Hygiène Buccodentaire, Formes Cliniques des Lésions Carieuses et Parodontopathies chez les Enfants Handicapés dans Deux Centres Spécialisés de Yaoundé

RESUME Introduction et buts. Les personnes handicapees semblent predisposees aux pathologies bucco-dentaires, mais de nombreuses barrieres limitent leur acces aux soins bucco-dentaires adaptes. Notre but etait de decrire les caracteristiques sociodemographiques, le niveau d’hygiene bucco-dentaire en termes de caries et parodontopathies chez des enfants handicapes, et d’evaluer leurs besoins en soins. Methodologie. Cette etude transversale s’est deroulee d’Octobre 2015 a Mai 2016, dans deux institutions de Yaounde, specialisees dans la prise en charge et la promotion des personnes handicapees. Nos sujets etaient âges de 3 a 18 ans, avec pour chacun, une situation de handicap identifiee. Les consentements eclaires des parents avaient ete obtenus. Les donnees sociodemographiques et la nature du handicap etaient precisees, puis un examen bucco-dentaire complet etait pratique. Une valeur p inferieure a 0,05 etait consideree comme significative. Resultats. Notre echantillon comportait 242 sujets. Le retard mental, l’infirmite motrice cerebrale et la deficience visuelle etaient les handicaps les plus frequents : 25,2%, 15,3% et 14,5% respectivement. Les parodontopathies etaient retrouvees dans 83,1% des cas, notamment la gingivite 72,6%. La carie dentaire etait presente chez 77,7% des patients pour un indice CAO de 3,5. Les besoins en soins carieux d’urgence s’elevaient a 83 exodonties et 130 soins endodontiques. Conclusion. Les enfants handicapes dans notre contexte, presentent une pathologie carieuse et parodontale d’autant plus severe que leur consommation de prestations bucco-dentaires est faible. Des efforts supplementaires doivent etre faits a differents niveaux pour ameliorer les soins dentaires preventifs et curatifs dans cette categorie sociale. ABSTRACT Introduction and goals. Disabled children seem predisposed to oral pathologies, but many barriers hinder their access to adequate oral care. Our aim was to describe the socio-demographic characteristics, the level of oral hygiene pertaining to cavities and periodontal diseases in disabled children, and to evaluate their dental care requirements. Methodology. This cross-sectional study was carried from October 2015 through May 2016, in two institutions in Yaounde, specialized in the management and promotion of disabled persons. Our subjects were aged 3 to 18 years, with an identified handicap for each. The written consents of the parents were gotten. Socio-demographic data and nature of disability were obtained. Then, a complete dental examination was performed. A p-value less than 0.05 was considered as significant. Results. Our sample comprised 242 subjects. Mental retardation, Cerebral palsy and Visual deficiency were the most frequent handicaps: 25.2%, 15.3% and 14.5% respectively. Parodontopathies were found in 83.1% of cases, mostly gingivitis 72.6%. Tooth decay in 77.7% of patients with a DMF index of 3.51. Emergency requirements for dental care were evaluated as follows: 130 teeth to be extracted then replaced, and 83 teeth to undergo endodontic treatment. Conclusion. Disabled children in our context, have significant poor level of oral hygiene as their attendance of oral health services is low. Extra efforts are mandatory at various levels in order to improve preventive and curative dental care in this social category.