Cuidados de higiene oral em pacientes com deficiência mental

Abstract

Background: Concerning oral health, many factors are present, such as prevention and promotion of oral health, good oral hygiene habits and a healthy life style. The patient with mental illness, due to their mental and physical challenges, will have some increased complications on the conjugation of all those parameters. It´s a group of people with inadequate or practically nonexistent oral hygiene habits, and the clinical attendance becomes a challenge due to their unpredictable behaviors. Objectives: The aim of this study was the assessment of the oral health situation at the Professional Association of Parents and Friends of the Citizen with Mental Illness (APPACDM) in patients with different mental disabilities, to make a specific evaluation of the DMFT index and Silness and Löe Index. A questionnaire was applied to the nurses and auxiliary staff, with questions concerning their knowledge about oral health, and the application of that same knowledge in the patients of this association. Participants and Methods: We conducted a pilot study designed as a cross-sectional epidemiological study where we evaluated a sample of patients with diverse pathologies, aged twelve to fifty eight years old of the APPACDM. We evaluated 138 patients through a clinical examination for analysis of the DMFT index and plaque index of Silness and Löe, but only 120 individuals were included in the study. Forty questionnaires were distributed to the nurses and auxiliary staff of this institution to evaluate their knowledge about oral health, but only twenty were collected. Results: From the 120 individuals observed, 66,7% were male and 33, 3% female. The mean age was 31,4 ± 10,967 years. The sample of patients was formed by 8 (6,7%) patients with Autism, 11 (9,2%) with Down Syndrome, 57 (47,5%) with Cognitive Deficit and 44 (36,7%) with a Mental Disability without a specific diagnostic of the pathology. In this study the average of decayed, lost and sealed teeth was 8,70 ± 6,28, where 72 (60%) patients had a DMFT Index ≥7. The average of decayed teeth was 3,70 ± 3,788, of missing teeth 3,85 ± 5,409 and filled teeth 1,17 ± 1,81. Relative to the Silness and Löe Plaque Index 87 (72,5%) of the individuals had a register code of 2 (Visible plaque in the gingival sulcus and dental surface). Conclusions: Patients with mental disabilities required higher oral healthcare, much due to their physical inability to perform correct oral health habits and in most cases due to the complete intellectual incomprehension of this concept and the importance that this is to the general health of a person. It was possible to observe the high level of decayed, missing and filled teeth and the presence of periodontal disease. It is required a greater adoption of preventive measures in these patients since birth, so it can be possible to prevent future and inevitable complications.

Date of Award	17 Sept 2012
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Jorge Leitão (Supervisor) & Nélio Jorge Veiga (Co-Supervisor)