The oral health of 219 residents with mental retardation living in a long-term-care institution near Milan was assessed. The dental and periodontal status, daily habits, oral hygiene, and oral mucosal status were evaluated. Of the sample, 179 (81.7%) were males. The mean age of the residents was 61.3 years, and the degree of cooperation was evaluated as good for 131 subjects (59.8%), fair for 79 (36.1%), and poor for nine (4.1%). The percentage of residents who were edentulous was 21.5% (47 subjects), of whom 28 subjects (59.6%) were without dentures. Evaluation showed an overall DMFT of 23.1, and the average number of missing teeth was 20.5. All subjects had periodontal disease: Forty-five subjects had calculus and/or shallow pockets (4-5 mm); 61 had deep pockets (> or = 6 mm). The most common mucosal lesion was oral stomatitis (49.3%). These findings underline the need for special programs aimed at institutionalized subjects with mental retardation.

The aim of the present study was to evaluate palatal morphology in Down syndrome (Ds) subjects, focusing on the effect of dental formula on the hard palate to assist clinicians when planning dental rehabilitation. Palatal landmarks were digitized with a three-dimensional (3D) computerized digitizer on the dental casts of 47 Ds subjects (23 dentate males, 9 edentulous males, and 15 dentate females) aged 20-45 years, 37 dentate reference individuals (20 males and 17 females) aged 30-39 years, and 14 edentulous reference males aged 55-72 years. The co-ordinates of the palatal landmarks were used to construct a mathematical equation of palatal shape, independent of dimensions. Palatal length, slope, width, and maximum palatal height in both the sagittal and frontal planes were measured. In males, palatal length, width, and height were significantly influenced by both the syndrome and edentulism (analysis of variance, P < 0.05). The same measurements were significantly reduced in Ds compared with dentate females (t-test, P < 0.05). In the sagittal plane, Ds did not modify palatal shape; in the frontal plane, Ds individuals showed a higher palate. Overall, palatal shape was influenced by both Ds and edentulousness. Therefore, Ds seems to alter the normal palatal size and shape, although verification on larger samples is required. The findings of the present study may encourage more interdisciplinary dentofacial therapy in the dental and orthodontic care of Ds subjects.

Although the paucity of didactic and clinical training in dental care for ID patients, this survey demonstrated a high level of student's interest in learning more about treating these subjects. The current results could suggest to revise the curricular standards of dental schools, by promoting ID-oriented education programmes.

Objectives  The aim of this study was to describe the clinical features of a cohort of patients suffering from bad breath observed at the Halitosis Unit of the Department of Stomatology – University of Milano. Moreover, the diagnostic and the short‐term therapeutic approach to these patients has been evaluated. Methods  The clinical chart of patients have been reviewed and relevant data collected to be analyzed with an Apple Powerbook G4 PC. Patients complaining of bad breath were admitted to the halitosis unit. At first visit they were submitted to (i) clinical interview (ii) oral and periodontal examination (iii) tongue coating index recording (iv) hedonic breath testing (count‐to‐twenty test, wrist‐lick test, spoon test, floss test) (v) measurement of oral VSC concentration with Interscan Halimeter®. By 1 week patients were submitted to professional prophylaxis and oral hygiene instructions with specific attention to tongue brushing. Patients were then prescribed with no‐alcohol chlorexidine 0.2% for 30 s mouthrinse plus 30 s gargle twice a day after brushing. At the control appointment after 2 weeks the tongue coating index, the hedonic tests and the oral VSC measurements were recorded again. Results  One hundred and nine patients (F = 52; M = 59) were observed and treated at the halitosis unit in the period 2000–2002. Thirteen patients were halitophobic without any objective evidence of bad breath whereas 14 had causal ENT diseases. Of the remaining 82 patients with halitosis from oral causes, 60 showed no evidence of active periodontitis. In this latter group a significant reduction of the hedonic test scores and of the oral VSC concentration was found in 85% of patients. Eighty percent also declared a subjective improvement. Conclusions  The clinical protocol described was effective for the diagnosis and treatment of oral halitosis; the treatment with chlorexidine 0.2% was successful in the short‐term control of the condition. Acknowledgement  This work was supported by the scientific fund FIRST 2000 – UNIMI.