Relationships between daily total fluoride intake and dental fluorosis and dental caries

Objective： To explore the relationships between the daily total intake of fluoride, dental fluorosis and dental caries. Methods： An epidemiological method was used to investigate the daily total intake of fluoride, dental fluorosis, and dental caries among 236 and 290 children aged 8-13 years in a severe endemic area and in a non-fluorosis control area, respectively. The children were divided into eight subgroups according to each child＇ s estimated daily total intake of fluoride. The prevalence of dental fluorosis and dental caries in each group was calculated. Results： As expected, elevated levels of fluoride intake were significantly associated with a higher prevalence of dental fluorosis and an increasing amount of more severe defect dental fluorosis. When the daily total F intake was 2.78 mg/child/day, the prevalence of dental fluorosis was nearly 100%, with the prevalence of defect dental fluorosis increasing with increasing fluoride intake. There was also a significant negative（inverse） dose-response relationship between the daily total intake of fluoride and the overall prevalence of dental caries, the prevalence of which decreased when the daily total intake of fluoride increased up to 3.32 mg/child/day. However, at higher levels of daily total intake of fluoride the prevalence of dental caries increased, giving rise to a U-shaped dose-response relationship curve. Conclusion： It is important to monitor total fluoride exposure and protect children from excessive fluoride intake, especially during the years of tooth development.

Groundwater Quality and Its Impact on Health: A Preliminary Evaluation of Dental Fluorosis in Julimes, Chihuahua, Mexico

Medical Geology can be defined as the branch of geology dealing with the relationship between natural geological aspects and health in organisms (humans and animals), trying to determine the influence of ordinary environmental factors on the geographical distribution of health issues. The main goals of this research were: 1) to evaluate the severity of dental fluorosis (DF) and fluoride concentration in groundwater, used for human consumption, as an indicator of overexposure to fluorides, 2) to estimate the Community Fluorosis Index (CFI) in the Julimes municipality in Chihuahua, Mexico. Nine water samples were collected in four locations in the Julimes area: Hacienda Humboldt, La Regina, Colonia San Jose, and Julimes. Samples were collected and stored in accordance with the Mexican standard (NOM-014-SSA1-1993). All the samples exceeded the maximum permissible limit established in the modified Mexican standard (NOM-127-SSA1-1994) of 1.5 mgL-1 for fluoride in water for human consumption. Average concentrations of 2.74 mgL-1 were found in Colonia San Jose, 2.19 mgL-1 in La Regina, 2.17 mgL-1 in Julimes and 2.06 mgL-1 in Hacienda Humboldt. Dental Fluorosis diagnosis was evaluated using the Dean Index and the CFI applied to residents. A total of 100 inhabitants were examined, with interviews and oral examinations also carried out. Dental Fluorosis prevalence was 92% overall for the municipality, while for Colonia San Jose was of 100%, of 88.89% for Hacienda Humboldt, 88.24% for Julimes and 96% for La Regina. Dental Fluorosis’ severity for the Julimes municipality was distributed as follows: 2% normal, 6% questionable, 8% very mild, 13% mild, 19% moderate, and 52% severe. An average CFI was found for the four localities of 3.02 points, with a very notable impact on public health.

Complete oral rehabilitation in a case with severe dental fluorosis

The authors have presented a technique of full occlusal rehabilitation in a case of severe dental fluorosis. In this technique, maxillary and mandibular anterior teeth were simultaneously prepared and restored first. This was followed by simultaneous preparation of maxillary and mandibular posterior teeth that were restored in canine guided occlusion. The technique and sequence followed here is unique and is not available in dental literature. This technique reduces number of appointments while fulfilling all objectives. Periodontal followup over 3 years was satisfactory. A restorative treatment protocol has been devised for fluorosis which will act as a guide for the dental practitioners.

Fluorosis and Dental Caries in the Hydrogeological Environments of Southeastern Communities in the State of Morelos, Mexico

Objectives: 1) To identify the hydrogeological characteristics and fluoride (F-) concentration in drinking water in the southeast of the state of Morelos, Mexico, and 2) to estimate the association between the prevalence and severity of fluorosis, dental caries, and water F-?concentration. Methods: A hydrogeological model was developed to determine the vertical distribution of lithostratigraphic units, rocks’ hydraulic conductivities, and groundwater flow characteristics. A total of 649 schoolchildren from two communities received oral examinations. One community was located in an area with 0.75 mg F-/L in the water supply and the other in an area with 1.6 mg F-/L. Fluorosis was assessed using the Thylstrup & Fejerskov Index (TFI) and the dental caries were assessed with the decayed, missing, and filled teeth (DMFT) index. The region groundwater was extracted from an inter-granular aquifer consisting of volcano clasts of intermediate volcanic chemical composition. Results: Oral examinations showed that 32.35% of the children had severe forms of fluorosis (TFI ≥ 4) in the community with 1.60 mg F-/L and 7.8% in the 0.75 mg F-/L community (p < 0.0001). DMFT = 0.53 (±1.28) and 0.42 (±0.95) in the community with 1.60 mg F-/L and 0.75 mg F-/L, respectively (p = 0.2259). Conclusions: The increasing extraction of underground water was associated with deeper water flows and higher F-?concentration. In the community with high F-concentration, a third of the children showed objectionable levels of fluorosis. Adequate groundwater management actions are required to reduce fluorosis risk.

Fluorine in Water and Dental Fluorosis in a Community of Queretaro State Mexico

The community La Llave, Queretaro State, Mexico, has not been identified by the sanitary authorities as living in a hazard area related to dental fluorosis. However;a high concentration of fluoride is found in their drinking water causing them dental fluorosis. Physical-chemical analysis was carried out in the groundwater sources to determine the prevalence of dental fluorosis risk and caries accordingly to criteria of The World Health Organization, and 154 school children of ages 10 to 13 years were examined. As a result, 1.9 mg/L of fluorine concentration in drinking water was obtained;dental fluorosis presence was detected in the school children with an incidence of about 98%, in 47% of cases severe fluorosis with a dental caries index of 3.06 was traced. The groundwater sources in La Llave community contains fluorine above the limits dictated by Mexican regulations, producing serious repercussions on the health of school children, with an unnaturally high incidence of dental fluorosis.

Prevalence of Dental Fluorosis in Mianwali and Mardan Districts

This study was conducted to assess the level of dental flourosis and Decaying, Missing, Filled Tooth (DMFT) of selected patients, in district Mardan village Rustam and District Mianwali village Harnoli. Study was conducted among people of age 10 - 60 years. The regions of Rustam and Harnoli are known to have high value of fluoride in drinking water. A cross sectional study was conducted among the subjects and the grade of fluorosis was calculated according to Deans Fluorosis Index. DMFT of each subject was also calculated. Total of 100 subjects were selected by simple random sampling technique among the population of Rustam and Harnoli and they were observed for the extent of fluorosis they had along with the number of decayed, missing and filled teeth they had Most of the population uses underground water, the water people commonly used was collected and was tested for amount of fluoride. The results show that there is a strong relationship between fluoride level and extent of fluorosis. Populations of both areas have dental fluorosis due to high concentration of fluoride in drinking water and also comparatively low DMFT because fluoride has caries protective effect.

Prospects of 3D Printing Technology in Dental Medicine

With the continuous advancement of technology,the application of 3D printing technology in the field of dental medicine is becoming increasingly widespread.This article aims to explore the current applications and future potential of 3D printing technology in dental medicine and to analyze its benefits and challenges.It first introduces the current state of 3D printing technology in dental implants,crowns,bridges,orthodontics,and maxillofacial surgery.It then discusses the potential applications of 3D printing technology in oral tissue engineering,drug delivery systems,personalized dental prosthetics,and surgical planning.Finally,it analyzes the benefits of 3D printing technology in dental medicine,such as improving treatment accuracy and patient comfort,and shortening treatment times,while also highlighting the challenges faced,such as costs,material choices,and technical limitations.This article aims to provide a reference for professionals in the field of dental medicine and to promote the further application and development of 3D printing technology in this area.

Prevalence of Dental Anomalies among Patients Who Report to the Komfo Anokye Teaching Hospital’s Orthodontic Clinic

BACKGROUND: Dental anomalies are variations from the established well-known general anatomy and morphology of the tooth as a result of disturbances during tooth formation. They can be developmental, congenital, or acquired and may be localized to a single tooth or involve systemic conditions. AIM: To evaluate the prevalence of dental anomalies in patients who report to the Komfo Anokye Teaching Hospital (KATH) dental clinics. METHOD: A descriptive cross-sectional design was used with a sample size of 92 patients aged 18 or older, obtained through convenience sampling. Data analysis was performed using SPSS version 26.0. RESULTS: The study included 92 patients aged 18 to 72 years, with 47.8% males and 52.2% females. Dental anomalies were observed in 51.1% of participants, with a higher prevalence in females (55.3%). The most common anomalies were diastema (48.3%), impacted teeth (22.0%), dilaceration (11.9%), and peg-shaped lateral teeth (6.8%). CONCLUSION: This study highlights the importance of conducting thorough dental examinations to identify and address dental anomalies, which may have implications for treatment. Early detection and correction of these anomalies are crucial to prevent future complications.

Associated Factors of Dental Caries among Intellectually Disabled Persons in Specialized Centers of Ouagadougou

Introduction: Several studies have reported a high prevalence of dental caries among the people with intellectual disabilities. In order to identify the sociodemographic, clinical and behavioral factors associated with it, we conducted a study in specialized centers welcoming subjects with intellectual disabilities in Ouagadougou (Burkina Faso). Objectives: The objective of this study was to identify the factors associated with it among intellectually disabled in the specialized centers of Ouagadougou. Methods: The study was cross-sectional analytical. The survey took place between November 2020 and January 2021 among people with intellectual disabilities in reception centers receiving a grant from the Ministry of Women, National Solidarity, Family and Humanitarian Action. Data collection was done with a questionnaire adapted from the World Health Organization (WHO) and dental caries was recorded according to WHO criteria in decayed, missing or filled teeth generating a DMF index. Logistic regression was used to identify factors associated with the presence of dental caries. Results: A total of 193 participants were included in the study with an average age of 12.4 years ± 7.9. The overall prevalence of caries measured with the DMF index was 58.6% 95% CI [51.2 - 65.8]. It was significantly associated with female gender (OR = 4.2;95% CI [1.4 - 12.5], p = 0,01), the clinical form of mental illness (epilepsy OR = 3.8 95%;CI [1.2 - 12.7], p = 0,02, trisomy OR = 5.0;95% CI [1.1 - 22.9], p = 0,03, motor autonomy OR = 0.2 95%;CI [0.1 - 0.7], p = 0,01) and at use of toothpaste OR = 9.33;95% CI [1.05 - 82.7], p = 0,04. Conclusion: Dental caries remains a very present pathology in most people living with an intellectual disability. Also, it is necessary to put in place prevention strategies to reduce its prevalence and improve access to oral care for these people.

An overview of autophagy in the differentiation of dental stem cells

Dental stem cells(DSCs)have attracted significant interest as autologous stem cells since they are easily accessible and give a minimal immune response.These properties and their ability to both maintain self-renewal and undergo multi-lineage differentiation establish them as key players in regenerative medicine.While many regulatory factors determine the differentiation trajectory of DSCs,prior research has predominantly been based on genetic,epigenetic,and molecular aspects.Recent evidence suggests that DSC differentiation can also be influenced by autophagy,a highly conserved cellular process responsible for maintaining cellular and tissue homeostasis under various stress conditions.This comprehensive review endeavors to elucidate the intricate regulatory mechanism and relationship between autophagy and DSC differentiation.To achieve this goal,we dissect the intricacies of autophagy and its mechanisms.Subsequently,we elucidate its pivotal roles in impacting DSC differentiation,including osteo/odontogenic,neurogenic,and angiogenic trajectories.Furthermore,we reveal the regulatory factors that govern autophagy in DSC lineage commitment,including scaffold materials,pharmaceutical cues,and the extrinsic milieu.The implications of this review are far-reaching,underpinning the potential to wield autophagy as a regulatory tool to expedite DSC-directed differentiation and thereby promote the application of DSCs within the realm of regenerative medicine.

Conditioned medium from human dental pulp stem cells treats spinal cord injury by inhibiting microglial pyroptosis

Human dental pulp stem cell transplantation has been shown to be an effective therapeutic strategy for spinal cord injury.However,whether the human dental pulp stem cell secretome can contribute to functional recovery after spinal cord injury remains unclear.In the present study,we established a rat model of spinal cord injury based on impact injury from a dropped weight and then intraperitoneally injected the rats with conditioned medium from human dental pulp stem cells.We found that the conditioned medium effectively promoted the recovery of sensory and motor functions in rats with spinal cord injury,decreased expression of the microglial pyroptosis markers NLRP3,GSDMD,caspase-1,and interleukin-1β,promoted axonal and myelin regeneration,and inhibited the formation of glial scars.In addition,in a lipopolysaccharide-induced BV2 microglia model,conditioned medium from human dental pulp stem cells protected cells from pyroptosis by inhibiting the NLRP3/caspase-1/interleukin-1βpathway.These results indicate that conditioned medium from human dental pulp stem cells can reduce microglial pyroptosis by inhibiting the NLRP3/caspase-1/interleukin-1βpathway,thereby promoting the recovery of neurological function after spinal cord injury.Therefore,conditioned medium from human dental pulp stem cells may become an alternative therapy for spinal cord injury.

Hepatocyte growth factor enhances the ability of dental pulp stem cells to ameliorate atherosclerosis in apolipoprotein E-knockout mice

BACKGROUND Atherosclerosis(AS),a chronic inflammatory disease of blood vessels,is a major contributor to cardiovascular disease.Dental pulp stem cells(DPSCs)are capable of exerting immunomodulatory and anti-inflammatory effects by secreting cytokines and exosomes and are widely used to treat autoimmune and inflam-mation-related diseases.Hepatocyte growth factor(HGF)is a pleiotropic cytokine that plays a key role in many inflammatory and autoimmune diseases.AIM To modify DPSCs with HGF(DPSC-HGF)and evaluate the therapeutic effect of DPSC-HGF on AS using an apolipoprotein E-knockout(ApoE-/-)mouse model and an in vitro cellular model.METHODS ApoE-/-mice were fed with a high-fat diet(HFD)for 12 wk and injected with DPSC-HGF or Ad-Null modified DPSCs(DPSC-Null)through tail vein at weeks 4,7,and 11,respectively,and the therapeutic efficacy and mechanisms were analyzed by histopathology,flow cytometry,lipid and glucose measurements,real-time reverse transcription polymerase chain reaction(RT-PCR),and enzyme-linked immunosorbent assay at the different time points of the experiment.An in vitro inflammatory cell model was established by using RAW264.7 cells and human aortic endothelial cells(HAOECs),and indirect co-cultured with supernatant of DPSC-Null(DPSC-Null-CM)or DPSC-HGF-CM,and the effect and mechanisms were analyzed by flow cytometry,RT-PCR and western blot.Nuclear factor-κB(NF-κB)activators and inhibitors were also used to validate the related signaling pathways.RESULTS DPSC-Null and DPSC-HGF treatments decreased the area of atherosclerotic plaques and reduced the expression of inflammatory factors,and the percentage of macrophages in the aorta,and DPSC-HGF treatment had more pronounced effects.DPSCs treatment had no effect on serum lipoprotein levels.The FACS results showed that DPSCs treatment reduced the percentages of monocytes,neutrophils,and M1 macrophages in the peripheral blood and spleen.DPSC-Null-CM and DPSC-HGF-CM reduced adhesion molecule expression in tumor necrosis factor-αstimulated HAOECs and regulated M1 polarization and inflammatory factor expression in lipopolysaccharide-induced RAW264.7 cells by inhibiting the NF-κB signaling pathway.CONCLUSION This study suggested that DPSC-HGF could more effectively ameliorate AS in ApoE-/-mice on a HFD,and could be of greater value in stem cell-based treatments for AS.

Human dental pulp stem/stromal cells in clinical practice

Dental pulp stem/stromal cells(DPSCs)are fibroblast-like,neural crest-derived,and multipotent cells that can differentiate into several lineages.They are relatively easy to isolate from healthy and inflamed pulps,with little ethical concerns and can be successfully cryopreserved and thawed.The therapeutic effects of DPSCs derived from animal or human sources have been extensively studied through in-vitro and in-vivo animal experiments and the findings indicated that DPSCs are effective not only for dental diseases but also for systemic diseases.Understanding that translational research is a critical step through which the fundamental scientific discoveries could be translated into applicable diagnostics and therapeutics that directly benefit humans,several clinical studies were carried out to generate evidence for the efficacy and safety of autogenous or allogeneic human DPSCs(hDPSCs)as a treatment modality for use in cell-based therapy,regenerative medicine/dentistry and tissue engineering.In clinical medicine,hDPSCs were effective for treating acute ischemic stroke and human exfoliated deciduous teeth-conditioned medium(SHED-CM)repaired vascular damage of the corpus cavernous,which is the main cause of erectile dysfunction.Whereas in clinical dentistry,autologous SHED was able to rege-nerate necrotic dental pulp after implantation into injured teeth,and micrografts enriched with autologous hDPSCs and collagen sponge were considered a treatment option for human intrabony defects.In contrast,hDPSCs did not add a significant regenerative effect when they were used for the treatment of post-extraction sockets.Large-scale clinical studies across diverse populations are still lacking to provide robust evidence on the safety and efficacy of hDPSCs as a new treatment option for various human diseases including dental-related problems.

Self-assembly of differentiated dental pulp stem cells facilitates spheroid human dental organoid formation and prevascularization

BACKGROUND The self-assembly of solid organs from stem cells has the potential to greatly expand the applicability of regenerative medicine.Stem cells can self-organise into microsized organ units,partially modelling tissue function and regeneration.Dental pulp organoids have been used to recapitulate the processes of tooth development and related diseases.However,the lack of vasculature limits the utility of dental pulp organoids.AIM To improve survival and aid in recovery after stem cell transplantation,we demonstrated the three-dimensional(3D)self-assembly of adult stem cell-human dental pulp stem cells(hDPSCs)and endothelial cells(ECs)into a novel type of spheroid-shaped dental pulp organoid in vitro under hypoxia and conditioned medium(CM).METHODS During culture,primary hDPSCs were induced to differentiate into ECs by exposing them to a hypoxic environment and CM.The hypoxic pretreated hDPSCs were then mixed with ECs at specific ratios and conditioned in a 3D environment to produce prevascularized dental pulp organoids.The biological characteristics of the organoids were analysed,and the regulatory pathways associated with angiogenesis were studied.RESULTS The combination of these two agents resulted in prevascularized human dental pulp organoids(Vorganoids)that more closely resembled dental pulp tissue in terms of morphology and function.Single-cell RNA sequencing of dental pulp tissue and RNA sequencing of Vorganoids were integrated to analyse key regulatory pathways associated with angiogenesis.The biomarkers forkhead box protein O1 and fibroblast growth factor 2 were identified to be involved in the regulation of Vorganoids.CONCLUSION In this innovative study,we effectively established an in vitro model of Vorganoids and used it to elucidate new mechanisms of angiogenesis during regeneration,facilitating the development of clinical treatment strategies.

Hepatitis B Vaccination in Medical and Dental Students: A Cross-Sectional Study

Background: Medical and dental students are at risk of Hepatitis B Virus (HBV) infection. The study aimed to assess the vaccination status against Hepatitis B Virus of students in clinical and non-clinical years of a private medical and dental college, and their knowledge, attitude, and awareness about the subject. Methods: A cross-sectional study was conducted using a pretested, self-administered questionnaire among 203 medical and dental students of CMH Lahore Medical College and Institute of Dentistry (CMH LMC & IOD) in Lahore, Pakistan. Participants were evaluated for their knowledge and vaccination status against Hepatitis B Virus. Students were considered to be fully vaccinated (recipients of 3 doses), partially vaccinated (recipients of 1 or 2 doses), and unvaccinated. Comparisons were made between students of clinical and non-clinical years. Data was entered and analysed using Statistical Package for the Social Sciences (SPSS) version 23. Results: Only 66% (n = 134) of the 203 participants had ever received a Hepatitis B Virus vaccine out of which a meagre 17.2% (n = 35) were fully vaccinated. No significant difference was found in vaccine uptake between students of clinical and non-clinical years (p-value = 0.181) despite significant differences seen in the knowledge of vaccination schedule (p-value = 0.001), the prevalence of needle-stick injuries (p-value = 0.001), and knowledge of protocols to be followed after a needle-stick injury (p-value = 0.001). Conclusion: Our study found that a large proportion of the student population is vulnerable to HBV infection. There is a need to create awareness regarding the subject to increase vaccine uptake. HBV vaccination should be offered to all currently enrolled students and be made mandatory at the time of admission in the future.

Comparison of Oral Manifestations in Hospitalized COVID-19 Positive Patients and COVID-19 Negative Dental Outpatients. A Case Series Study and Literature Review

Background: The Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease, also named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which can cause various systemic manifestations that pose a threat to human life. Oral lesions in patients with COVID-19 may appear during or after the illness and may or may not be a consequence of the viral infection. Objective: In this case series we compare the oral manifestations in hospitalized COVID-19 positive patients and COVID-19 negative dental outpatients. Methods: 60 hospitalized COVID-19 patients and 41 control patients, were examined for oral signs and symptoms. The controls were dental patients who visited the hospital for dental care without complaining of any problems related to the oral cavity itself. Results: We have observed a strong association between certain clinical findings and COVID-19, including alterations in taste (ageusia, dysgeusia, and hypogeusia), anosmia, hairy tongue, tongue imprints, red tongue, erythematous candidiasis, pseudomembranous candidiasis, and exfoliative cheilitis. A trend but not statistically significant association at the level of 5% was also noted for colored tongue, linea alba, and pale mucosa. On the contrary, fissured tongue and oral mucosa pigmentation were more frequent in the controls, statistically significant at the level of 5%. Conclusion: COVID-19 has been found to impact the oral cavity, resulting in various oral lesions that can be attributed to either the direct action of the virus or the patient’s immune response.

Clinical trials using dental stem cells:2022 update

For nearly 20 years,dental stem cells(DSCs)have been successfully isolated from mature/immature teeth and surrounding tissue,including dental pulp of permanent teeth and exfoliated deciduous teeth,periodontal ligaments,dental follicles,and gingival and apical papilla.They have several properties(such as self-renewal,multidirectional differentiation,and immunomodulation)and exhibit enormous potential for clinical applications.To date,many clinical articles and clinical trials using DSCs have reported the treatment of pulpitis,periapical lesions,periodontitis,cleft lip and palate,acute ischemic stroke,and so on,and DSC-based therapies obtained satisfactory effects in most clinical trials.In these studies,no adverse events were reported,which suggested the safety of DSC-based therapy.In this review,we outline the characteristics of DSCs and summ-arize clinical trials and their safety as DSC-based therapies.Meanwhile,we also present the current limitations and perspectives of DSC-based therapy(such as harvesting DSCs from inflamed tissue,applying DSC-conditioned medi-um/DSC-derived extracellular vesicles,and expanding-free strategies)to provide a theoretical basis for their clinical applications.

Actual Practical Attitude and Knowledge of Dental Implants among Senior Dental Students and General Dentists Graduated from Some Saudi and Non-Saudi Dental Schools

Objective: To assess the actual practical attitude and knowledge of dental implants among senior dental students and general dentists graduated from some Saudi and Non-Saudi dental schools. Methods: A total of 300 senior dental students and general dentists participated in the study. Hard copies of the self-designed, multiple-choice questionnaires were distributed to all participants. The questionnaire consisted of 31 questions in five parts. Data were collected and analyzed using Chi-square test and t-test, where p Results: There is a statistically significant relationship between the participants’ answers, and their dental schools. Participants’ general knowledge, training, and teaching of dental implants, as well as information about restorations retained for the dental implants, were higher among participants from Saudi dental schools than participants from non-Saudi dental schools, while the information about dental implants was higher among participants from non-Saudi dental schools than participants from Saudi dental schools. Conclusion: We conclude that the actual practical attitude and knowledge of dental implants among participants in the current study was insufficient. Therefore, dental implant education in the undergraduate curricula of dental schools surveyed should be updated to include teaching, laboratory training, and preclinical and clinical training.

Managements of Special Health Care Needs Patients from Dental Assistant Point

The main role of this article is to describe dental assistants and the dental department’s role in the dental delivery system for Special health care needs (SCHN) by creating a structure to educate the dental assisting profession and project factors that have a significant impact on the dental assistant. The dental assisting management of SCHN patient’s profession including dental Assistance general responsibilities, regulation credentialing, and education. The SCHN patient’s management creates a challenge in all area of the dental department. Handling patient with a SCHN is underexplored throughout the dental staff especially when there is not enough theoretical foundation, education and training to deal with this category of patients. SCHN patients are defined as individuals who have abnormal behavioral impairments, mental conditions or/and chronic disease or abnormal laboratory results. Thus, the aim of this article is to guide all dental assistance staff in the best dental management choice for SCHN patients. All health care teams are part of patient care in most medical settings. A work environment supportive ensures positive outcomes for patient care. This article was considered as those categories of patients required more care and special way to deal with, moreover language, age, gender and education level of the patient are also considered significant parries. Not Many studies were found to support the care of SCHN patients in dentistry department. Taking experience from other area help to design a system to handle the SCHN even if it requires hiring a Dentist who is specialized in that filed.