Dental Case Study Case Study

Dental Case Study

The patient in the case that is presented is a Latino male just over 13 years old. He has sickle cell anemia, and suffers from an intellectual disability. This paper reviews the case study from a dental health perspective.

What is sickle cell anemia? The genesis of this disease is found within the abnormal hemoglobin in the blood stream; the red blood cells that carry oxygen throughout the body change shape when the individual has sickle cell anemia. Hemoglobin S. has the effect of changing the shape of the red blood cells so that they become "…fragile, sickle-shaped" and they bring less oxygen to the tissues of the body (National Library of Medicine). Moreover, the shape of the changed red blood cells means that cells can become "stuck more easily in small blood vessels" and they also break into many pieces which of course reduces the amount of oxygen to the body's tissues. The patient suffers from fatigue, from a rapid heart rate, his eyesight suffers, he has ulcers on the lower legs in many instances and his ability to think is reduced (National Library of Medicine). Painful episodes may last for several days; they are called "crises" and when a sickle cell patient has a crisis he is in severe pain (the bones in the back and chest are especially vulnerable to these attacks) (National Library of Medicine).

Why was this patient chosen for a case study -- what are his needs? According to author Amr Moursi, Associate Professor and Chairman of the Department of Pediatric Dentistry at the New York University College of Dentistry (Moursi, 2012), the 13-year-old was a recent immigrant to the U.S. from the Dominican Republic, and he clearly needed to see a dentist for his decaying teeth.Brief background: His mother speaks only Spanish but his father is bilingual so when the boy goes to the hospital (he has been hospitalized four times for sickle cell crises) both mother and father are present. The father indicated that the boy was "extremely resistant to oral home care," and as a result he doesn't brush his teeth. He was been on penicillin prophylaxis through the first nine years of his life but when he went to the dentist he was not on any medication. The hematologist asked that the boy be admitted to the hospital for a day when the dental work was to be conducted.

He needed to be placed under general anesthesia (GA) and needed to be monitored for his levels of hemoglobin; the doctor believed that a blood transfusion may be necessary. Because he is a patient with sickle cell, prior to his treatment the dentist needs to know: when his last vaso-occlusive crisis occurred; was there any damage to any organs; his history of transfusions; what infections has he had; and what psychosocial issues he has experienced recently.

Dental care and dental examination for this patient: The patient has a "highly cariogenic" diet because….....