Caring for Patients with Special Needs

By Jamie Collins, RDH on August, 10 2021
Caring for Patients with Special Needs
Jamie Collins, RDH

Jamie has been in the dental field for nearly 20 years, both as an assistant and hygienist. In addition to clinical practice, she is also an educator, speaker, and has contributed to multiple textbooks and curriculum development in addition to being a frequently published author.

We all have those patients who leave an imprint on our heart. For me, that has been many of my patients with special needs, such as development disabilities. However, the challenges in providing care and expectations are not the same as you see in neurotypical peers.

I often hear from many dental professionals that they are not comfortable seeing patients who may require care beyond our typical routines. While it may be challenging for us to adapt the ways we see patients, it’s important to know that for those patients, it may be a day-altering event. Here are some tips that can help increase the odds of success when treating patients with special needs.

Teach how your patients learn
Many of our patients with developmental disabilities are incredibly knowledgeable, especially around topics of interest. The key is to find out what motivates your patients and drives interest. Take autism for example. I have learned about many topics in great detail from my patients with autism. Tailor your teaching around those topics if possible.

Often times our patients perceive their world in a different manner, taking our words very literally. Be clear and concise with directions, providing homecare or post-op instructions in writing. This clears up any confusion and aids caretakers in ensuring the patient’s needs are addressed.

Oral health challenges
It’s not uncommon for a patient with developmental disabilities to have a co-condition that’s also being treated. Anxiety, gastro-intestinal disturbances and ADHD, for example, are commonly associated with conditions such as autism. Most of our patients with developmental disabilities are on at least one medication to manage associated symptoms or conditions.

The polypharmacy effect combined with poor or lacking oral care creates a perfect storm for caries and periodontal disease. Many times, enlarged or protruding tongues to work around can make treatment more difficult. Combining that with difficulty swallowing is enough to make any dental provider run behind.

Managing an appointment
Not all patients with developmental disabilities can be seen in a general practice setting; however, adapting how we treat them can increase the odds for success. Plan ahead, reduce your water flow and allow more time if needed.

Schedule during office quiet times to reduce distractions and be mindful of your voice. Maintain a calm and soothing tone if possible. Implement a cordless handpiece to allow you to practice at any angle if needed without the restriction of cords. A quiet handpiece is even better. Most importantly, have fun! You never know what you may learn from your patients!

The patience and compassion you show the patient and family will have a larger impact than the dental care you deliver. While we are seeing these patients for an hour at a time, what we do can affect the whole day for that patient and family.

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