Table 5.
First Author, Date, Reference | Type of Article | Sample Size | Article Key Points | Barriers and Limitations |
---|---|---|---|---|
Peak, 1992 [14] | Case report | 5 year old girl | Severe bruxism-gross attrition of canines and incisors, Bilateral masseteric hypertrophy, No caries Patient education, Relaxation techniques, Lower polythene occlusal splint, Sedation or GA recommended. |
None |
Ribeiro, 1997 [15] | Case series | 17 patients with mean age of 7.33 | Bruxism (n = 14/17) Non-physiological dental attrition Digit/hand sucking or biting, mouth breathing, drooling, tongue thrusting. Palatal shelving, anterior open bite Gingivitis 76% (n = 13/17) 2.7% tooth surfaces had dental caries. |
None |
Alpoz, 1999 [16] | Case Report | 5 year old girl | A girl with daytime bruxism. Dental wear, with near complete loss of the dental crown, albeit without exposure to pulp. The patient was offered nitrous oxide sedation and alginate samples were obtained to create a flexible splint for the upper jaw, to be used only when the parents were up and watched, because the patient was not bruxed at night. |
Single case study |
Kohyama, 2001 [17] | Review article | Review | Disturbance in phasic chin muscle activity during rapid-eye-movement sleep (REMS); an elevation of phasic inhibition index (PII), without disturbing of tonic inhibition index (TII) due to functional impairment of the pontine tegmentum. |
Reports on autistic tendency in SMEI (severe nocturnal enuresis, autism) patients were not found. |
Magalhães, 2002 [18] | Case series | 13 patients age 9 years. | Update on the oral (bruxism) and general aspect (stereotyped hand movements, scoliosis) of the disorder. Oral hygiene instruction Dental prophylaxis. Application of topical fluoride. Construction of bite-plane. Acupuncture |
Do not have the measure of the efficacy of bruxism treatment in Rett syndrome patients. |
Khalil, 2002 [19] | Case report | 7 year old girl | The girl weighed 14 kg, was weak, grinding her teeth constantly, and had a poor ability to open her mouth and stretch her neck. Importance of BIS monitor in inducing and maintaining level of anesthesia in children sensitive to drugs |
Did not measure the wear on the teeth so do not have the measure of the efficacy of bruxism treatment in Rett syndrome patients. |
Friedlander, 2003 [20] | Review | Review | Dentists caring for individuals with Rett, fragile X must be familiar with the manifestations of these diseases. They must also be familiar with the medications (anticonvulsants, anti-hypertensives, etc.) used to treat the associated behaviors as they might cause adverse reactions. | None |
Lavas, 2006 [21] | Original Research | 125 females with mean age of 19.6 years. | This study provides data describing Rett syndrome female difficulties from parents/caregivers aspect regarding eating, communication, functional and oral and dental problems. | The information from the study has been compromised to a small extent by the variation in the number of answers for different questions. |
Alfonso, 2007 [22] | Original research | 108 patients with mean age 31 years. | Protocol was planned and implemented coordinating with health care levels and workers, it provides necessary dental treatment to a large number of disabled people, who would not have received it otherwise. | It remains to be studied, the success or failure of treatments. A patient satisfaction and a cost analysis is still to be done. |
Green, 2008 [23] | Review article | Review | Early interventions make the symptoms of the disorder less obvious. Management strategies for pediatric ASD population (Rett syndrome) describing behavioral and drug therapy. | Communication problem, dentists should have patience understanding of this neurological condition. Educating parents and patients in preventive care is imperative. |
Manish, 2010 [24] | Case report | 8 year old girl | Four stages of Rett’s syndrome have been defined to help characterize the disorder and improve its recognition and diagnosis. Kids with Rett’s syndrome frequently display autistic-like symptoms at an early stage. Certain signs may include jumping on the knees, sleeping problems, a wide-spread gait, teeth grinding and chewing difficulty, slow growth, hallucinations, cognitive disabilities, and breathing difficulties when waking up, such as hyperventilation, apnea, and air swallowing. |
Limited case study |
Ji-sung, 2011 [25] | Case report | 19 year old girl | Many difficulties and issues for anesthetic management of RS patients, such as scoliosis and muscular tonicity and breathing abnormalities, ranging from centrally mediated hyperventilation to apnea, should be considered. Ante grade fiber optic-guided oro-tracheal intubation was possible to perform by an experienced anesthesiologist in patient with limited mouth opening. |
Management could not be carried out in an effective and comprehensive manner. |
Fuertes, 2011 [26] | Review article | 35 cases of RS patients from 1985 to 2007 | Drug-related oral manifestations include xerostomia, stomatitis, glossitis, erythema multiform, sialorrhea, gingivitis, dysphagia etc. Oral findings more prevalent in RS are bruxism, open bite, a high arched palate and gingivitis. |
Patient communication capacity. Controversy in bruxism treatment, Sample being too small. |
Morgan, 2012 [27] | Review article | Review | This review examined the effectiveness of interventions for oropharyngeal dysphagia in children with neurological impairment. The three studies included in the review examined oral sensorimotor treatments and lip strengthening interventions. | Insufficient randomized trials to evaluate the effectiveness of interventions for oropharyngeal dysphagia. |
Fuertes, 2014 [28] | Case control study | RS Patients = 41 Mean age [13.37 (±) 3.19 years], Control match group = 82 | Observational case-control study, followed the protocol of WHO for conducting health surveys. Data recorded by questionnaire and oral examination used to document caries indicators, CPI (Community Periodontal Index) and oral manifestations. Patients with RS: caries score was lower than the control group, they had increased frequency of periodontal problems, dental wear, drooling, high arched palate and anterior open bite. Oral habits of RS patients: diurnal bruxism, followed by stereotyped tongue movements and oral breathing. |
Limited case study. |
Aleksandra, 2014 [29] | Original research | 37 RS female patients of 2–31 years and 34 Gender- matched Control group of 2–30 years | RTT participants have more difficulty reading emotional expressions and these problems are linked to atypicalities in scanning. | Single problem for each pairing of familiar/novel expressions and secondly, use of a single familiarization time for each problem. |
Janas, 2015 [30] | Case report | 18 year old girl |
RS patients shall be sent to a medical center where appropriate medical and testing services and qualified personnel are available. Intra oral examination: teeth grinding—bruxism, difficulties in chewing and swallowing, neglect of oral cavity hygiene, oral inflammation with hypertrophic gingiva also many cavities in teeth. Extra oral examination showed hand wringing and washing movements, sudden lurching of the head towards the shoulder. |
No specific recommendations on behavior guidance for the dental examination of RS patients. |
Marvin, 2015 [31] | Review article | Review | Dentists may be the first healthcare providers to recognize that a 1- or 2-year-old child has some type of extraordinary pervasive behavioral disorder. | Treatment modalities are wide and tend to be of much error and no cure is present as these pervasive disorders present various entities. No reliable empirical biological tests (e.g., blood tests or brain scans) for ASD are reliable. |
Omer, 2016 [32] | Case report | 4.5 years old girl | Regional anesthesia should be preferred for suitable operations in patients with Rett syndrome since it reduces opioids, anesthetic requirements and postoperative respiratory depression. Patients with RS had a lower anesthetic dose requirement compared to the control group and suffered prolonged apnea at the postoperative period. |
Utilization of BIS monitored not done to follow anesthetic depth and to titrate the effect of anesthetic agent. |
Mezzedimi, 2017 [33] | Case study | 61 female patients with mean age of 13.6 years. |
Oral apraxia, dyskinetic tongue movements, prolonged oral stage, and poor bolus formation were the most common findings in all patients and progressive dysphagia was noted by caregivers. Useful instructions and suggestions for preventing dysphagia that facilitates in eating. |
Single case reported. |
Lai YYL, 2018 [34] | Case study | 242 females. |
Dental problems reported in severe genotype RS patients included gingival bleeding; and dental trauma from falls, bruxism or malocclusion. The incidence of restoration and extraction of teeth decreased with higher levels of income although extractions were more common than restorations. |
Limited patient collaboration. |
Pia, 2019 [35] | RCT | 5 female patients. | Treatment with botulinum toxin (BTX) for hyper salivation is effective in reducing saliva production that may help in oral motor functions such as eating and bruxism. | Missing data in income level analysis, the allocated age for the incidence calculations had varied implications for analysis and comparison of the data and finally unclear formal diagnosis of GORD were made. |