1171H
Fig. 17.23 Dental chair with moulded
cushion supports (courtesy of Dr Bitte
Ahlborg, Mun-H-Center, Sweden).17.4.2 Oral health and operative procedures
There is little in the dental literature to suggest that the oral/dental health of children
with spina bifida is different from other children with impairments. The same
principles of treatment apply to these children as to others who are impaired, namely
aggressive prevention and early intervention with a radical approach if dental
treatment under general anaesthesia is required.
17.4.3 Home care
The issues relevant to spina bifida have been covered in the appropriate sections
under intellectual and physical impairment.
17.5 PHYSICAL IMPAIRMENT⎯MUSCULAR DYSTROPHY
17.5.0 Introduction
Muscular dystrophy is a group of muscle diseases which present as progressive
atrophy and weakness of skeletal muscles with resultant disability and deformity. The
muscle fibres degenerate and are replaced by fatty and fibrous tissue. The disease is
eventually fatal as a result of recurrent respiratory infections. Prevalence rates in
children are of the order of 4 per 100,000 children.
17.5.1 General considerations
The child with muscular dystrophy will initially be mobile but as the disease
progresses, they will become reliant on a wheelchair to move around. A respirator
will be necessary in the later stages of the disease and patients are then confined to
home or to residential care. There are a number of variants of the disease with
different signs and symptoms. Males are exclusively affected in the Duchenne-type,
while facial musculature is always affected in the fascioscapulohumeral-type, but
rarely in other forms.
17.5.2 Oral health
The oral/dental effects of the disease are numerous and include: