Strategies and dental care in the treatment of patients with myelomeningocele.

Myelomeningocele (MMC) is a congenital malformation that occurs in the embryonic period, characterized by failure in closure of the caudal portion of the neural tube during central nervous system formation. Alterations and complications can be associated with this condition, such as hydrocephalus, neurogenic bladder, orthopedic problems, and motor and cognitive impairment. This patients with MMC also have predisposition to develop latex allergy and high caries risk and activity due to deficient oral hygiene, fermentable carbon hydrate-rich diet and prolonged use of sugar-containing oral medications. This paper reports the oral findings and dental treatment in a 15-year-old female patient diagnosed with MMC and describes the strategies used to improve dental treatment conditions and reduce the impact of associated risks to her health. The measures and precautions adopted in this case could be useful to reduce the barriers for patients with the same condition to access oral health care: regular visits to the dentist, initiating as early as possible; frequent reinforcement of oral homecare instructions and diet counseling; minor adaptions to the dental chair and dental office to improve ease of access due to patients' mobility problems; prevention of latex-related allergic reactions; reduction of gag reflex during dental procedures.