In the field of dentistry, a special needs patient is a person with a physical, medical, intellectual, or developmental diabilities that affects their ability to maintain good oral health or receive standard dental treatment. Some examples include people with Down’s syndrome, AHDH, Alzheimer’s disease, autism, arthritis, or paralyzed people. These individuals have a higher risk of developing oral pathologies (in some cases life-threatening) than the able population, and also have a high need for preventative dental treatment from an early age. Fortunately, alternative dental services have been developed to effectively treat individuals with special needs.
In special needs dentistry, certain accommodations are provided to make visiting the dentist easier for the patient. Dental practices offering special needs dentistry are equipped with disability-friendly amenities such as: disabled parking privileges; wheelchair ramps; specialized reclining wheelchairs; walkers; and special dental chairs.
Some special needs patients, such as those with autism or ADHD, may have strong, negative reactions to the restrictiveness of the dental chair or to dental tools. A special needs patient who finds it hard to sit still, or who is crying or screaming, is very difficult to treat, and the risk of injury to the patient is also increased. Thus, while special needs dentistry seeks to make dental treatment safer and more comfortable for the patient, another goal is to make it easier for the dentist to do his or her job. In this sense, another aspect of special needs dentistry is providing solutions like sedation, papoose boards, and noise reduction headphones to relax or restrain the patient.
A critical component of special needs dentistry is the level of skill and comfort that the dental care staff has when it comes to dealing with special needs people. While many dental professions are trained in things such as proper ergonomic techniques when lifting a patient, there is much to be said for a dentist’s chair-side manner when dealing with a special needs person. Patience and compassion are crucial aspects of successful special needs dentistry and should always be taken into consideration when seeking dental care for a special needs person.
Maintaining oral health with good dental care is very important for patients with Down’s syndrome. Children with Down’s syndrome usually have serious dental development issues including malformed, missing, and misaligned teeth. In addition, individuals with Down’s syndrome have a very high rate of gingivitis and periodontal disease and need frequent deep cleanings to keep periodontal disease from progressing and causing tooth loss.
Most Down’s syndrome patients also have serious bite problems that require orthodontic correction. Complicating the dental care needs of the Down’s syndrome patient is the low manual dexterity and intellectual impairment present and the low tolerance of oral care by caregivers. The result is a generally poor level of home oral care.
At the same time that Down’s syndrome patients are in need of professional dental care, most patients have a very low tolerance for dental care in a traditional dental office. Compounding this problem is that most dental offices lack the experience and the patience necessary for handling Down’s syndrome dental patients. Some patients can learn to tolerate short periods of time in a dentist’s chair, but even these patients cannot tolerate the often extensive and invasive dental procedures that Down’s syndrome patients require.
Sleep and sedation dentistry is an excellent alternative for providing much needed dental care to Down’s syndrome patients an other dental patients with developmental disabilities in a safe and humane manner. Dentists who specialize in sleep and sedation dentistry have additional training in performing dentistry on patients who are much more sedated than in traditional dentistry. These dentists use advanced sedation techniques including deep conscious sedation and full unconscious sedation.
Depending on the procedures to be performed and the needs of the patient, the sleep and sedation dentist will determine the appropriate sedation level. Some procedures can be performed in the dentist’s office while others may be done in a specially equipped surgical suite or hospital operating room. Sleep and sedation dentistry allows special needs patients to get the dental care they need safely, painlessly, and free of anxiety.
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