Periodontal Diseases in Patients with Special Health Care Needs

Abstract

A wide variation of people with an impairment or disability requires a "special care dentistry" once their general manifestations directly act in the oral cavity. This target public is inserted into the following categories: neuromotor disability, sensory disability, mental disorder, infecto-contagious diseases, chronic systemic diseases, and systemic conditions. Among the several oral illnesses found in these groups, periodontal diseases have been the most frequent, becoming a major challenge for the dental practitioners. Thus, we described the microbiological, histopathological, and clinical features of periodontal diseases in each "special health care needs" group. Advances in "Omic" technologies have suggested the application of molecular biology methods to assess the genomics (genes), proteomics (proteins), transcriptomics (mRNA), and metabolomics (metabolites) aspects of periodontal diseases. These researches aim to promote a better understanding of the mechanisms involved in the pathogenesis and in the identification of new biomarkers of periodontal diseases that help in diagnosis of periodontal diseases and in tissue responses after treatments of gingivitis and periodontitis. As an alternative therapy, some bioactive materials and photobiomodulation may be indicated once they strongly stimulate the periodontal tissue regeneration, attenuate the inflammatory processes, and/ or promote the reconstruction of the microstructure of the periodontium.

Training dental hygiene students to care for patients with disabilities

“…5,6 Oral health status among adults with intellectual, acquired, and developmental disabilities is worse as compared to that of the general population, with higher rates of periodontal disease, missing teeth, and untreated caries. 5,[7][8][9] Craniofacial defects, malocclusion, anomalies in tooth development, and delayed eruption patterns may also be observed. 10 Affected individuals often present with poor oral hygiene, which increases their susceptibility to dental disease.…”

“…People with special healthcare needs and the frail elderly disproportionately carry a higher burden of oral disease and face the greatest barriers to accessing regular preventive and other dental care services 5,6 . Oral health status among adults with intellectual, acquired, and developmental disabilities is worse as compared to that of the general population, with higher rates of periodontal disease, missing teeth, and untreated caries 5,7–9 . Craniofacial defects, malocclusion, anomalies in tooth development, and delayed eruption patterns may also be observed 10 .…”