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This case report describes a 12-year-old child diagnosed with cerebral palsy who was attended in the dental service in October 2012 with a chief complaint of caries. The dental history revealed that the child had difficulty in opening his mouth, chewing, and swallowing. In the intraoral examination, the patient had an atretic palate, fibrous gingiva, gingival bleeding, malocclusion, and presence of calculus in the supra and subgingival regions and presented epilepsy and low weight. In the complementary examinations, blood pressure was checked and the blood count was read. The treatment plan was done with scraping in the upper and inferior jaw, 4 sessions of polishing, and prophylaxis. During the treatment, the surgical removal of elements 44 and 42 was performed, and it was decided to perform another tooth extraction, after the complete healing, of element 31. The patient was followed up by the service for 5 years and died in 2017.

Hydrocephalus is a pathology characterized by increased head circumference and intracranial pressure with cerebrospinal fluid expansion. Goldenhar syndrome is a congenital anomaly due to errors in morphogenesis, causing variations in the face, ears, and vertebra, constantly associated with other congenital visceral malformations. This article aims to describe the case of a 5-year-old boy diagnosed as having hydrocephalus associated with Goldenhar syndrome. He was referred by a multidisciplinary medical team for the dental evaluation to adapt the oral environment because of the high tooth decay occurrence. This adequacy was achieved through prophylaxis, fluoride application, supervised brushing, restorations, periapical radiographs for exodontia, and educational activities with those who take care of the patient. The team concluded that treatment should be carried out with a multidisciplinary approach, seeking to improve the appearance and functionality of the affected structures and aiming at preventive control to ensure their psychosocial integration.

The 22 q11.2 deletion syndrome, also known as DiGeorge syndrome, is the subject of the loss of a submicroscopic segment of DNA in the 22 q11.2 region. It presents a great variability of clinical characteristics in affected individuals. Among the clinical manifestations are fissure of the palate, nasal speech, cardiovascular problems, and dysmorphic facial features. This case report describes a 15-year-old girl, clinically diagnosed as having DiGeorge syndrome, who attended a dental service for patients with special needs presenting with malocclusion, difficulty in chewing, and suspected heart disease. The patient was diagnosed with mixed developmental disorder and epilepsy, both uncontrolled, presenting pictures of hallucinations in the dental chair. The treatment plan was established through panoramic radiography, complete blood count, and medical release. Restorations, prophylaxis, scaling with fluorine application, and exodontia of elements 74, 83, and 84 were realized. The patient is still being treated at the dental health service.

The dentigerous cyst is the second odontogenic cyst that most affects the maxilla. The patient attended in service of oral pathology in 2015 with asymptomatic lesion and without paresthesia, hypoesthesia, or other complaints in the maxillary sinus. Extraoral examination showed volume increasing in the left middle third of the face and exophthalmos of the left ocular globe. Radiography revealed delimitation and extension of area. Aspiration puncture confirmed the cystic nature. Incisional biopsy was performed with histopathologic diagnosis of dentigerous cyst. The treatment consisted in marsupialization and monthly analysis of the lesion regression for 1 year and 6 months along with a tomographic examination, obtaining satisfactory regression. The patient was submitted to surgery removing the entire lesion and associated tooth. After 2 months of follow-up, the patient is in good general condition, without signs of recurrence and without sensory or motor deficit.

Down syndrome is a chromosomal disorder caused by trisomy in chromosome 21.The oral cavity manifests many changes induced by the environment as well as alteration in immune system. The objective is to report a 12-year-old male pediatric dental patient who is attended in the dental care service for patients with special needs. He was a heart patient and a carrier of Down syndrome, presenting aggressiveness and endurance on the dental attendance. His problem was a toothache; however, the clinical examination verified mixed dentition, periodontal disease, high incidence of dental caries, malocclusion, staining on teeth, mouth breathing, narrow palate, and macroglossia. The treatment was accomplished through adequacy, prophylaxis, fluoride application, restorations, periapical radiography to exodontia, and the "hug technique." The importance of orientation about the dental health care of patients with Down syndrome to the professional teams is essential, beyond proper procedure and knowledge about the oral characteristics and how a dental surgeon could act to promote the integrality.