いわゆる病病連携が奏功した障害者に対する集学的歯科治療について

In recent years, the oral environments of disabled people are well maintained by dental specialists for the disabled; however, because serious conditions requiring dental therapy do occur in disabled patients, we created a referral system for multidisciplinary dentistry for the disabled. In this report, we describe the successful implementation of this referral system and the treatment outcomes of disabled patients who underwent therapy by dental specialists. The patients were 12 disabled people, comprising 9 males and 3 females, who had been undergoing dental treatment in Tokushima Red Cross Hinomine Rehabilitation Center for People with Disabilities and had visited Tokushima University Hospital between January 2010 and March 2013. Their ages ranged from 14 to 71 years old, with a mean of 32.5 years old. The most common types of disabilities were hypophrenia: 7 patients (58.3%); cerebral palsy: 4 patients (33.3%), autism: 3 patients (25.0%), malformation syndrome: 2 patients (16.7%), etc. were found. The most frequent complications were epilepsy: 5 patients (41.7%); cured patent ductus arteriosus, laryngomalacia, asthma, hypertension, and ventilatory impairment were found in 1 patient (8.3%). Regarding oral diseases, chronic periodontitis and dental caries: 11 cases (91.7%), impacted wisdom teeth and persistence of deciduous teeth: 2 cases (16.7%) and oral cancer: 1 case (8.3%), were found. Concerning treatment, tooth extraction: 11 cases (91.7%), crown restoration: 5 cases (41.7%), pulpectomy: 2 cases (16.7%) and tumor resection: 1 case (8.3%), were safely performed. The procedures were performed under intravenous sedation in 6 cases, and under general anesthesia in the other 6 cases. Our referral system may contribute to the development of low-risk dentistry for the disabled.