Sunday, May 23, 2010

Special Needs Patients and Pediatric Dentistry














Special Patients.... Aren't all patient's special? Yes, of course, but there are those who require additional attention and care. These patients are generally classified as "special needs" patients. These are children (and adults) that have medical conditions which can limit their ability to fit comfortably into the normal routine of a dental office. They may have difficulty communicating, cooperating or have physical limitations of one sort or another. Children with Down syndrome or Cerebral Palsy make up most of the patients in this group. There are many other syndromes or handicapping conditions that can require special attention from the doctor and staff in the dental office. Many special needs patients we see have no mental deficits or problems, it's only physical limitations. Others have very severe disabilities.

Working with these patients can be difficult, but can also be quite rewarding. Some of the sweetest and most fun times are with our Down syndrome patients. (The picture here is of John Mark Stallings, son of former Alabama football coach Gene Stallings.)

Routine dental exams and cleanings can be a challenge, not only for the parent or caretaker, but of course for the dental team. X-rays are often not possible and just getting a good look can be very difficult. How do we do fillings or other more technically precise procedures if the patient is moving or unable to cooperate? Well, that's where Pediatric Dentists use their training and experience to find the best solution to a difficult problem. Many times special needs patients are treated in a similar manner as other patients. In some cases, however, the use of general anesthesia is the preferred method. Being asleep for dental treatment allows, x-rays, good dentistry all with the patient pleasantly asleep during the procedures. In addition to health concerns, Down syndrome patients often have specific dental problems like delayed eruption of teeth. There is often a higher incidence of missing and malformed teeth as well. Patients may develop malocclusions where normal orthodontic treatment modalities are limited. Many special needs patients have difficulty maintaining good oral hygiene.

One cannot state the profound satisfaction of working with special needs patients. The parents of these kids are quite amazing. Some of these "children" are in their 30's+, so the parents are much older than that, but they still show a loving dutiful caring for their children.

24 comments:

William Taylor said...

Thank you so much for this blog. For the rest of us who are not educated in dentistry these things can be terrifying. It means a lot to have folks like you sharing info in such a helpful way - and to see comments from others sharing the same problems.

I wanted to post questions on another subject you discussed awhile back (pedo partial) but the comments were locked in that section. Is there a better place to comment on past information, or even a way to contact you directly?

Thanks so much.

Dr. Dean Brandon said...

Comment where you like. Comments are generally closed when the comments and discussions there are rather complete and very extensive. I think you will find lots of info there.

Mark said...

Hey nice blog!

Your post is pretty useful for the dental community. Thanks for taking the time and effort.
There’s a free clinical webinar that you might wanna check out. It is titled “Pediatric Dentistry Pearls” and will be conducted on June 17, 2010 from 7-8pm EST. It’s gonna be presented by Dr. Lance Kisby. Anyone interested can register on: http://www.e-dds.com/form.asp

Mark

Pol said...

nice blog!!!

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pediatric emr said...

Thank you so much for this wealth of information. Remember prevention is better than a cure,so make sure that you have an eye care examination.

jayn

Celso - Long Beach Invisalign Braces said...

Thanks for sharing info on pediatric dentistry and dental care for special people and the special attention needed by them.

You have to adjust to their behavior and personalities in order to perform dental care.

Working with them might be difficult, but the emotional rewards are priceless.

Caring for others comes first.

Cosmetic Dentists Grants Pass said...

Somehow, I think, medical and dental providers also have a duty to be as dutiful to "special" patients like their parents are to them

Dentists Torrance said...

Thanks for bringing up such a relevant topic. Special needs patients require more care and attention, so dentists need to be armed with the proper knowledge of how to handle these patients the best way possible.

Dr. Dean Brandon said...

Just to be clear, any dentist (general or specialist) can make treatment of special needs patients a priority with proper effort and education.

dancilhoney said...

It's hard to find great service so I will be returning with and future dental needs at dentist in chandler

Joel said...

Dental practice for patients who needs special treatment is very challenging. Good thing that there's a (Chicago) sedation dentist who can manage the painless procedure for dental surgery. IV or Intravenous sedation is an effective drug to be used for dental practice. If a patient takes a dosage of IV, he will feel drowsy and fall asleep in a minute. With that, it would be easy for cosmetic dentist (Chicago) to do dental operation and the patient won't feel the pain.

Western Dental said...

I'm really glad to see you addressing this sensitive topic. Special needs patients do require more time and care. Thank you for the informative blog entries.

Western Dental

Air Techniques, Inc. said...

Communicate with a person who has special needs and extend more patience. If possible, talk to the patient on his or her level of understanding.

Brazilian Dentist said...

Very good post of special patients. They need special cares e must have a different treatment.

Dr. Dean Brandon said...

I do worry how some special needs patients receive care after they turn 18 or 19 years old. For low income families, Medicaid expires around that time. We see many patients beyond that age. Of course Pediatric Dentists are well trained to see patients with special needs or developmental disabilities. Still, there are only so many of us. Hopefully, the general dentists our there will educate themselves and also be able to treat these folks. It certainly is appropriate for a 35 year old patient to be seen by a good general dentist rather than a pediatric dentist.

Dallas Pediatric Dentist said...

That will be really challenging and I agree that the satisfaction that you will get from helping these "special" patients are just different.
Thanks that there are lots of people who are giving proper care and attention to them...

Oklahoma City Pediatric Dentist said...

I have know some parents of special kids and they say that they are really thankful that there are these kinds of doctors who patiently help them and their kids and make things a lot more easier and better for them.
I also appreciate those dentist who are helping these kids, I sense them as doing their jobs more than what it calls for, they are doing things with love and concern for their patients.
More power!

Emr Rating said...

think one of the greatest hurdles is overcoming misconceptions in the minds of regulators, doctors and patients alike. I just returned from a trip to Germany and colleagues there are amused about America's 3rd World-like medical records situation.

Anonymous said...

my son has Asd... and i am looking for a dentist.. he has had all his baby teethed pulled. 20 of them because he drinks a pediatric formula mason is highly sentive in the mouth he didnt eat anything for over 2 years saw a pediatric dentist yesturday who says he has 2 cavitys all ready on his big boy teeth.. he has only had them for 3 months.. he had a large build up of calculus on his baby teeth.. i wanna know if he does have cavities..can he be put to sleep for the fillings .i know he will not be able to handle the sound of the drill in his mouth..

Dr. Dean Brandon said...

Yes, many children and special needs adults can be placed under general anesthesia for dental procedures. Each case is different, but most pediatric dentists have this treatment option available. Read more about this on my blog.

Anonymous said...

FYI--It is Down syndrome (no "S" in Down and the s is not capitalized in syndrome.

Dr. Dean Brandon said...

So noted and corrected--Thanks.

dentist philadelphia said...

This article gives the light,thanks for sharing