HOLISTIC DENTAL APPROACH FOR VISUALLY IMPAIRED CHILDREN: A NARRATIVE REVIEW

Visual impairment is one of the most common disabilty. It requires a lot of attention especially in the field of dentistry. These children are often deprived of oral health care needs due to dental neglect. This is a comprehensive review that focuses on prevalence, etiology as well as treatment modalities for these children. It comprises barriers to dental health and various methods which can be used to overcome the challenges.

Epidemiology, etiology, types and outcomes of dental neglect in children

Dental neglect is a common condition among children and it can be associated with several adverse events as dental caries, dental pain and inflammation, infections, trauma, bleeding and other complications that might result from inadequate administration of adequate prevention and treatment modalities. However, many children and parents are not adequately aware of these events and the potential diseases that might be associated secondary to them. Dental neglect is a common condition that might affect children of different age groups and might also extend to adult groups and is affected by the demographics and socioeconomic characteristics of the affected populations. Furthermore, the etiology of dental neglect is variable and parenteral, child and clinical care should all be integrated to achieve better oral health. Many adverse events have been reported as dental caries and other periodontal diseases that might have a significant impact on the affected teeth and the succeeding permanent ones, which might impact the quality of life in the affected children. Accordingly, dental neglect should be given full care to enhance the outcomes of oral health in children.

The Impact of Dental Neglect on Oral Health Among 16-30-Year-Olds in Dhulikhel, Kavrepalanchok, Nepal

Introduction: Oral health status is linked to oral health behaviour and dental neglect can be an important parameter for assessment of oral health status. Such evaluation will help in providing and planning appropriate health promotion activities to target population. Objective: To assess socio-demographic variations in Dental Neglect (DN) and to determine the association between DN and oral health. Methods: Analytical cross-sectional study done at dental hospital in Dhulikhel from September-November 2020. A sample of 327 aged 16-30 years were selected by convenience sampling technique. Demographic details along with DN were collected through the DN questionnaire. Both self-reported oral health and oral health status were assessed. Oral health status was determined by using the Oral Hygiene Index-simplified (OHI-S) and the Decayed Missing Filled index (DMFT). Results: Majority 170 (52%) of the sample were from high DN group. A total of 187 (57.2%) of the participants rated their oral health status as all right. Higher number of participants were seen in the fair group of oral hygiene status. Significant correlations were found between education and OHI-S scores. Mean DMFT score was 3.6±1.6 which had higher mean Decayed (D) component as compared to the Missing (M) and Filled (F) components in the index. Conclusion: Dental neglect is present among the study population and is associated with self-reported oral health status. Disparities were observed between the socio-demographic variables and DN. The DN Scale can be used in dental health promotion and also in evaluation of health promotion interventions.

Paediatric case of group A streptococcal pharyngitis, arthritis and osteomyelitis associated with dental neglect

Group A streptococcus (GAS) causes a wide variety of infections in the paediatric population, ranging from pharyngitis to rare but severe invasive diseases, such as bacterial arthritis and osteomyelitis. Dental neglect is a type of child neglect in which caregivers fail to provide adequate care and treatment for dental diseases. This results in poor oral hygiene and can lead to complications including sepsis. We report the case of a 4-year-old boy, suffering from child neglect, presenting with GAS pharyngitis and subsequent bacterial arthritis in the right ankle, osteomyelitis in the right talus and abscess in the right calcaneus. He was first treated with penicillin, which was changed to clindamycin because of a suspected drug-induced rash. He was discharged after 6 weeks of intravenous therapy when symptoms had resolved and inflammatory markers were within the normal range. The case highlights that dental neglect may present a risk for subsequent invasive infections.