Practical protocols for the prevention of dental disease in community settings for people with special needs: the protocols

Abstract

People with special needs have more dental disease and more missing teeth than the general population. They also have reduced access to oral health diagnostic, preventive, interceptive and treatment services. If services are available, they can be complicated and costly. It is critical to prevent dental diseases in these individuals. This article presents a set of practical protocols for preventing dental disease in people with special needs. These protocols are designed to be used in community settings outside of a dental office.

Antimicrobial effects of the combination of chlorhexidine and xylitol

“…27 However, at high concentrations, this product seems to affect the cellular content, thus being bactericidal. 8,28 In our study, chlorhexidine was applied in groups G2 (CHX + XYL) and G3 (CHX), showing large reductions in the biofilm levels at different periods of time (p <0.05). In the analysis performed at the end of the study (sixth month), such reductions were 46.9% and 38.9%, respectively.…”

“…23 Furthermore, S. mutans is able to demineralise hydroxyapatite, thus demonstrating its relevance in the development of caries. 1,8,24 This key role played by S. mutans in the formation of cariogenic biofilm is a hypothesis already accepted in dentistry, since it is the best explanation for caries aetiology. 25 Therefore, reducing the levels of this micro-organism in the oral cavity seems to be crucial for controlling caries in general.…”

“…4,6,8,11,26 At low concentrations, chlorhexidine can be considered a bacteriostatic agent 3 because it affects the metabolic activity of microorganisms by acting on cell membranes, causing intracellular disruption. 27 However, at high concentrations, this product seems to affect the cellular content, thus being bactericidal.…”

“…In spite of all recommendations, this child might have consumed more than 5-10 g/kg/day, which might explain the symptoms. 8 Future studies need to investigate the safety of using these combinations, since another possibility is that the subject may have consumed a dosage lower than 5-10 g/kg/day, but was more susceptible to present reactions to these drugs.…”

Estrategia de intervención educativa sobre la salud bucal en pacientes de 6 a 32 años con Síndrome de Down

“…Las personas con Síndrome de Down describen cambios y manifestaciones clínicas orales frecuentes como: pigmentaciones, gingivitis crónica generalizada, cálculos, enfermedad periodontal severa, pérdida ósea y pérdida prematura de dientes, aumentando su incidencia y severidad por el difícil acceso a los servicios de salud de este grupo de personas (6)(7)(8)(9)(10). La enfermedad periodontal es la más común de las patologías bucales asociadas con este síndrome.…”