A desmistificação do atendimento odontológico a pacientes pediátricos acometidos pela anemia falciforme

Abstract

Sickle cell anemia is a hemoglobinopathy and is among the most common hereditary diseases in Brazil. Resulting from defects in the structure of hemoglobin (Hb), this is an autosomal recessive genetic condition that has carriers that necessarily inherit a paternal and a maternal mutation. Such mutation occurs in the hemoglobin beta gene, generating an altered Hb molecule, called “S”. Originally from Africa and brought to Brazil by the compulsory immigration of blacks in the country, there is an ethnic predilection for sickle cell anemia, being more prevalent in blacks, browns and Afro-descendants in general. However, currently, this disease is present in all continents of the world, due to population migration. Among the complications of sickle cell anemia, stand out as sickle cell crises, characterized by intense pain, ischemic tissue damage and / or damage to all organs and systems (brain, heart, liver, kidneys, skin, eyes, skeleton and lungs); chronic hemolytic anemia and acute chest syndrome, the latter being potentially fatal. These complications are mainly due to the important vasoocclusion that these requirements specify. This is due to a series of mechanisms, including an erythrofalciformation where, under hypoxic conditions, as red blood cells have their shape changed to a structure that resembles a crescent or a sickle (hence the name "sickle cell") and, consequently, they become rigid, losing their flexibility. Erythrofalciformation will trigger a cascade of subsequent events that will result in vasoocclusion. Complications of this systemic disorder that affect the oral cavity include, among the most common, aseptic pulp necrosis, periodontal disease, mandibular nerve neuropathy and osteomyelitis. The high prevalence of the disease in Brazil determined the institution of the National Policy on Sickle Cell Disease (PNADF) Ministry of Health, which aims to reduce the morbidity and mortality of the disease, enabling early diagnosis, the use of special immunobiologicals and antibiotic prophylaxis. This work aims to elucidate the dental surgeon about the disease and its complications, systemic and oral, and describe the criteria for dental care for pediatric patients affected by sickle cell anemia, in order to demystify some misconceptions and clarify possible doubts about dental problems in the treatment of, affected by this disease and its complications.