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Saúde oral no paciente com deficiência : uma revisão sistemática
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Abstract(s)
Introdução: Segundo a Organização Mundial da Saúde, 15% da população vive com algum tipo de deficiência, porém, os cuidados de saúde oral disponíveis não estão ajustados à demanda que este número exige. Neste sentido, o objetivo do presente estudo é avaliar a real condição oral do paciente com deficiência física (paralisia cerebral) e intelectual (síndrome de Down), através da análise de variáveis de saúde oral, comparando-as com o estado de saúde oral da população em geral. Materiais e métodos: A presente revisão sistemática foi realizada de acordo com as normas PRISMA, tendo por base uma questão de investigação sob o acrónimo PICO: “Pacientes com deficiência física ou intelectual apresentam uma pior condição oral do que a população em geral?”. A dissertação foi registada na plataforma PROSPERO com o número CRD42024501253. A pesquisa foi realizada em 3 bases de dados, PubMed, Scopus e Cochrane, tendo em consideração os critérios de inclusão (estudos e artigos de pesquisa primária, com amostra igual ou superior a 10 pessoas, idade igual ou inferior a 18 anos, de 2016 a 2024 e em inglês ou português). A avaliação da qualidade dos estudos foi realizada de acordo com a The Newcastle-Ottawa Scale (NOS) e, de cada estudo, foram retiradas as seguintes informações: autor, ano de publicação, país, tipo de estudo, tamanho (n), idade, género, objetivos de cada estudo e as variáveis de saúde oral que foram analisadas (cárie e erosão dentária, saúde gengival, traumatismo dentário, má-oclusão e bruxismo). Resultados: Foram obtidos no total 231 estudos para a deficiência física e 214 estudos para a intelectual. Após a remoção de duplicados e leitura do título e resumo, sobraram 17 artigos para leitura integral nas deficiências físicas e 27 nas intelectuais. Tendo em conta os critérios de inclusão e exclusão, foram incluídos na presente revisão sistemática 6 artigos nas deficiências físicas e 8 artigos nas intelectuais, obtendo-se um total de 14 artigos, cada um com um grupo de estudo (deficiência física ou intelectual) e um grupo de controlo (população em geral). A cárie dentária foi a variável mais analisada, seguida da saúde gengival, má-oclusão, traumatismos dentários e, por fim, bruxismo. Os resultados obtidos foram organizados em gráficos, onde se verificou a maior prevalência de cárie dentária no grupo com paralisia cerebral e, contrariamente, no grupo com síndrome de Down a prevalência foi inferior. Já em relação à erosão, saúde gengival e traumatismo dentário, a percentagem de casos foi superior nos grupos de estudo. Relativamente à má-oclusão, esta foi significativamente mais prevalente na população de estudo, assim como o bruxismo, porém, esta variável foi apenas analisada num estudo. Conclusão: De um modo geral, os resultados obtidos permitiram concluir que o estado de saúde oral se encontra mais deteriorado na população com deficiência, à exceção da cárie dentária nos pacientes com síndrome de Down, que foi mais prevalente no grupo de controlo (sem deficiência). Estes resultados evidenciam a necessidade de profissionais especializados nesta área, que consigam corresponder às demandas destes pacientes, quebrando as barreiras que estas deficiências impõem.
Introduction: According to the World Health Organization, 15% of the population lives with some type of disability, however, the oral health care available is not adjusted to the demand that this number requires. In this sense, the aim of the present study is to evaluate the real oral condition of patients with physical (cerebral palsy) and intellectual disabilities (Down syndrome), through the analysis of oral health variables, comparing them with the oral health status of the general population. Materials and methods: This systematic review was carried out according to the PRISMA standards, based on a research question under the acronym PICO: "Do patients with physical or intellectual disabilities have a worse oral condition than the general population?". The dissertation was registered on the PROSPERO platform with the number CRD42024501253. The search was carried out in 3 databases, PubMed, Scopus and Cochrane, taking into consideration the inclusion criteria (primary research studies and articles, with a sample of more than 10 people, aged 18 years or less, from 2016 to 2024 and in English or Portuguese). The quality of the studies was evaluated according to The Newcastle-Ottawa Scale (NOS) and, from each study, the following information was taken: author, year of publication, country, type of study, size (n), age, gender, objectives of each study and the oral health variables that were analyzed (dental caries and erosion, gingival health, dental trauma, malocclusion and bruxism). Results: A total of 231 studies were obtained for physical disability and 214 studies for intellectual disability. After removing duplicates and reading the title and abstract, 17 articles remained for full reading in the physical and 27 in intellectual disabilities. Considering the inclusion and exclusion criteria, 6 articles on physical disabilities and 8 articles on intellectual disabilities were included in this systematic review, resulting in a total of 14 articles, each with a study group (physical or intellectual disability) and a control group (general population). Dental caries was the most analyzed variable, followed by gingival health, malocclusion, dental trauma and, finally, bruxism. The results obtained were organized in graphics, where the highest prevalence of dental caries was found in the group with cerebral palsy and, on the contrary, in the group with Down syndrome the prevalence was lower. In relation to erosion, gingival health and dental trauma, the percentage of cases was higher in the study groups. Regarding malocclusion, this was significantly more prevalent in the study population, as well as bruxism, however, this variable was only analyzed in one study. Conclusion: In general, the results obtained allowed us to conclude that the oral health status is more deteriorated in the population with disabilities, except for dental caries in patients with Down syndrome, which was more prevalent in the control group (without disabilities). These results highlight the need for professionals specialized in this area, who can meet the demands of these patients, breaking the barriers that these disabilities impose.
Introduction: According to the World Health Organization, 15% of the population lives with some type of disability, however, the oral health care available is not adjusted to the demand that this number requires. In this sense, the aim of the present study is to evaluate the real oral condition of patients with physical (cerebral palsy) and intellectual disabilities (Down syndrome), through the analysis of oral health variables, comparing them with the oral health status of the general population. Materials and methods: This systematic review was carried out according to the PRISMA standards, based on a research question under the acronym PICO: "Do patients with physical or intellectual disabilities have a worse oral condition than the general population?". The dissertation was registered on the PROSPERO platform with the number CRD42024501253. The search was carried out in 3 databases, PubMed, Scopus and Cochrane, taking into consideration the inclusion criteria (primary research studies and articles, with a sample of more than 10 people, aged 18 years or less, from 2016 to 2024 and in English or Portuguese). The quality of the studies was evaluated according to The Newcastle-Ottawa Scale (NOS) and, from each study, the following information was taken: author, year of publication, country, type of study, size (n), age, gender, objectives of each study and the oral health variables that were analyzed (dental caries and erosion, gingival health, dental trauma, malocclusion and bruxism). Results: A total of 231 studies were obtained for physical disability and 214 studies for intellectual disability. After removing duplicates and reading the title and abstract, 17 articles remained for full reading in the physical and 27 in intellectual disabilities. Considering the inclusion and exclusion criteria, 6 articles on physical disabilities and 8 articles on intellectual disabilities were included in this systematic review, resulting in a total of 14 articles, each with a study group (physical or intellectual disability) and a control group (general population). Dental caries was the most analyzed variable, followed by gingival health, malocclusion, dental trauma and, finally, bruxism. The results obtained were organized in graphics, where the highest prevalence of dental caries was found in the group with cerebral palsy and, on the contrary, in the group with Down syndrome the prevalence was lower. In relation to erosion, gingival health and dental trauma, the percentage of cases was higher in the study groups. Regarding malocclusion, this was significantly more prevalent in the study population, as well as bruxism, however, this variable was only analyzed in one study. Conclusion: In general, the results obtained allowed us to conclude that the oral health status is more deteriorated in the population with disabilities, except for dental caries in patients with Down syndrome, which was more prevalent in the control group (without disabilities). These results highlight the need for professionals specialized in this area, who can meet the demands of these patients, breaking the barriers that these disabilities impose.
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Saúde oral Deficiência Paralisia cerebral Síndrome de Down Oral health Disability Cerebral palsy Down Syndrome
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