbite side. Some of these differences were significant as a function of the sex and age of the study sample

Oral health in children with physical (Cerebral Palsy) and intellectual (Down Syndrome) disabilities: systematic review I

Introduction: Traditionally, patients with physical and/or intellectual disabilities presented greater oral pathology, owing to their condition and to other external factors. Improved social and health conditions make it necessary to update knowledge on their oral and dental health. Material and Methods: For this purpose, a bibliographic review was done regarding the state of oral health of children with these two types of disability, in comparison with a control group. Some of the guidelines of the PRISMA statement were taken into account. The ranking of the articles found is based on the modified Newcastle-Ottawa Quality Assessment Scale. The final number of articles evaluated was 14. Parameters such as dental caries, oral hygiene, gingival health, dental traumas, malocclusion and habits were considered. Results: There is no consensus among authors regarding dental caries, oral hygiene and gingival health. The different results obtained are due in part to the fact that the methodologies used were not the same. However, it has been noted that, when studying other parameters and regardless of the methodology employed, the results obtained are similar. Conclusions: Children with physical and intellectual disabilities constitute a group that needs early and regular dental care in order to prevent and limit the severity of the pathologies observed

How to improve communication with deaf children in the dental clinic

It may be difficult for hearing-impaired people to communicate with people who hear. In the health care area, there is often little awareness of the communication barriers faced by the deaf and, in dentistry, the attitude adopted towards the deaf is not always correct. A review is given of the basic rules and advice given for communicating with the hearing-impaired. The latter are classified in three groups ? lip-readers, sign language users and those with hearing aids. The advice given varies for the different groups although the different methods of communication are often combined (e.g. sign language plus lip-reading, hearing-aids plus lip-reading). Treatment of hearing-impaired children in the dental clinic must be personalised. Each child is different, depending on the education received, the communication skills possessed, family factors (degree of parental protection, etc.), the existence of associated problems (learning difficulties), degree of loss of hearing, age, etc

Dental treatment for disabled children in the Spanish Public Health System

Cada vez son más los esfuerzos del Sistema Sanitario Público Español por cubrir todas las necesidades médicas que pueda tener la población. La salud bucodental es un aspecto que cada día interesa más a la sociedad, fundamentalmente a los padres que desean que sus hijos tengan una adecuada condición oral. Los niños discapacitados, tanto físicos como psíquicos, constituyen un colectivo que no siempre recibe las atenciones odontológicas que precisan. El objetivo de esta revisión bibliográfica es valorar los servicios que presta la Sanidad Pública Española a estos niños. Hemos observado que existe una importante discrepancia en cuanto a los diferentes tipos de tratamientos bucodentales que se realizan a estos pacientes según sea la Comunidad Autónoma a la que pertenezcan. Así, en ciertas Comunidades Autónomas, como Asturias, Navarra y Extremadura, incluso se lleva a cabo una atención específica de los pacientes discapacitados infantiles. En otras como, Ceuta, Melilla, la atención, por parte de la Sanidad Pública, es más generalizada

Program for coordinated dental care under general anaesthesia for children with special needs

Aim: To draw up a program for coordination of dental care for children with special needs between the Course at the Universidad Complutense de Madrid (UCMC) (Specialisation in holistic dental care for children with special needs), and the Disabled Children?s Oral Health Unit (DCOHU) within the Madrid Health Service (SERMAS). Material and methods: UCMC Protocol for children with special needs. Design of a clinical pathway based on consensus amongst the professionals involved. Results: Algorithm for dental care for children with special needs. Matrix covering all activities and timing for full dental diagnosis in such patients (general health, oral health and behaviour) to facilitate proper referral of patients requiring general anaesthesia. Inclusion in the matrix of those responsible for each activity. Conclusions: Improved team work (University ? primary health care) in patient evaluation, in provision of information to parents and guardians and in health care quality. From the teaching point of view, students learn to adopt a systematic approach in the decision-making process

Criteria for selecting children with special needs for dental treatment under general anaesthesia

Objective: To study criteria for helping to select children with special needs for dental treatment under general anaesthesia. Materials and methods: Group of 30 children (aged under 18) examined on the Course at the Universidad Complutense de Madrid (UCM) (Specialisation on holistic dental treatment of children with special needs) and subsequently referred to the Disabled Children?s Oral Health Unit (DCOHU) within Primary Health Care Area 2 of the Madrid Health Service (SERMAS) where dental treatment under general anaesthesia was given during 2005. Relevant data were taken from their case histories with regard to their general health, oral health and behaviour. Results: In most of the children (22 children), it was possible to carry out a complete dental diagnosis. With regard to medical diagnoses, the most frequent pathology was cerebral palsy (8 children), but it was not possible to establish a link between the pathology and the use of general anaesthesia. With regard to oral health, most of the children received restorative treatment in all 4 quadrants (26 children). On the basis of scales for behavioural evaluation and movement, most of the children (17 children) showed clearly negative behaviour, with movements that interrupted or hindered examination. Conclusions: With the exception of certain specific medical problems, the reasons for using general anaesthesia for dental treatment in children with special needs are extensive treatment needs and bad behaviour, both of which can be judged objectively

A cephalometric method to diagnosis the craniovertebral junction abnormalities in osteogenesis imperfecta patients

Osteogenesis imperfecta (OI) is a hereditary bone fragility disorder that in most patients is caused by mutations affecting collagen type I. Their typical oral and craneofacial characteristics (Dentinogenesis imperfecta type I and class III malocclusion), involve the dentist in the multidisciplinary team that treat these patients. It is usual to perform lateral skull radiographs for the orthodontic diagnosis. In addition, this radiograph is useful to analyse the junctional area between skull base and spine, that could be damaged in OI. Pathology in the craneovertebral junction (CVJ) is a serious complication of OI with a prevalence ranging from rare to 37%. To diagnosis early skull base anomalies in these patients, previously the neurological symptoms have been appear, we make a simple cephalometric analysis of the CVJ. This method has four measurements and one angle. Once we calculate the values of the OI patient, we compare the result with the mean and the standard deviations of an age-appropriate average in healthy controls. If the patient has a result more than 2,5 SDs above the age- appropriate average in healthy controls, we should to refer the patient to his/her pediatrician or neurologist. These doctors have to consider acquiring another diagnostic images to be used to determine cranial base measurements with more reliability. Thereby, dentists who treat these patients, must be aware of the normal radiological anatomy of the cervical spine on the lateral cephalogram

Recursos para Flipped Learning: Moodle versus Edpuzzle

[ES] La principal particularidad del modelo invertido de aprendizaje o flipped learning (FL) radica en el cambio de roles profesor-estudiante y lo que supone respecto a la distribución del tiempo para ambos. Durante la clase, no se incorporan nuevos conocimientos, estos los adquiere el alumno con anterioridad, pero se resuelven dudas y se realizan prácticas o ejercicios con el apoyo del profesor. Para los docentes, esta inversión del uso del tiempo marca una gran diferencia entre los modelos de aprendizaje invertido y tradicional. Utilizar FL es complejo y requiere tiempo. Se deben establecer objetivos de aprendizaje, planificar la secuencia de actividades, crear materiales de alta calidad y dar acceso a los estudiantes al contenido antes y fuera de la clase. El objetivo de este trabajo fue comparar el uso de 2 recursos digitales (Moodle y Edpuzzle) en las prácticas de Odontopediatría del Grado de Odontología de la Universidad Complutense de Madrid. Solo los alumnos matriculados en la asignatura participaron en el estudio, divididos en 3 grupos de 25 alumnos, con 2 profesores encargados de cada uno. Se aplicó FL en 2 grupos que utilizaron distintos recursos (A: Moodle y B: Edpuzzle) mientras que los alumnos restantes (grupo C) recibieron docencia presencial tradicional. Todos los alumnos tuvieron acceso a los vídeos demostrativos del procedimiento objeto de las prácticas. Nuestros resultados demostraron que podemos realizar FL con distintos recursos digitales, como Moodle y Edpuzzle. Sin embargo, las calificaciones obtenidas por los alumnos fueron superiores con Edpuzzle y por tanto, su aprendizaje mejoró al compararlo con Moodle y con la enseñanza tradicional. Concluimos que resulta más adecuado el uso de Edpuzzle para la aplicación de FL en las prácticas de Odontopediatría.Gallardo López, N.; Caleya Zambrano, A.; Feijóo García, G.; Sánchez Sánchez, E.; De Nova García, J.; Mourelle Martínez, R. (2021). Recursos para Flipped Learning: Moodle versus Edpuzzle. En Proceedings INNODOCT/20. International Conference on Innovation, Documentation and Education. Editorial Universitat Politècnica de València. 661-668. https://doi.org/10.4995/INN2020.2020.11891OCS66166