Pacientes pediátricos de alta complexidade: análise da saúde bucal e quadros infecciosos antes e após acompanhamento odontológico domiciliar

Abstract

Pediatric patients with disabilities in home care are exposed to a high risk of developing serious infections, which may manifest systemic compromise due to the disease or the therapeutic procedures to which they were subjected. Given that oral health care has been increasingly important for the reestablishment and quality of life, there is a great need for dental and multidisciplinary monitoring for children who require home medical care. Therefore, the objective of this research was to evaluate the oral health conditions of children monitored by the Home Care Service offered from the Federal University of Uberlandia (SAD-UFU), as well as to evaluate the occurrence of infectious conditions before and after regular dental monitoring of these children. The assessment of oral health conditions was carried out using the Simplified Oral Hygiene Index (IHO-S) and the caries indices (DMFT and dft). In addition, monthly census data on variables related to infectious conditions, deaths and use of antibiotics were collected in the SAD-UFU database. Data were collected before and after 12 months of weekly dental follow-up of patients (n=55). The values were computed in spreadsheets, with scores being assigned to all response variables studied, so that it was possible to carry out quantitative analysis in the statistical program SPSS version 18.0. In addition to the descriptive analysis, the McNemar test was used to compare data (p<0.05). No difference was identified in the statistical proportion for the rate of gingival hyperplasia (50.0% in 2021 and 31.3% in 2022; p=0.648), plaque (56.3% in 2021 and 31.3% in 2022; p =0.648), calculus (56.3% in 2021 and 25.0% in 2022; p=0.648) and gingival bleeding (62.5% in 2021 and 37.5% in 2022; p=0.648), but there was a change in the context and decrease in the percentage in the year in which they had dental care. However, a statistical difference was identified for the death rate (0.8% in 2021 and 0.5% in 2022; p<0.001), for the number of hospitalizations (9.2% in 2021 and 5.3% in 2022; p<0.001) and use of antibiotics (47.2% in 2021 and 34.8% in 2022; p<0.001). It was concluded that the occurrences of gingival hyperplasia, plaque, calculus, gingival bleeding, death, hospitalization and use of antibiotics in domiciled pediatric patients decreased in the year in which there was weekly dental monitoring.