DENTAL TREATMENT IN A PATIENT WITH SPECIAL NEEDS IN PRIMARY CARE – CLINICAL CASE

Introduction and Objective: We met Felipe Miranda de Castro, 28, epileptic and with cerebral palsy in a monthly home visit. With the support of the Family Health Strategy Team we gained his parents’ confidence and advised them on the use of anti-epilepsy drugs which cause severe gingival enlargement, leading to gingival hypertrophy due to poor hygiene and continuous mouth breathing, thus drying the mucosa. The patient was advised as to proper hygine and the treatment was concluded in an outpatient setting – Basic Healthcare Unit facility, with no hospitalization needed. Gingival bleeding and cariogenic pain was decreased with this procedure, thus helping the patient’s masticatory and digestive capacity. Method: We started the treatment in a dentist chair after three months of visits, with a lot of difficulty to brush teeth due to musce stiffness, Restorations were concluded with average time of one hour per visit. We used biteguardsmade of tongue depressor sticks and gauze and we used the suction nonstop so as to avoid aspiration of debris and blood. Result and Conclusion: The change in hygiene habits and the crown-root smoothing led to an improvement in the clinical Picture, regardless of the type of drug used, The severe hypertrophy was removed surgically, re-establishing tissue anatomy and physiology, controlling dental biofilm and inflammation. The treatment was successful in a Basic Healthcare Unit, without the need for transportation to specialized hospitals. The importance of this case is to show that the distance to referral hospitals make family members give up going to the dentist. With this intervention we provided na improvement to the family quality of life and reduced treatment cost as it was not necessary to make trips to the hospital.