2019 Volume 40 Issue 1 Pages 39-43
Patients with Rett syndrome（RTT）face problems such as difficulty with conscious dental treatment, respiratory abnormalities, and difficulty with airway management. We received a request for domiciliary dental treatment, but there would be difficulty with conscious dental treatment. Herein, we report on perioperative management at home including that of dental treatment under hospitalization with general anesthesia of severely mentally and physically disabled persons with Rett syndrome.
The patient was a 40-year-old woman. She had severe mental retardation, epilepsy, and cerebral paralysis. She had been diagnosed with RTT at the age of 18 years. She had difficulty keeping a sitting position, needed total help with daily living activities, had no verbal communication ability, and had light scoliosis. Four months after initial diagnosis, she received dental treatment under general anesthesia by a different dental office, but the dental treatment was stopped because of distrust. We received a request for domiciliary dental treatment by decreasing dietary intake and for untreated caries teeth. Because there would be difficulty in conscious dental treatment, we undertook such treatment including extraction, conservative treatment, and prosthodontic treatment under hospitalization with general anesthesia. Subsequently, we managed her prophylactic oral treatment in the outpatient clinic under intravenous anesthesia, with home visit guidance by the dental hygienist.
It seems important to have safe dental treatment by anesthesia management, product dental prosthesis considering the function and cleanability, and making sure of guidance together with simple treatment administered via home visits that enables overall regional dental care.
