2020, Number 1
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Odovtos-Int J Dent Sc 2020; 22 (1)
Management of a Child with Reactive Attachment Disorder in the Dental Clinical Setting: A Case Report
Garrocho-Rangel A, Romero-Huízar H, Ruiz-Rodríguez S, Campos-Lara NP, Pozos-Guillén F, Pozos-Guillén A
Language: English
References: 19
Page: 39-46
PDF size: 735.62 Kb.
ABSTRACT
Reactive attachment disorder (RAD) is an early childhood mental health
disease characterized by impaired social interactions and communication abilities,
and neurological deficits in the child’s developing brain. This disorder can significantly
affect the pediatric patient’s behavior in the dental setting. An uncooperative 9-yearold
Mexican girl, who was residing in a temporary home, was referred by a general
dental practitioner to the Postgraduate Pediatric Dental Clinic with her caretaker,
requesting dental examination and treatment. The patient presented with a previous
diagnosis of RAD with intellectual/social disability. With the psychiatrist’s guidance,
an exhaustive oral prophylaxis was carried out in the initial appointments, followed
by diverse restorative treatments under the continuous application of behavioral
management techniques. These restorative procedures included resin restorations
and pit-fissure sealants, under local anesthesia and rubber-dam isolation, on the first
four permanent molars. The entire treatment was completed in six weeks. The patient
and her caretaker were provided with detailed educational and motivational strategies
for improving the patient´s oral hygiene, and they also received nutritional advice. For
control reviews and the reinforcement of preventive habits, future appointments were
carefully scheduled. An interdisciplinary pediatric collaboration between the dentist,
nurse, and psychiatrist was fundamental for improving the patient’s oral health and
general welfare.
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