Title page with text "SPECIAL NEEDS DENTISTRY" # Definitions and Parametres - **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. - 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. # **Definitions and Parametres** ## **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 PATIENTS** - **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? # **Community Locations of Special Needs Patients** **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 PATIENT - **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 # **Dental Considerations of the Special Needs Patient** ## **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 **DENTAL CONSIDERATIONS OF THE SPECIAL NEEDS PT. CON’T.** - **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.** ## **Common Dental Diseases and Causes** - **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** 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!* # **AODL (Activities of Daily Living)** - **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!* [[L1 Special Needs.pdf#page=1|L1 Special Needs, p.1]] [[L1 Special Needs.pdf#page=2|L1 Special Needs, p.2]] [[L1 Special Needs.pdf#page=3|L1 Special Needs, p.3]] [[L1 Special Needs.pdf#page=4|L1 Special Needs, p.4]] [[L1 Special Needs.pdf#page=5|L1 Special Needs, p.5]] [[L1 Special Needs.pdf#page=6|L1 Special Needs, p.6]]