Journal of Korean Dental Science

Korean Academy of Dental Science (대한치의학회)
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Considerations for Invasive Dental Treatment in Disabled Patients

  • Eun-Jung Kwak (National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital)
  • Received : 2023.03.16
  • Accepted : 2023.04.11
  • Published : 2023.06.30
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Abstract

Dental treatment for the disabled should be a customized that considers the characteristics and degree of cooperation of each disabled patient. There are additional considerations during implant treatment and tooth extraction in disabled patients. Since some brain lesion disorder or cardiac disease patients may be taking antiplatelet or anticoagulant medications, it is necessary to evaluate whether these medications should be discontinued before an invasive procedure. Precautions should be taken for patients with heart valve disease considering the risk of infective endocarditis, especially during invasive dental procedures. Moreover, disabled patients may have difficulty in following instructions and cautions. There are specific considerations for each stage of implant treatment in disabled patients. In the case of patients who are in the pre- or post-transplant state, it is necessary to assess their general condition and oral disease due to the risk of infection. Since disabled patients with various systemic diseases may visit the dental clinic, it is important to understand their characteristics and treatment process in order to flexibly adjust the dental treatment plan accordingly.

Keywords

References

  1. Corcuera-Flores JR, Delgado-Munoz JM, Ruiz-Villandiego JC, Maura-Solivellas I, Machuca-Portillo G. Dental treatment for handicapped patients; sedation vs general anesthesia and update of dental treatment in patients with different diseases. Med Oral Patol Oral Cir Bucal. 2014; 19: e170-6.  https://doi.org/10.4317/medoral.19555
  2. Davies R, Bedi R, Scully C. ABC of oral health. Oral health care for patients with special needs. BMJ. 2000; 321: 495-8.  https://doi.org/10.1136/bmj.321.7259.495
  3. Ningrum V, Wang WC, Liao HE, Bakar A, Shih YH. A special needs dentistry study of institutionalized individuals with intellectual disability in West Sumatra Indonesia. Sci Rep. 2020; 10: 153. 
  4. Alshatrat SM, Al-Bakri IA, Al-Omari WM. Dental service utilization and barriers to dental care for individuals with autism spectrum disorder in Jordan: a case-control study. Int J Dent. 2020; 2020: 3035463. 
  5. Barry S, O'Sullivan EA, Toumba KJ. Barriers to dental care for children with autism spectrum disorder. Eur Arch Paediatr Dent. 2014; 15: 127-34.  https://doi.org/10.1007/s40368-013-0075-y
  6. Fallea A, Zuccarello R, Cali F. Dental anxiety in patients with borderline intellectual functioning and patients with intellectual disabilities. BMC Oral Health. 2016; 16: 114. 
  7. Forman CR, Svane C, Kruuse C, Gracies JM, Nielsen JB, Lorentzen J. Sustained involuntary muscle activity in cerebral palsy and stroke: same symptom, diverse mechanisms. Brain Commun. 2019; 1: fcz037. 
  8. Choi SM. Movement disorders following cerebrovascular lesions in cerebellar circuits. J Mov Disord. 2016; 9: 80-8.  https://doi.org/10.14802/jmd.16004
  9. Park J. Movement disorders following cerebrovascular lesion in the basal ganglia circuit. J Mov Disord. 2016; 9: 71-9.  https://doi.org/10.14802/jmd.16005
  10. Escanilla-Casal A, Aznar-Gomez M, Viano JM, Lopez-Gimenez A, Rivera-Baro A. Dental treatment under general anesthesia in a group of patients with cerebral palsy and a group of healthy pediatric patients. Med Oral Patol Oral Cir Bucal. 2014; 19: e490-4.  https://doi.org/10.4317/medoral.19568
  11. Loyola-Rodriguez JP, Aguilera-Morelos AA, Santos-Diaz MA, Zavala-Alonso V, Davila-Perez C, Olvera-Delgado H, Patino-Marin N, De Leon-Cobian I. Oral rehabilitation under dental general anesthesia, conscious sedation, and conventional techniques in patients affected by cerebral palsy. J Clin Pediatr Dent. 2004; 28: 279-84.  https://doi.org/10.17796/jcpd.28.4.e103u071237388h8
  12. Saez-Alcaide LM, Sola-Martin C, Molinero-Mourelle P, Paredes-Rodriguez V, Zarrias-Caballero C, Hernandez-Vallejo G. Dental management in patients with antiplatelet therapy: a systematic review. J Clin Exp Dent. 2017; 9: e1044-50.  https://doi.org/10.4317/jced.54079
  13. Felix J, Chaban P, Ouanounou A. Dental management of patients undergoing antithrombotic therapy. J Can Dent Assoc. 2020; 86: k17. 
  14. Lockhart PB, Gibson J, Pond SH, Leitch J. Dental management considerations for the patient with an acquired coagulopathy. Part 2: coagulopathies from drugs. Br Dent J. 2003; 195: 495-501.  https://doi.org/10.1038/sj.bdj.4810660
  15. Jurjans K, Vikmane B, Vetra J, Miglane E, Kalejs O, Priede Z, Millers A. Is anticoagulation necessary for severely disabled cardioembolic stroke survivors? Medicina (Kaunas). 2019; 55: 586. 
  16. Chahine J, Khoudary MN, Nasr S. Anticoagulation use prior to common dental procedures: a systematic review. Cardiol Res Pract. 2019; 2019: 9308631. 
  17. Cho YW, Kim E. Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery? Restor Dent Endod. 2013; 38: 113-8.  https://doi.org/10.5395/rde.2013.38.3.113
  18. Erath JW, Hohnloser SH. Anticoagulation in atrial fibrillation: current evidence and guideline recommendations. Herz. 2018; 43: 2-10.  https://doi.org/10.1007/s00059-017-4648-0
  19. Almutairi AR, Zhou L, Gellad WF, Lee JK, Slack MK, Martin JR, Lo-Ciganic WH. Effectiveness and safety of non-vitamin K antagonist oral anticoagulants for atrial fibrillation and venous thromboembolism: a systematic review and meta-analyses. Clin Ther. 2017; 39: 1456-78.e36.  https://doi.org/10.1016/j.clinthera.2017.05.358
  20. Kwak EJ, Nam S, Park KM, Kim SY, Huh J, Park W. Bleeding related to dental treatment in patients taking novel oral anticoagulants (NOACs): a retrospective study. Clin Oral Investig. 2019; 23: 477-84.  https://doi.org/10.1007/s00784-018-2458-2
  21. Fortier K, Shroff D, Reebye UN. Review: an overview and analysis of novel oral anticoagulants and their dental implications. Gerodontology. 2018; 35: 78-86.  https://doi.org/10.1111/ger.12327
  22. Ito HO. Infective endocarditis and dental procedures: evidence, pathogenesis, and prevention. J Med Invest. 2006; 53: 189-98.  https://doi.org/10.2152/jmi.53.189
  23. Holland TL, Baddour LM, Bayer AS, Hoen B, Miro JM, Fowler VG Jr. Infective endocarditis. Nat Rev Dis Primers. 2016; 2: 16059. 
  24. Wilson WR, Gewitz M, Lockhart PB, Bolger AF, DeSimone DC, Kazi DS, Couper DJ, Beaton A, Kilmartin C, Miro JM, Sable C, Jackson MA, Baddour LM; American Heart Association Young Hearts Rheumatic Fever, Endocarditis and Kawasaki Disease Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Cardiovascular and Stroke Nursing; and the Council on Quality of Care and Outcomes Research. Prevention of viridans group streptococcal infective endocarditis: a scientific statement from the American Heart Association. Circulation. 2021; 143: e963-78. Erratum in: Circulation. 2021; 144: e192. Erratum in: Circulation. 2022; 145: e868. 
  25. Lockhart PB, Bolger A, Baddour LM. The 2021 American Heart Association Statement on prevention of infective endocarditis: what's new? J Am Dent Assoc. 2021; 152: 880-2.  https://doi.org/10.1016/j.adaj.2021.08.001
  26. Isaacson B, Jeyapalina S. Osseointegration: a review of the fundamentals for assuring cementless skeletal fixation. Orthop Res Rev. 2014; 6: 55-65.  https://doi.org/10.2147/ORR.S59274
  27. Parithimarkalaignan S, Padmanabhan TV. Osseointegration: an update. J Indian Prosthodont Soc. 2013; 13: 2-6.  https://doi.org/10.1007/s13191-013-0252-z
  28. D'haese J, Ackhurst J, Wismeijer D, De Bruyn H, Tahmaseb A. Current state of the art of computer-guided implant surgery. Periodontol 2000. 2017; 73: 121-33.  https://doi.org/10.1111/prd.12175
  29. Chen P, Nikoyan L. Guided implant surgery: a technique whose time has come. Dent Clin North Am. 2021; 65: 67-80.  https://doi.org/10.1016/j.cden.2020.09.005
  30. Georgakopoulou EA, Achtari MD, Afentoulide N. Dental management of patients before and after renal transplantation. Stomatologija. 2011; 13: 107-12. 
  31. Guggenheimer J, Eghtesad B, Stock DJ. Dental management of the (solid) organ transplant patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 95: 383-9.  https://doi.org/10.1067/moe.2003.150
  32. Guggenheimer J, Mayher D, Eghtesad B. A survey of dental care protocols among US organ transplant centers. Clin Transplant. 2005; 19: 15-8.  https://doi.org/10.1111/j.1399-0012.2005.00251.x
  33. Kwak EJ, Kim DJ, Choi Y, Joo DJ, Park W. Importance of oral health and dental treatment in organ transplant recipients. Int Dent J. 2020; 70: 477-81.  https://doi.org/10.1111/idj.12585
  34. Weinberg MA, Segelnick SL, Kay LB, Nair V. Medical and dental standardization for solid organ transplant recipients. N Y State Dent J. 2013; 79: 35-40. 
  35. Kitamura M, Mochizuki Y, Miyata Y, Obata Y, Mitsunari K, Matsuo T, Ohba K, Mukae H, Yoshimura A, Nishino T, Sakai H. Pathological characteristics of periodontal disease in patients with chronic kidney disease and kidney transplantation. Int J Mol Sci. 2019; 20: 3413. 
  36. Rattaz C, Dubois A, Michelon C, Viellard M, Poinso F, Baghdadli A. How do children with autism spectrum disorders express pain? A comparison with developmentally delayed and typically developing children. Pain. 2013; 154: 2007-13.  https://doi.org/10.1016/j.pain.2013.06.011
  37. Solodiuk JC. Parent described pain responses in nonverbal children with intellectual disability. Int J Nurs Stud. 2013; 50: 1033-44.  https://doi.org/10.1016/j.ijnurstu.2012.11.015
  38. van Dijk M, Valkenburg A, Boerlage AA, Tibboel D, Veerkamp JS. Children with intellectual disabilities and pain perception: a review and suggestions for future assessment protocols. Eur Arch Paediatr Dent. 2009; 10: 57-60.  https://doi.org/10.1007/BF03321600
  39. Kumbargere Nagraj S, Prashanti E, Aggarwal H, Lingappa A, Muthu MS, Kiran Kumar Krishanappa S, Hassan H. Interventions for treating post-extraction bleeding. Cochrane Database Syst Rev. 2018; 3: CD011930.