Journal of Dental Medicine

Background and Aims: The status of oral diseases in children with visual impairments is a topic of concern for dental researchers. The aim of this study was to evaluate the rate of dental caries in these children according to the PUFA index.
Materials and Methods: To evaluate the rate of tooth decay, sixty 6-12 year old children with visual impairments were selected by convenience sampling in 2022 in Isfahan-Iran. The examination and pufa/PUFA index (exposed pulp, residual root mucosal ulcers, fistulas, and abscesses) were recorded.  Data were analyzed with Mann-Whitney tests (comparison of pufa/PUFA index according to gender, type of disorder and severity of disorder) and Spear-Man (examining the relationship between pufa/PUFA index and child age).

Results: The means of pufa/PUFA index in primary and permanent dental systشems were 0.89±0.68 and 0.44±0.2, respectively, of which the highest portion was related to the caries with pulp involvement. There was no significant relationship between the pufa and PUFA index according to gender, type of disorder, and severity of visual impairment (P<0.05). Also, only a significant and direct relationship was observed in pufa between the primary tooth system and age (P=0.042).

Conclusion: Untreated caries in children with visual impairment based on the PUFA index in primary and permanent dental systems had a relatively low prevalence. The highest  PUFA index portion was related to the tooth decay with pulpal involvement. Furthermore, untreated caries in primary teeth were increased by increasing the children’s age.

 This article presents a challenging case of a 64-year-old man with episodic fever, urticarial rash, and arthralgia, prompting a detailed diagnostic process. Despite initial considerations of adult-onset Still's disease, the atypical symptoms led to further investigations, revealing a periapical abscess through a dental examination. The patient's symptoms significantly improved following dental intervention, challenging the initial diagnostic inclination towards a rheumatological disorder. This case underscores the importance of thorough physical examinations and interdisciplinary collaboration in reaching accurate diagnoses. The ultimate diagnosis of systemic presentation due to an occult dental abscess, highlights the need for a comprehensive approach to medical evaluations, considering various clinical aspects and avoiding diagnostics biases. This case study serves as a reminder of the evolving landscape of medical diagnostics and the continued significance of holistic patient assessments and physical examination as valuable practicing skills.