{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T20:50:44Z","timestamp":1773089444367,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T00:00:00Z","timestamp":1612483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Special Care in Dentistry"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Joubert syndrome (JS) is a rare autosomal recessive inherited ciliopathy caused by gene mutation. Manifestations can include intermittent dyspnea, apnea, ataxia, and other nervous system abnormalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>The patient was a 21\u2010year\u2010old female with JS, severe intellectual disability, cerebral palsy, and epilepsy. Dental caries in both mandibular lower first molars was diagnosed by a local dentist, and the patient was referred to us for further treatment. Although her oral hygiene was good, the dental caries had reached the vicinity of the dental pulp. The caries had developed symmetrically on both first molars and was completely covered with the gingiva. As she was hesitant to receive treatment without anxiolysis, we considered using general anesthesia or intravenous sedation. However, we were recommended against it by the patient's family doctor because of the risk of apneic episodes in JS. Accordingly, dental treatment was performed over multiple days through physical behavior adjustment, while providing oxygenation (3 L\/min) in preparation for an apneic episode. The dental treatment was successfully completed with a good postoperative outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Dental treatment can be safely performed in patients with JS through physical behavior adjustment, thereby minimizing the risk of an apnea attack.<\/jats:p><\/jats:sec>","DOI":"10.1111\/scd.12572","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T06:48:25Z","timestamp":1612766905000},"page":"411-416","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Treatment of dental caries in a patient with Joubert syndrome without the use of sedatives: A case study"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8694-2469","authenticated-orcid":false,"given":"Yuki","family":"Oda","sequence":"first","affiliation":[{"name":"Department of Special Care Dentistry Hiroshima University Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keita","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Osaka Dental University Hospital  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiaki","family":"Furutani","sequence":"additional","affiliation":[{"name":"Department of Special Care Dentistry Hiroshima University Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuko","family":"Wakita","sequence":"additional","affiliation":[{"name":"Dental Hygienists Section Hiroshima University Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoko","family":"Hama","sequence":"additional","affiliation":[{"name":"Hiroshima Oral Health Center  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miwa","family":"Miyauchi","sequence":"additional","affiliation":[{"name":"Hiroshima Oral Health Center  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiyuki","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Special Care Dentistry Hiroshima University Hospital  Hiroshima 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and dental malformation and short stature in a patient with neurological problems: a variant of the oculodentodigital dysplasia syndrome or a new syndrome","volume":"6","author":"Shakiba M","year":"2012","journal-title":"Iran J Clin Neurol"}],"container-title":["Special Care in 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