UNIVERSIDADE ESTADUAL PAULISTA
“JÚLIO DE MESQUITA FILHO”
Instituto de Ciência e Tecnologia
Campus de São José dos Campos
ORIGINAL ARTICLE DOI: https://doi.org/10.4322/bds.2023.e3646
1
Braz Dent Sci 2023 Jan/Mar;26 (1): e3646
Dental care for patients with special needs at a private higher
education institute
Atendimento odontológico a pacientes com necessidades especiais em uma instituição privada de ensino superior
Ana Lucia Franco RICARDO
1
, Rosemeire Arai YOSHIDA
1
, Renata Oliveira GUARÉ
1
,
Cristiane de Almeida Baldini CARDOSO
1
, Sérgio Lúcio Pereira de Castro LOPES
2
, Karolina A. C. FARDIM
2
,
André Luiz Ferreira COSTA
1
, Maria Teresa Botti Rodrigues dos SANTOS
1
1 - Universidade Cruzeiro do Sul, Department of Dentistry. São Paulo, SP, Brazil.
2 - Universidade Estadual Paulista “Júlio de Mesquita Filho”, Science and Technology Institute, Department of Diagnosis and Surgery. São
José dos Campos, SP, Brazil.
How to cite: Ricardo ALF, Yoshida RA, Guaré RO, Cardoso CAB, Lopes SLPC, Fardim KAC, et al. Dental care for patients with special
needs at a private higher education institute. Braz Dent Sci. 2023;26(1):e3646. https://doi.org/10.4322/bds.2023.e3646
ABSTRACT
Objective: Patients with special needs are those individuals who need special care for an undetermined period of
time or for lifetime. The present study is aimed to address the dental care of special needs patients at a private higher
education institute in the city of São Paulo. Material and Methods: A descriptive, retrospective study was performed for
analysis of 210 dental records of special needs patients who were treated at the Dental Department for Special Patients
of the Cruzeiro do Sul University between 2012 and 2018. Data on gender, age, diagnosis of the debilitating condition,
reason of the consultation, continued use of medications, radiographic images and dental treatments provided were all
collected before being submitted to descriptive and inferential statistical analysis (chi-square test) at a signicance level
of 5%. Results: As for the types of dental procedures assessed in the present study, of the 210 patients, 24% needed
dental curative treatments in which periodontal therapy was the most prevalent type, whereas endodontic treatments
had the lowest prevalence, representing 4% only. There was a high prevalence of chronic systemic diseases, affecting
56% of the dental records, whose age group was above 40 years old. Conclusion: Regular dental check-ups should be
prioritized in patients with special needs to avoid more invasive interventions as found in our group.
KEYWORDS
Dental care for disabled patients, disabled person; Health prole; Oral treatment; Special needs.
RESUMO
Objetivo: Pacientes com necessidades especiais são aqueles indivíduos que necessitam de cuidados especiais por tempo
indeterminado ou por toda a vida. O presente estudo tem como objetivo abordar o atendimento odontológico de pacientes
com necessidades especiais em uma instituição privada de ensino superior da cidade de São Paulo. Material e Métodos: Foi
realizado um estudo descritivo, retrospectivo, para análise de 210 prontuários odontológicos de pacientes com necessidades
especiais atendidos no Departamento de Odontologia para Pacientes Especiais da Universidade Cruzeiro do Sul entre 2012 e
2018. Dados sobre sexo, idade, diagnóstico da condição debilitante, motivo da consulta, uso continuado de medicamentos,
imagens radiográcas e tratamentos odontológicos prestados foram todos coletados e posteriormente submetidos à análise
estatística descritiva e inferencial (teste do qui-quadrado) ao nível de signicância de 5%. Resultados: Quanto aos tipos de
procedimentos odontológicos avaliados no presente estudo, dos 210 pacientes, 24% necessitaram de tratamentos curativos
dentários em que a terapia periodontal foi o tipo mais prevalente, enquanto os tratamentos endodônticos tiveram a menor
prevalência, representando apenas 4%. Houve alta prevalência de doenças crônicas sistêmicas, acometendo 56% dos casos,
cuja faixa etária era superior a 40 anos. Conclusão: Check-ups odontológicos regulares devem ser priorizados em pacientes
com necessidades especiais para evitar intervenções mais invasivas como em nosso grupo.
PALAVRAS-CHAVE
Assistência odontológica para pessoas com deciências; Perl de saúde; Tratamento oral; Necessidades especiais.
2
Braz Dent Sci 2023 Jan/Mar;26 (1): e3646
Ricardo ALF et al.
Dental care for patients with special needs at a priv ate higher education institute
Ricardo ALF et al.
Dental care for patients with special needs at a private higher
education institute
INTRODUCTION
Disabled patients are those individuals who
need medical and dental care directed to their
condition, which may involve differentiated
care for a period of time or even indenitely.
These individuals were shown to have a greater
susceptibility to comorbidities capable of
compromising their well-being. According to
the World Health Organisation (WHO), the
prevalence of disabled individuals in the world
is 1:10 people [1].
In Brazil, 15% of the population has special
needs, with the majority being highly concentrated
in the northeast region of the country, that is,
16.8%. According to the Brazilian Institute of
Geography and Statistics (IBGE), it is estimated
that of the 10% of the individuals with special
needs, only 3% has received dental treatment,
which corresponded to 480,000 patients [2].
The National Curriculum Guidelines for
Dentistry Courses, in force since 2002, establish
that undergraduate discipline should prepare
dental surgeons to be capable of performing as a
generalist. However, it is extremely important that
dental care for special needs patients is included so
that some necessities of this group of individuals
can be met. To do so, it is necessary that the
undergraduate student and future practitioner have
a curriculum consisting of clinical and theoretical
components to provide a satisfactory dental care
to these patients. Therefore, the importance of
broadly addressing the discipline of special needs
patients (SNPs) on an integrated basis has been
recognised as dental care for this group of patients
should be scientically grounded [2,3]. According
to the Ministry of Health Guidelines, the discipline
of SNPs is not mandatory in Brazil, which explains
the still limited number of dental schools in this
subject [4].
The strategies and approaches for these
patients should encompass the interdisciplinarity.
Therefore, it is paramount to consider that dental
care for SNPs, in both public and private sectors,
should be performed with participation of a
multiprofessional and/or multidisciplinary team
to achieve the best possible oral and general
health conditions. Such dental care might often
be performed by undergraduate students whose
curriculum has the discipline of SNPs [5].
One of the most challenging situations in
providing dental care for SNPs has to do with
the management of behaviour during the clinical
practice. To do so, it is not only necessary to
have technical-scientific knowledge, but also
sensitivity in understanding the individual desires
of each patient as well as of their family in order
to determine the best way to perform the dental
treatment [6].
Embracement is the rst step in making the
user and his or her family feel condent regarding
the dental treatment. Establishing bonds with the
patient by listening, respecting and dialoguing is
another important aspect for efciently operating
the reference and counter-reference systems
aimed at secondary care and preventing the
patient from becoming misguided following the
procedure in the sector of reference. The counter-
reference for primary health care is presented to
the undergraduate student as being as important
as the referral to higher levels of outpatient or
inpatient secondary care. Because not always
such an important step is performed at the levels
of secondary and inpatient care, the systems of
periodic preventive maintenance are essential for
the health of these patients [6].
Disabled people have been neglected
regarding the specic health care they need, in
addition to being in a situation of disadvantage
regarding medical care for diseases and
occurrences common to anyone. A major part of
these people not only suffer more from chronic
diseases and need more hospitalisation, but
they also use less outpatient care services, such
as dental consultations. A study performed by
Castro et al. [7] showed that physically disabled
patients in the cities of the State of São Paulo had
24 times less dental visits than non-disabled ones.
The main reasons reported were difcult access
to dental ofces and clinics, lack of preparation
of the practitioners to handle the deficiency
and financial difficulties. Dental care for this
population has been historically performed on
a sporadic basis, that is, with no systematic
follow-up and often provided by philanthropic
institutions, which is the reason why the oral
condition of these patients is poor [8].
Oral health still has a low priority compared
to other medical care services for these individuals.
However, the presence of oral pain and infection
can potentially impair the systemic condition of
SNPs [9,10]. Some years ago, dental treatment
for SNPs was often provided under general
anaesthesia on an inpatient basis. Nowadays,
3
Braz Dent Sci 2023 Jan/Mar;26 (1): e3646
Ricardo ALF et al.
Dental care for patients with special needs at a priv ate higher education institute
Ricardo ALF et al.
Dental care for patients with special needs at a private higher
education institute
thanks for the research on this new dental
specialty, the several aspects of each group of
SNP has been increasingly known, thus limiting
the indications for general anaesthesia [11,12].
This share of the population, despite the
advances and mobilisation for recognising their
needs, has been still facing personal, economic
and social challenges, among them, the difcult
access to oral health care [13].
Problems such as government policies,
educational programs for oral health care at
the universities and public network systems,
qualification of specialised personnel and
services, dental resources, shortage of specialised
professionals and preventive programs, lack of
policies aimed at assisting SNPs, among others,
are considered factors contributing to the poor
oral health situation of these patients [9].
In view of the conditions inherent to the
dental care for SNPs, the practitioner lacking
this competence does not feel prepared to
provide dental care for this population, which
will have repercussions on the often-unnecessary
referral to a hospital for treatment under general
anaesthesia [12].
While there has been several researches
about oral care for patients with special needs, a
study which gained insight into dental care health
care for this population related to brazilian dental
higher education institutes setting is lacking.
The present study is aimed to address the
dental care of special needs patients at a private
higher education institute in the city of São Paulo.
MATERIAL AND METHODS
After approval by the Institutional Review
Board of the Cruzeiro do Sul University
(UNICSUL) under protocol number 3733742,
a descriptive retrospective study was performed
with 210 dental records of SNPs treated at the
Dental Department for Special Patients of the
Cruzeiro do Sul University between 2012 and
2018 at the São Miguel Paulista Campus, São
Paulo. The patients were treated by senior
undergraduate students (7
th
and 8
th
semesters)
under the discipline of special needs patients in
the dentistry curriculum.
The variables were distributed according
to the disabling conditions, gender, age group,
radiographic images (the type of radiograph
taken during treatment), continued use of
medications, preventive procedures and type
of dental procedures performed (restorative,
surgical, periodontal and endodontic).
The SNPs were grouped into seven
categories according to their medical diagnosis
as follows [14]: 1) Physical deciency: cerebral
palsy, encephalic vascular accident, medullary
lesion and motor alteration; 2) Congenital
anomaly: Down’s syndrome; 3) Behavioural
disorder: autistic spectrum disorder; 4) Psychiatric
disorders: schizophrenia and obsessive-
compulsive disorder; 5) Chronic systemic
diseases: asthma, diabetes mellitus, systemic
arterial hypertension, cardiopathies epilepsy,
chronic renal insufciency, autoimmune disease,
infectious-contagious disease; 6) Drug-addiction;
and 7) Systemic diseases: cancer, multiple
sclerosis, Chagas’ disease and transplanted
patients.
As inclusion criteria, only fully completed
dental records with a free and informed consent
form signed by the caretaker or legal guardian,
and containing types of treatment: preventive,
curative, surgical, periodontal and endodontic)
were considered for study. Patients were
grouped according to the age under the WHO
criteria adapted from elsewhere: 0-9 years old,
10-19 years old, 20-39 years old and older than
40 years.
The data collected from the dental records
were tabulated into spreadsheets and the results
expressed descriptively and presented in tables.
Data analysis was descriptive and statistically
inferential (Chi-square test) by using the SPSS
software, version 15.0, at a signicance level of
5%.
RESULTS
Of the 210 dental records, 50.9% corresponded
to males and 49.1% to females. As for males, there
were higher percentages of physical deciency (9%),
behaviour disorders (2%) and psychiatric disorders
(8.2%), whereas females had a higher percentage
of diabetes mellitus (12%). Cardiopathies (6%)
and systemic arterial hypertension (8%) had higher
percentages in males. Data on the distribution of
debilitating conditions by gender are shown in
Table I.
In Table II, one can observe that the age of the
SNPs varied from 2 to 92 years old. The individuals
4
Braz Dent Sci 2023 Jan/Mar;26 (1): e3646
Ricardo ALF et al.
Dental care for patients with special needs at a priv ate higher education institute
Ricardo ALF et al.
Dental care for patients with special needs at a private higher
education institute
were divided into four age groups and relating to
their debilitating conditions. Physical deciency
was observed in the individuals of all age groups,
whereas 119 ones had chronic systemic diseases,
mainly affecting those individuals older than
40 years (44%). Therefore, individuals with
chronic systemic diseases are signicantly older
(
P
< 0.001).
In Table III, one can observe that radiographic
images were present in 54.8% of the cases. There
was no statistically signicant difference between
the groups.
In Table IV, one can observe that special
needs patients with chronic systemic diseases
make signicantly more use of medications on a
continued basis (
P
< 0.0001).
As shown in Table V, the seven most
prevalent debilitating conditions correspond to
the diagnoses of chronic systemic disease (56%),
physical deciency (16%), psychiatric disorders
(12%), congenital anomaly (9%), behavioural
disorder (3%), drug-addiction (1.5%) and
systemic disease (2%), totalising a sample of
210 patients.
Table I - Distribution of the debilitating conditions by gender
Debilitating condition
Male gender Female gender Total
n % n % n %
Physical deficiency
Cerebral palsy 3 1.4 5 2.6 8 4.0
Others 14 7.6 11 4.4 25 12.0
Congenital anomaly
Down’s syndrome 7 3.0 12 6.0 19 9.0
Behavioural disorder
Autistic spectrum disorder 5 2.0 0 0.0 5 2.0
Psychiatric disorders
Schizophrenia 17 8.0 8 4.0 25 12.0
Obsessive-compulsive disorder 1 0.2 0 0.0 1 0.2
Chronic systemic diseases
Diabetes mellitus 11 5.0 25 12.0 36 17.0
Systemic arterial hypertension 17 8.0 18 8.9 35 16.9
Cardiopathies 13 6.0 10 5.0 23 11.0
Others 14 8.0 11 6.0 25 12.0
Drug-addiction 3 1.5 0 0.0 3 1.5
Systemic condition 2 0.96 3 1.44 5 2.4
Total 107 103 210
Groups did not differ regarding gender. Chi-square test (
P
= 0.1934).
Table II - Distribution of the debilitating conditions by age group
Debilitating condition
Age group
Total0-9 yrs 10-19 yrs 20-39 yrs >40 yrs
n % n % n % n %
Physical deficiency 1 0.1 7 3.6 9 4.3 16 7.6 33
Congenital anomaly 3 1.42 8 3.8 6 2.9 2 0.9 19
Behavioural disorder 1 0.8 20 9.6 2 1,0 0 0.0 5
Psychiatric disorders 0 0 5 2.4 8 3.8 13* 6.5 26
Chronic systemic diseases 4 1.9 4 1.9 18 8.5 93 44.0 119
Drug-addiction 0 0 0 0 3 1.5 0 0.0 3
Systemic condition 0 0 0 0 1 0.5 4.0 2.0 5
*Chi-square test.
5
Braz Dent Sci 2023 Jan/Mar;26 (1): e3646
Ricardo ALF et al.
Dental care for patients with special needs at a priv ate higher education institute
Ricardo ALF et al.
Dental care for patients with special needs at a private higher
education institute
In Table VI, one can observe that periodontal
treatment corresponded to 30% of the dental
procedures, whereas preventive and curative
dental treatments corresponded to 25% and
24%, respectively. Surgical dental procedures
(tooth extraction) corresponded to 17%, whereas
endodontic treatments were the least performed,
with 4%.
The average time of treatment was shorter
than three months in 46.5% of the sample, and
46.7% of the patients were discharged from the
treatment.
DISCUSSION
The profile of the disabled individuals
who sought dental treatment at the Dental
Department for Special Patients of the Cruzeiro
do Sul University, a private higher education
institute, was evaluated. Of the 210 dental
records analysed, 52.8% corresponded to males
and 47.2% to females.
Table III - Distribution of the 210 patients with debilitating conditions according to their radiographic images
Debilitating condition
Yes No
n % n %
Physical deficiency 12 5.75 21 1.5
Congenital anomaly 11 5.24 8 4.5
Behavioural disorder 2 0.5 3 1.4
Psychiatric disorders 15 7.14 11 6.5
Chronic systemic diseases 70 34.0 49 31.1
Drug-addiction 3 1.40 0 0.0
Systemic condition 2 0.95 3 1.42
Total 115 55.0 95 45.0
Chi-square test (
P
= 0.1837).
Table IV - Distribution of the 210 patients with debilitating conditions according to their continued use of medication
Debilitating condition
Yes No
n % n %
Physical deficiency 7 3.4 26 12.0
Congenital anomaly 4 1.9 15 7.14
Behavioural disorder 2 1.0 3 1.42
Psychiatric disorders 23 11.0 3 1.42
Chronic systemic diseases 10* 5.0 14 6.70
Drug-addiction 3 1.40 0 0.00
Systemic condition 2 0.95 3 1.42
Total 146 70.0 64 30.0
*Chi-square test (
P <
0.0001).
Table V - Distribution of the 210 patients with debilitating
conditions according to the early procedures
Debilitating condition R % NR
Physical deficiency 33 16 0
Congenital anomaly 9 9 0
Behavioural disorder 5 3 0
Psychiatric disorders 26 12 0
Chronic systemic diseases 19 56 0
Drug-addiction 3 2 0
Systemic condition 5 2 0
Total 210 0
R: present; NR: absent.
Table VI - Distribution of the 210 patients with debilitating
conditions according to the dental procedures performed
n Dental Procedure %
54 Restoration 24
39 Surgery 17
70 Periodontics 30
8 Endodontics 4
59 Prevention 25
152 Anamnesis
6
Braz Dent Sci 2023 Jan/Mar;26 (1): e3646
Ricardo ALF et al.
Dental care for patients with special needs at a priv ate higher education institute
Ricardo ALF et al.
Dental care for patients with special needs at a private higher
education institute
Other studies also corroborated our ndings.
Faker et al. [8] evaluated 351 dental records of
patients treated at the Dental Clinics for Patients
with Special Needs of the School of Dentistry,
Universidade Federal Fluminense, reporting
percentages of 52.94%, retrospectively.
In our study, the variation in age group
ranged from 3 to 93 years old, with a mean age of
39 years (± 50%). However, in a study conducted
at the School of Dentistry, Universidade Federal
Fluminense, Faker et al. [8] reported an age
variation from 3 to 37 years old with a mean
age of 9.65 (±24,04) years old. Data indicate
that an early approach with access to dental
care services leads these individuals to attend
preventive programs, which ensures a signicant
improvement in their quality of life [13].
Periapical radiographic images were
obtained from 54.8% of the individuals. The type
of radiographic image often depends on the
systemic condition of the disabled individual
being evaluated.
The indication of continued use of
medications is related to the treatment of the
patient’s systemic condition. Therefore, it is
paramount that the dental surgeon knows about
the possible drug interactions between continued
medications and local anaesthetic and/or dental
drugs [10,11]. One can observe that 50% of the
individuals who frequently use these medications
are those with chronic systemic conditions.
As for the types of dental procedures
evaluated in the present study, of the 210 patients,
24% needed dental restoration, especially
periodontal treatment. In addition, the need of
preventive procedures was demonstrated in 30%
of the patients, which shows the importance of
prevention interventions for this population.
According to the results obtained by other
authors [8,10] curative treatments correspond
to 54.1% of all dental procedures, thus being the
most frequently performed one.
Endodontic treatments were the least
prevalent ones, representing 4% in the present
study. On the other hand, the number of patients
undergoing surgical dental procedures was
higher than those undergoing endodontic
procedures, which may be related to the fact
that the latter require more collaboration from
the patients. These results show how difcult is
the collaborative management of the disabled
patients for the endodontic treatment, leading
to tooth extraction as a nal option [8]. As a
result, radical dental procedures are chosen to
the detriment of more conservative ones
The increase in the population’s life
expectancy leads to a greater prevalence of
chronic diseases, such as diabetes mellitus and
hypertension [15]. By analysing the prole of the
patients in the present study, one can highlight
the high prevalence of chronic systemic diseases
as 119 individuals (56% of the cases) were
affected, a population within the age group of
40 years or older.
In the present study, congenital anomalies
were found to be more prevalent in younger
individuals, that is, 4-9 years old. These results can
indicate a shorter life expectancy for individuals
with syndromes compared to non-syndromic
ones. It was also observed that 9% (19 cases) of
the individuals had Down’s syndrome. Down’s
syndrome is the most common congenital
anomaly resulting in mental, behavioural,
physical and oral changes [16].
The comparison between our results and
the few ones in the literature on the prole of
SNPs did not allow us to make a correspondence
between the percentages in each debilitating
condition described here. This may have been
due to geographical differences regarding the
healthcare services offered, since people living
in these regions have their own social-economic
characteristics [13], beyond the conditions
inherent to a service that attends SNPs.
In Brazil, one can observe that the number
of higher education institutions offering the
discipline of special needs patients is smaller
than the demand. The qualification of dental
professionals should contemplate this issue to
meet the disabled patients’ rights. Moreover, the
problems faced by this population regarding the
access to oral care services are impaired.
These patients have a greater prevalence of
oral diseases such as caries lesions, missing teeth,
periodontal problems, para-functional habits and
malocclusions, all of which occurring mainly
due to the poor oral hygiene caused by physical
and psychiatric limitations, including type of
diet, difcult mastication and deglutition, and
medications taken on a daily basis [8].
This population with special needs, despite
the advances and mobilization for recognizing
7
Braz Dent Sci 2023 Jan/Mar;26 (1): e3646
Ricardo ALF et al.
Dental care for patients with special needs at a priv ate higher education institute
Ricardo ALF et al.
Dental care for patients with special needs at a private higher
education institute
their demands, has still been facing personal,
economic and social challenges, including
difculties to meet their oral health needs [12].
Problems related to public policies,
educational programs for oral health care at
the universities and public network systems,
qualification of specialised personnel and
services, availability of dental resources, shortage
of specialised professionals to meet the demand
for preventive programs, lack of policies aimed
at assisting SNPs, among others, are considered
factors contributing to the poor oral health
situation of these patients [8].
Of the dental schools offering the discipline
of special needs patients in Brazil, 27 (48.21%)
provide it at both theoretical and practical levels,
25 (44.64%) at a theoretical level and four
(7.14%) at a practical level only [8,17].
In the eld of health care, disabled patients
are mainly assisted by the public healthcare system
and higher education institutions. Therefore, both
account for collecting, organising, analysing and
interpreting data on the current reality, as well
as for discussing the services provided by the
higher education and healthcare organisations,
including qualication discipline not available in
the undergraduate curricula [17].
In this way, one can observe that
undergraduate dental discipline should become
adequate and make changes in their curriculum
in order to allow professionals to be able to meet
the healthcare needs of the population and public
healthcare system. In fact, there is a gap in the
curriculum of dentistry regarding the education
of professionals who will treat disabled patients.
Consequently, dental surgeons do not feel able
and condent to treat this population as they
lack a generalist background, which does not
comply with the norms set by the 2001 National
Curriculum Guidelines (NCGs).
This study contains some limitations that
should be addressed. First, the quality of dental
records information. Second, the great variety of
age and conditions of the subjects.
CONCLUSION
The greatest need was for curative
procedures. The analysis of the data led to the
conclusion that prevention measures of dental
diseases are needed in order to avoid more
invasive interventions and routine follow-up for
these subjects.
Author’s Contributions
ALFR: Study conception and design, analyses
and interpretation of the data; nal approval of
the version to be published. RAY: Analyses and
interpretation of the data; nal approval of the
version to be published. ROG: Drafting the article;
Analyses and interpretation of the data; Final
approval of the version to be published. CABC:
Drafting the article; Analyses and interpretation
of the data; Final approval of the version to be
published. SLPCL: Analyses and interpretation
of the data; Final approval of the version to be
published. KACF: Analyses and interpretation
of the data; Final approval of the version to
be published. ALFC: Drafting the article; Final
approval of the version to be published. MTBRS:
Study conception and design, analyses and
interpretation of the data; Final approval of the
version to be published.
Conict of Interest
All authors of this work declare no conict
of interest.
Funding
This research was supported by Coordenação
de Aperfeioamento de Pessoal de Nível Superior
(CAPES), funding number “001”.
Regulatory Statement
The study was approved by the Institutional
Review Board of UNICSUL, according to protocol
number 3733742.
REFERENCES
1. United Nations. Convention on the rights of persons with
disabilities [Internet]. New York: United Nations; 2008. p. 3.
(United Nations Treaties Series; no. 2515) [cited 2022 oct 1].
Available from: https://treaties.un.org/doc/publication/unts/
volume%202515/v2515.pdf
2. Brasil. Ministério da Saúde. Diretrizes da Política Nacional de
Saúde Bucal [Internet]. Brasília: Coordenação Nacional de Saúde
Bucal, Departamento de Atenção Básica, Secretaria de Atenção
à Saúde; 2004 [cited 2022 oct 1]. Available from: https://bvsms.
saude.gov.br/
3. Kamen S. History of dentistry for the handicapped: past, present
and future. Dent J. 1976;42(7):347-51. PMid:142013.
8
Braz Dent Sci 2023 Jan/Mar;26 (1): e3646
Ricardo ALF et al.
Dental care for patients with special needs at a priv ate higher education institute
Ricardo ALF et al.
Dental care for patients with special needs at a private higher
education institute
4. Faulks D, Norderyd J, Molina G, Macgiolla Phadraig C, Scagnet
G, Eschevins C,etal. Using the International Classification of
Functioning, Disability and Health (ICF) to describe children
referred to special care or paediatric dental services. PLoS
One. 2013;8(4):e61993. http://dx.doi.org/10.1371/journal.
pone.0061993. PMid:23614000.
5. Brasil. Resolução n° CNE/CES 3/2002 de 19 de fevereiro. Institui
as Diretrizes Curriculares Nacionais dos Cursos de Farmácia e
Odontologia. Diário Oficial da União; Brasília; 2002 Mar 4.
6. Wolff AJ, Waldman HB, Milano M, Perlman SP. Dental students’
experiences with and attitudes toward people with mental
retardation. J Am Dent Assoc. 2004;135(3):353-7. http://dx.doi.
org/10.14219/jada.archive.2004.0187. PMid:15058626.
7. Castro SS, Cesar CL, Carandina L, Barros MB, Alves MC,
Goldbaum M. Physical disability, recent illnesses and health
self-assessment in a population-based study in São Paulo,
Brazil. Disabil Rehabil. 2010;32(19):1612-5. http://dx.doi.
org/10.3109/09638281003611060. PMid:20158374.
8. Faker K, Di Lanaro N, Paula VA, Tostes MA. Profile of special needs
patients assisted in a dental project. Braz Dent Sci. 2016;4(4):14-
20. http://dx.doi.org/10.14295/bds.2016.v19i4.1300.
9. Casamassimo PS, Seale NS, Ruehs K. General dentists’
perceptions of educational and treatment issues affecting
access to care for children with special health care needs. J
Dent Educ. 2004;68(1):23-8. http://dx.doi.org/10.1002/j.0022-
0337.2004.68.1.tb03730.x. PMid:14761169.
10. Loeppky WP, Sigal MJ. Patients with special health care needs
in general and pediatric dental practices in Ontario. J Can Dent
Assoc. 2006;72(10):915. PMid:17187705.
11. McGeown D, Mac Giolla Phadraig C, Whelehan D, Nunn
JH. Dental decision-making under general anesthesia for
patients with disabilities: A qualitative study. Spec Care
Dentist. 2022;42(1):20-7. http://dx.doi.org/10.1111/scd.12631.
PMid:34255384.
12. Anders PL, Davis EL. Oral health of patients with
intellectual disabilities: a systematic review. Spec Care
Dentist. 2010;30(3):110-7. http://dx.doi.org/10.1111/j.1754-
4505.2010.00136.x. PMid:20500706.
13. Monteserín-Matesanz M, Esparza-Gómez GC, García-Chías B,
Gasco-García C, Cerero-Lapiedra R. Descriptive study of the
patients treated at the clinic “integrated dentistry for patients
with special needs” at Complutense University of Madrid (2003-
2012). Med Oral Patol Oral Cir Bucal. 2015;20(2):e211-7. http://
dx.doi.org/10.4317/medoral.20030. PMid:25662539.
14. Dougall A, Pani SC, Thompson S, Faulks D, Romer M, Nunn
J. Developing an undergraduate curriculum in special care
dentistry, by consensus. Eur J Dent Educ. 2013;17(1):46-56.
http://dx.doi.org/10.1111/eje.12011.
15. Jia H, Zack MM, Thompson WW. The effects of diabetes,
hypertension, asthma, heart disease, and stroke on quality-
adjusted life expectancy. Value Health. 2013;16(1):140-7. http://
dx.doi.org/10.1016/j.jval.2012.08.2208. PMid:23337225.
16. Fiske J, Shafik HH. Down’s syndrome and oral care. Dent
Update. 2001;28(3):148-56. http://dx.doi.org/10.12968/
denu.2001.28.3.148. PMid:11819976.
17. Kohata VKG, Zacarias RP Fo, Alves AO, Medina PO, Hanan
SA. Profile of patients with special needs assisted at a
Brazilian University. Pesqui Bras Odontopediatria Clin Integr.
2019;19(1):e4057. http://dx.doi.org/10.4034/PBOCI.2019.191.37.
André Luiz Ferreira Costa
(Corresponding address)
Universidade Cruzeiro do Sul, Postgraduate Program in Dentistry, São Paulo, SP,
Brazil.
Email: alfcosta@gmail.com
Date submitted: 2022 Oct 01
Accept submission: 2023 Mar 07
