Quartz 4

1. Special Needs Dentistry

3 min read

Definitions and Parametres12

Special Needs Dentistry

  • Is that part of dentistry concerned with the oral health of people adversely affected by an intellectual, medical, physical or psychiatric disability, regardless of age.
  • Helping anyone who has a disability that prevents them from what we call normal dental health.
  • Is dentistry for basically anyone who has a disability (who can’t independently care for their own oral health).
  • Is a continuum of care—babies→ children→ adults→ geriatric patients.
  • Geriatric person=65+
  • Geriatric patient=any compromised adult with one or more chronic, debilitating medical, physical, mental or psycho-social problem.

Traditional Groups of Special Needs Patients

  • Traditionally there are 3 groups of Special Needs Patients:
    • Hospital inpatients and outpatients that are medically compromised.
    • Intellectually and/or physically disabled & patients with chronic mental illness
    • Frail & functionally dependent older adults.

Community Locations of Special Needs Patients3

Where do patients with disabilities live? LOCATIONS:

  1. At home
    • Living alone—with or without community assistance
    • Living with their parents
    • Living with their children
  2. Residential care—retirement villages with tiered levels of med. care
  3. Aged care facilities (nursing homes)
  4. Hospitals/Mental hospitals
  5. Ronald McDonald Houses
  6. In prisons
  7. On the streets

Although at any one point in time, only a small proportion of our older population lives in residential care, the likelihood of the future need for the use of residential care is high. Older adults (65+) will require permanent housing and doubles for 80+. Higher for females. Why?

Dental Considerations of the Special Needs Patient4

Considerations

  1. Communication (patient and carer)
  2. Time management (app’t. length/pt. stamina-how long can they sit?)
    (Bathroom breaks here at the Dental School!)
  3. Access to the oral cavity / limited by your equipment
  4. Patient’s capacity to understand
  5. Ability to get patient into chair
  6. Ability of patient to cooperate
  7. Consent
  8. Current health status
  9. Radiographs?
  10. Shaking & other unexpected pt. movements
  11. Financial
  12. Denture labelling

Common Dental Diseases and Causes5

  • Caries (especially root caries) and Periodontal Disease are the 2 most common dental diseases in this group of patients.
  • The primary cause of these conditions is inadequate oral hygiene, either by the patient or carer.
  • Dentures may not be cleaned properly either and mucosal lesions of fungal origin may occur.

AODL (Activities of Daily Living)6

  • ACTIVITIES OF DAILY LIVING include:
    1. Talking
    2. Eating (food selection) & Chewing (no. of times) & Swallowing
    3. Brushing & Flossing
    4. Rinsing
    5. Walking
    6. Seeing & Observing
    7. Hearing
    8. Dexterity
    9. Source of Income
    10. Ability to go to shops
    11. Cooking & Cleaning
    12. Toileting

If the patient cannot carry out these activities, the carer is the most important person in their lives. Carer’s training is imperative!

Footnotes

  1. Original PDF page 1: L1 Special Needs, p.1 ↩

  2. Original PDF page 2: L1 Special Needs, p.2 ↩

  3. Original PDF page 3: L1 Special Needs, p.3 ↩

  4. Original PDF page 4: L1 Special Needs, p.4 ↩

  5. Original PDF page 5: L1 Special Needs, p.5 ↩

  6. Original PDF page 6: L1 Special Needs, p.6 ↩

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