Moderated by:
Molly Stice
Considerations when treating patients with special needs
Dental treatment and oral hygiene care for patients with special needs can be challenging due to their decreased manual dexterity and intellectual impairment. My dental school has a special needs clinic, so I have learned a few techniques to aid in better compliance with oral hygiene and better cooperation while in the dental chair. With the decreased manual dexterity, electric toothbrushes, dual-sided toothbrushes, and dental floss holders make it easier for them to brush and floss. The skinny handle on a toothbrush makes it difficult for them to grab and hold, so adding a tennis ball or a Velcro strap to the end of the handle makes it easier for them to hold and use. Also, it's important to instruct the caregiver on proper oral hygiene practices and show them how to help brush the patient's teeth. It's easier for the caregiver to stand behind the patient and cradle the patient's head in one arm while brushing with the other arm. As far as increasing cooperation while in the dental office, it is important to schedule short appointments typically in the morning or at the best time of day for the patient. Gradually exposing the patient to the dental office and dental equipment helps ease their nerves. Patients with special needs typically like routine and do not do well with change. Therefore, having the same staff, dentist and operatory will make them feel more comfortable and increase their cooperation. It is also helpful for the caregivers to have a routine when it comes to oral hygiene practices, such as brushing/flossing at the same time every day in the same room. Lastly, the tell-show-do technique is very helpful when performing a dental procedure on a patient with special needs. Trust is gained, anxiety is reduced, and cooperation is enhanced. These are some simple techniques I have found helpful when treating patients with special needs. What are your experiences with patients with special needs, and what are some other recommendations to improve cooperation and compliance?