Congenital insensitivity to pain with anhidrosis (CIPA) is a rare, autosomal recessive disorder; affected patients are characterized by inability to feel pain and to sweat over the entire body, as well as by mental retardation. Because, in the oral examination, no specific findings on soft or hard tissue may be found except possible lesions due to self-mutilation, early recognition and diagnosis are essential for these patients. Pediatric dentists must be aware of the clinical manifestations and treatment considerations related to uncontrolled body temperature, tactile hyperesthesia and lack of pain reflex. In this case report, dental management of CIPA was suggested by presenting a 6-year follow-up of young patient.
Body Temperature ; Dentists ; Diagnosis ; Diagnosis, Oral ; Follow-Up Studies ; Hereditary Sensory and Autonomic Neuropathies ; Humans ; Hyperesthesia ; Hypohidrosis ; Intellectual Disability ; Pain Insensitivity, Congenital ; Reflex ; Sweat

The purpose of this study was to analyze outpatient referral patterns of children in Jeonbuk National University Dental Hospital. All patients under 16 years old who were consulted from the external facilities were reviewed based on the electronic medical record of Jeonbuk National University Dental Hospital from 2015 to 2018.Total 720 boys and 460 girls with an average age of 7.4 years were referred from local dental clinic (85.2%) for treatment severity (90.2%). 3.2% of patients has disability with the highest number of intellectual disabilities. The patients were usually referred at the pre-treatment stage with higher rates if they had disability or medical problem. Referral rate by chief complaints was highest in surgery, followed by reparative treatment and orthodontic treatment. 2(nd) referrals in pediatric dentistry had a higher rate of referrals to minor surgery and pulp treatment than of first referrals. The time point of 2(nd) referral was relatively delayed with increased ratio of ‘during treatment’.These results suggest necessities of appropriate case selection and referral based reasonable criteria for pediatric dentist.
Child ; Dental Clinics ; Dentists ; Electronic Health Records ; Female ; Humans ; Intellectual Disability ; Jeollabuk-do ; Minor Surgical Procedures ; Outpatients ; Pediatric Dentistry ; Referral and Consultation