Wednesday, March 6, 2013

Special Needs Patients

Special Needs Patients
People with special needs need dental treatment as much as those without special needs, yet they receive dental care less frequently. Special needs patients may have a mental or physical disability or have a chronic physical condition. There are community based dental programs which specifically aim to improve the dental health of special needs patients. If your community does not have any of these programs, any dentist is qualified to provide the care necessary for dental health. The most common special needs identified by the dental community are patients with immunocompromised disorders, autism, and Down ’s syndrome.

Immunocompromised patients and dental treatment

One challenge for the dental community is patients with immunocompromised disorders. Patients with immunocompromised disorders have issues that tend to be caused by tobacco use, malnutrition, and poor oral hygiene. Patients with leukaemia develop gingival bleeding and purpura. Patients with herpes viral infections develop lesions, ulcers, and periodontal disease. Patients with a low white cell count development oral lesions. This condition is controlled by antiretroviral medication. The dentist should be made aware of all conditions that an immunocompromised patient is afflicted with. The dentist will then take whatever special precautions are necessary to administer the dental services, while protecting the patient’s immune system.

Mentally challenged patients with poor oral health increase their struggle for social acceptance by allowing their teeth to deteriorate. Challenges to treating mentally ill patients include fear and lack of training on the part of dental professionals. Patients with Down’s syndrome and Autism are in the same situation.

Down’s syndrome and Dental treatment

Patients with Down’s syndrome many times have significant impairments of the mouth. Children who are afflicted with Down’s syndrome experience delayed development of the teeth and jaw. Sometimes the first tooth will not erupt until after the first 18 months and the complete set of teeth may not all appear until after three years of age. This, in turn, delays the adult teeth. It is not uncommon for Down’s syndrome patients to be missing adult teeth and many times the teeth are smaller than that of a patient without Down’s syndrome.

Patients with Down’s syndrome require a different approach to a routine dental appointment. The dentist and staff need additional time to explain the procedure and possibly move at a slower pace during the visit to allow the patient to develop a level of comfort. With Down’s syndrome adults and children, it is recommended that the procedure be demonstrated and then the patient be allowed to ask questions and express any concerns. Down’s syndrome patients have a larger and thicker tongue than other patients, which makes it a logistical challenge to accommodate the tongue during cleanings and examinations. In addition, patients with Down’s syndrome have reduced muscle tone in the mouth. This results in less rigorous chewing and additional food particles left in the mouth and on the teeth after eating. For the dentist, this means that cleanings may need to be scheduled more frequently and the patient should be educated on merits of brushing after every meal. The dentist would also want to take additional time to demonstrate the use of an electric toothbrush and floss holders.

Autism and dental treatment

Autism is a neurological disorder that emerges during the first three years of a child’s life. The syndrome affects the areas of the brain that are responsible for social interaction skills and communication. Delayed and reduced social skills, interactive speech limitations, and sensorimotor defects are the main symptoms of Autism. Children with Autism look just like any other child, but they experience challenges functioning and communicating in a social environment. Patients with Autism should be slowly introduced to the dental environment. Autistic patients will be comforted by bringing a familiar item with them for comfort such as a blanket or favorite toy. The caregiver is the best person to guide the dentist on the best method of approach, which would cause the patient the least amount of stress and anxiety in the situation. The dental staff should meet with the caregiver prior to the treatment to ensure that the patient is in a setting that they are comfortable with.
If you or a loved one has special needs, it is important to seek regular dental treatment. It is recommended that prior to making an appointment that you discuss the special needs with the receptionist and ask if their office can accommodate you. If their response is favorable, make an appointment to interview the dentist. Discuss with the dentist the full scope of the patient’s medical condition and what special needs he/she has. Ask the dentist if he treats other patients with special needs and what special training he has to address your specific needs. More often than not, this interview will allow the dentist to develop a treatment plan for the patient. Dentists are doctors committed to oral health. Most diseases and conditions have an effect upon the mouth, teeth, and gums and dentists understand the broad scope of treatments required.

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