Caring for Patients with Special Needs

Caring for the dental health of someone who has a disability often proves challenging. A person with Alzheimer's disease, for instance, may neglect daily oral care and get defensive if a loved one or caregiver tries to help. Parkinson's, cerebral palsy, multiple sclerosis, and other conditions that affect movement can interfere with brushing and flossing. For those with Down syndrome or autism, even a routine cleaning can be traumatic.

Additionally, many of these individuals take medications that cause side effects, such as dry mouth, that contribute to decay. Some may not have seen a dentist in years. Finding a dental practice that specializes in treating people with disabilities and has the expertise to earn the trust of special needs patients can be a lifesaver to family members and caregivers.

Understanding the Challenges
Those caring for people who have special needs know all too well how factors related to an individual's disability impact everyday tasks that many of us take for granted. Dentists with experience catering to these patients are well-versed in the unique challenges commonly associated with conditions such as these:

Alzheimer's – As Alzheimer's disease progresses, symptoms of forgetfulness and dementia increasingly take a toll on a person's hygiene and daily routine. The patient may become confused and even combative. Caregivers' attempts to help may fall short. As a result, a person with Alzheimer's may require frequent cleanings and dental check-ups, and oral sedation and other comfort measures may be a necessity for even simple procedures.

Parkinson's – The tremors associated with Parkinson's make it progressively more difficult for those affected by the condition to control their movement. Fine motor skills required for brushing and flossing diminish. An estimated 40 percent of Parkinson's patients suffer from depression, as well. They also face an increased risk for dementia. Good dental health can contribute to a high quality of life, helping them continue to enjoy the pleasures of fine meals and conversation.

Cerebral palsy – In addition to problems with movement and mobility, many people with cerebral palsy can't swallow properly. An excess of harmful bacteria, which saliva usually helps wash out, remains inside the mouth. Spasticity, circulation challenges, and other neurological complications also contribute to poor oral hygiene. So, it's essential for patient health plans to include regular dental visits.

Down syndrome – A key to treating those with Down syndrome or other developmental delays is trust. It's important to assure these patients that they won't be harmed or restrained in any way. Because one of the hallmarks of Down syndrome is an enlarged tongue, many patients have overactive swallow or gag reflexes. Their immune systems also may be compromised, so measures to prevent the spread of infection and to proactively treat periodontal disease are crucial for this population.

Medications used to treat complications of these conditions frequently contribute to dental problems as well. Xerostomia, or “dry mouth,” is a common side effect. Symptoms include mouth dryness, burning sensations, difficulty eating, difficulty swallowing or speaking, sore throat, irritation of the tongue, and painful ulcerations. Since it is linked to eating problems, xerostomia can negatively impact nutrition, too.

A Compassionate Approach
Providing comprehensive dental care for people with disabilities requires a high level of expertise, patience, and compassion. Fortunately, advances in dentistry have significantly benefited special needs patients. Oral or intravenous sedation allows for even the most complex procedures while patients sleep. Less invasive procedures minimize recovery time. Even patient education has improved with new tools to help illustrate oral care techniques for both patients and caregivers. Overall, with a dentist who understands special needs patients, oral healthcare can be a positive an empowering experience for everyone involved.

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