CHAPTER 16 Special Needs Patient Care
BASIC PRINCIPLES OF CARE FOR SPECIAL NEEDS PATIENTS
Disability is a permanent or long-term condition, including physical, medical, psychological, and/or mental limitations, that requires individual consideration in planning treatment. Risk factors for NOT achieving oral health are listed when involved.
Levels of Function
Common Barriers to Healthcare
Americans with Disabilities Act (ADA) helped improve access to healthcare. Includes laws that govern wheelchair access to public buildings and restrooms, barrier-free public buildings, improved telecommunications for hearing- and vision-impaired individuals. Prohibits discrimination on basis of disability in employment, government, public accommodations, education, commercial facilities, telecommunications, and transportation. Dental offices are viewed as places of public accommodation. Special needs patients still face many barriers.
Box 16-1 American Dental Association Standards for Accessible Design
CLINICAL STUDY
Age | 17 YRS | SCENARIO |
Sex | Male Female | During an intraoral examination of a new patient, generalized moderate gingivitis is noted. The patient has not had dental radiographs taken for 2 years. He is unable to keep his mouth open, and communication with him is difficult. |
Chief Complaint | Unknown | |
Medical History |
Patient with Sensory Impairment
Patient with sensory impairment has loss of sight or hearing that makes communication and other daily living issues difficult. Sensory impairments often occur as result of infection, trauma, or disease, but some may be inherited.
CLINICAL STUDY
Age | 70 YRS | SCENARIO |
Sex | Male Female | Patient has kept regular dental visits and was seen 3 months ago for his routine maintenance appointment. On intraoral examination the newly hired dental hygienist finds that he has a very red marginal gingiva around #20, which is a full crown. |
Chief Complaint | “My gums are really bleeding on this tooth!” | |
Medical History |