2019 Volume 61 Issue 4 Pages 187-196
We report the case of a tuberous sclerosis complex (TSC) patient with severe chronic periodontitis, in whom we undertook intensive non-surgical periodontal treatment under general anesthesia and continuous supportive periodontal therapy (SPT) under intravenous sedation. The 43-year-old male patient visited our clinic with the chief complaint of tooth movement. He had never received periodontal treatment because of his maladaptation to dental treatment.
Periodontal examination revealed gingival inflammation with easy bleeding, deep periodontal pockets with pus discharge, and intense tooth mobility. His severe intellectual disability interfered with his brushing his teeth by himself and also caused him to refuse being assisted for brushing his teeth. We performed full-mouth scaling and root planing (SRP) under general anesthesia, in combination with antimicrobial therapy, and started the patient on SPT under intravenous sedation. These interventions led to a dramatic improvement in the patient's periodontal tissue condition and also led to improvements in his daily life, such as his beginning to allow being assisted with toothbrushing and his becoming more expressive.
People with disabilities frequently show early-onset infected periodontitis, which often becomes severe by middle age. While these patients have dental care needs, they/their families often find it difficult to identify dental clinics that would accept people with disabilities. Also, there are relatively few dental clinics that are equipped sufficiently to provide appropriate dental services for severely disabled people. We report this case to emphasize the need to recognize the current situation in relation to the problems of dentistry for the disabled, who are at a high risk of periodontal disease. We consider that it is necessary to strengthen cooperation among primary, secondary, and tertiary dental-medical institutions and local communities such as schools and other facilities, to enable dental intervention at an early stage in the disabled.
