Evidence-based dental management in the new era of sickle cell disease

Hsu, Lewis L.; Fan-Hsu, Judy

doi:10.1016/j.adaj.2020.05.023

Cited by 13 publications

(14 citation statements)

References 92 publications

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“…The IAN becomes the mental nerve after emerging through the mental foramen. Compression, injury, or damage to the IAN near its exit from the mental foramen is thought to be the etiology of this jaw pain and paresthesia that has been reported in a small population of patients with SCD, termed “numb chin syndrome.”10 Although this patient’s facial swelling was nonodontogenic, this case emphasizes the importance of oral health in SCD because of increased vulnerability, such as dental caries and necrosis of the tooth, nerve, and blood vessels 11,13. The oral cavity can serve as a nidus for infection and be a cause for painful sickle cell crisis, leading to emergency hospital admission 11…”

Section: Discussionmentioning

confidence: 93%

“…She was determined to have a periosteal, localized effusion in the right masticator space, but no odontogenic lesion, and did well with noninvasive management. While previous reports have described this phenomenon,7–10 few reports were in the pediatric population, as recently reviewed 10,11. Sickle vaso-occlusive episodes can be associated with fever without infection.…”

Section: Discussionmentioning

confidence: 99%

“…10 Although this patient's facial swelling was nonodontogenic, this case emphasizes the importance of oral health in SCD because of increased vulnerability, such as dental caries and necrosis of the tooth, nerve, and blood vessels. 11,13 The oral cavity can serve as a nidus for infection and be a cause for painful sickle cell crisis, leading to emergency hospital admission. 11 The differential diagnosis for this patient included both bacterial abscess and noninfected effusion in periosteum and nearby localized soft tissues from infarction or vascular occlusion.…”

Section: Discussionmentioning

confidence: 99%

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Vaso-occlusive Pain Crisis Mimicking Mandibular Abscess in an Adolescent with Sickle Cell Disease

Rahim

Mbadiwe³

et al. 2021

Journal of Pediatric Hematology/Oncology

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In people with sickle cell disease (SCD), oral abscesses are concerning clinical conditions and carry a high risk of postoperative sickle cell complications. We present an unusual case of a 14-year-old girl with SCD whose initial presentation of facial swelling, headaches, jaw pain, and paresthesia mimicked an odontogenic abscess. She was diagnosed with vaso-occlusive crisis in the mandibular bone and successfully managed noninvasively. This is among the youngest cases of paresthesia in the lower lip in SCD, which provided a clue that postponing invasive aspiration or biopsy was possible under empiric antibiotics and close observation.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Vaso-occlusive Pain Crisis Mimicking Mandibular Abscess in an Adolescent with Sickle Cell Disease

Rahim

Mbadiwe³

et al. 2021

Journal of Pediatric Hematology/Oncology

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“…Management strategies for dental treatment of SCD patients lack of uniformity and dental professionals mostly base their treatment options on symptomatic therapeutic approaches and practical guidelines [3]. A scoping review concluded that evidence-based dental treatments specific for people with SCD are limited to case-control studies, case series and expert opinion [85].…”

Section: Dental Treatment/managementmentioning

confidence: 99%

Sickle Cell Disease: An Overview of Oral Health Considerations for Pediatric Patients

Eleftherou

Arhakis

Davidopoulou

2021

EJDENT

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Aim: This literature review aims to update the evidence for orofacial manifestations and current treatment recommendations for children and adolescents with sickle cell disease. Background: Sickle cell disease is a frequent hemoglobinopathy and a life-threatening genetic disorder. The lifelong condition is characterized by chronic hemolytic anemia and vaso-occlusive crisis that may occur in a variable range of clinical presentations in different regions of the body, including the oral cavity. Review results: This review explored the most common orofacial alterations of pediatric patients with SCD. Dental caries is a common finding in SCD pediatric patients, especially in those who are socio-economically vulnerable. Moreover, malocclusions occur in high prevalence in SCD pediatric patients. Other oral health complications seen in SCD patients include periodontal inflammation, bone changes, infections, mental nerve neuropathy, facial overgrowth, delayed tooth eruption, dental anomalies, pulp necrosis, soft tissue alterations and salivary changes. Dental infections may trigger a vaso-occlusive crisis leading the patient to a higher probability on arriving in hospital emergency departments and in need for further hospital admission to deal with the correlated complications. Thus, preventive dental care and non-invasive dental procedures are the principal focus in SCD patients in order to avoid possible subsequent complications. Conclusion: The review showed that in pediatric patients with SCD the risk for orofacial manifestations and complications depends not only on the presence of SCD but also on other confounding factors such as oral hygiene, diet habits and social conditions. Moreover, more well-designed epidemiological studies are necessary to assess the real link between SCD disease and its impact on stomatognathic health.

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“…However, the literature indicates that not all symptom heterogeneity can be explained by genetic factors. Patients with SCD often have other chronic health conditions and comorbidities that can benefit from coordination of their health care services 13,[19][20][21][22][23] . Asthma can especially exacerbate sickle cell disease complications 21 , and asthma care is well-known to benefit from community health workers interventions (CHW) 24 .…”

Section: Introductionmentioning

confidence: 99%

Healthcare coordination and medical expenditures for Sickle Cell Disease patients with different levels of health utilization risk

Hsu¹,

Wang

Munoz³

et al. 2022

Preprint

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Sickle Cell Disease (SCD) has a complex array of symptoms and is associated with high healthcare expenditures. A comprehensive care program may help to reduce expenditures of children with SCD. This research describes SCD comprehensive care program enrollees’ expenditure patterns by level of hospitalization risk over a three-year period and estimates whether coordination of care services reduced costs for those with different risk levels. Medicaid claims data were collected for program patients with SCD. Data from the one year prior to program enrollment categorized patients as High, Medium, or Low risk for incurring inpatient expenditures. We compared utilization risk groups on inpatient expenditures by year after program enrollment. The trends in expenditures are shown in the subgroup analyses (descriptively). 361 program enrollees ages 1 to 27y had SCD; 8.9% were categorized as High risk of utilizing hospitalization services, 47.9% were at Medium risk, and 43.2% were at Low risk. The High Utilization and Medium Utilization Risk groups showed trends of expenditure reduction, but the trends may be due to regression of extreme group costs toward the mean. The lack of a statistically significant cost benefit might be due to small sample size, low engagement in the program services, short duration of intervention, and inability to distinguish the appropriateness of healthcare utilization for SCD.

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Evidence-based dental management in the new era of sickle cell disease

Cited by 13 publications

References 92 publications

Vaso-occlusive Pain Crisis Mimicking Mandibular Abscess in an Adolescent with Sickle Cell Disease

Vaso-occlusive Pain Crisis Mimicking Mandibular Abscess in an Adolescent with Sickle Cell Disease

Sickle Cell Disease: An Overview of Oral Health Considerations for Pediatric Patients

Healthcare coordination and medical expenditures for Sickle Cell Disease patients with different levels of health utilization risk

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