Dentistry And People With Intellectual And Developmental Disabilities

IMG-20121230-WA0013As both a father to a young man with Autism (that’s my guy, Michael, to the right, giving me a big hug!) and as a dentist, I was terribly saddened to learn the results of recent study that examined the dental health of adults with developmental or intellectual challenges.

The Journal of the American Dental Association revealed these disheartening facts about this special needs population:

  • One third have untreated cavities;
  • 80% have gum disease; and
  • 10% are missing teeth.

Why does this population have such poor oral health?

There are many reasons to explain the study’s results, although absolutely none in my mind to justify them. Getting to the reasons, they can include:

  • Poor communication as many individuals with special needs have difficulty understanding their dentist’s or hygienist’s instructions;
  • Poor manual dexterity. It is not uncommon for people with cognitive challenges to also experience difficulties with respect to their fine or gross motor skills. This can make carrying out an effective oral hygiene routine difficult or even impossible;
  • Medication. Often people who take prescribed drugs can experience dry mouth as a side effect. This condition brings with it a host of potential dental problems;
  • Behavioural challenges. Many people with cognitive challenges find it difficult to sit still or tolerate a dental appointment.

Solutions to this serious problem

In this day and age, where we have at our disposal the marvels of modern dentistry and the impressive track record behind behavioral science, I feel that these statistics are completely unacceptable. The dental profession and society at large must work together to ensure that we bring about change and improve the dental health of this at-risk population, remembering that compromised oral health is not limited to the mouth. It can and does ultimately impact one’s overall health which makes this deficiency in our healthcare system that much more serious and in need of urgent attention.

Here are some tips that I suggest to the families and caregivers of people with special needs in my practice:

  • Provide as much information as you can. Talk to us – we are happy to take the time to learn and plan. The more we know in advance about each individual’s likes, dislikes and possible fears, the better equipped we can be to address them.
  • Do things gradually. The first time you bring in a patient with special needs, do so just for a quick visit. Introduce him/her to me and my staff, let us give him/her a tour of the office. The next time, just have him/her sit in one of our dental chairs and watch a bit of tv. Move as quickly or slowly with this “desensitization process” as necessary for your individual’s particular needs. If you need help with these and other steps, we’d be happy to guide you through them. The only thing we ask is that you book these practice visits with our front desk staff in advance to ensure that we can be well prepared to make each and every visit to our office an extremely positive experience.
  • Set up a support system at home to help your learner with special needs carry out an effective oral hygiene program. We are more than happy to help educate caregivers on how to do this.
  • Use visuals to help your learner achieve success in his/her oral hygiene routine. Videos, pictures timers and special devices like timers and ultrasonic brushes can be extremely effective in doing this. We can provide you with guidance in this respect as well.

In closing, I remind everyone of Mahatma Gandhi’s words of wisdom, “The measure of a civilization is how it treats its weakest members.”

Steven Deskin is a Brantford Dentist in general practice.

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