IS SPECIAL ORAL HEALTH CARE
care is an approach to oral health care that is tailored to the
specific needs of persons with a variety of medical, disabling,
or mental conditions. Consider a person with diabetes who is at
increased risk of gum disease; a young child who needs dentures
because of a genetic disorder, a person with arthritis who is unable
to hold a toothbrush. Dentists and other health professionals must
often develop innovative approaches to serve these patients. The
treatment challenges are heightened by the diversity among special
do patients need special care?
people need routine oral health care, but have physical limitations
or conditions that require delivery of care beyond the routine.
Oral health care staff, for example, might need to learn wheelchair
transfer, some sign language to communicate with deaf patients,
or how to manipulate adaptive oral hygiene devices and instruct
patients in their use. Persons with conditions such as Down syndrome,
Alzheimer's disease, or autism, as well as the homebound and institutionalized
may require innovative approaches to routine oral health care.
patients have medical and oral conditions that call for extraordinary
oral health care and require dental professionals to have specialized
knowledge. A broad range of acquired and genetic craniofacial defects
such as cleft lip and palate or bone loss from trauma or surgery
often require extensive reconstructive and therapeutic procedures
that involve a number of health specialists. Other disorders such
as ectodermal dysplasia and osteogenesis imperfecta directly affect
tooth and maxillofacial development and demand specialized treatment.
systemic diseases, including diabetes mellitus, AIDS, and SjÓgren's
syndrome, and certain medical treatments have oral health implications.
A dentist might need to develop a treatment strategy for an organ
transplant patient, determine the best anesthetic alternative for
a patient with heart disease, or develop an oral health plan for
a patient prior to cancer treatment. Beyond their impact on general
health, oral cancers and their treatments can also leave patients
with eating, speaking and swallowing difficulties. In addition,
many drugs cause oral health problems, such as gum overgrowth associated
with long-term phenytoin use or xerostomia that results from many
over-the-counter and prescription medications.
managing special care patients communication is essential among
all members of the health care team, including oral health professionals.
With the increasing numbers of patients who require special care
and the far-reaching effects of the Americans with Disabilities
Act, there is a pressing need for awareness and understanding of
oral health special care issues among all medical, dental, and rehabilitation
can I get more information?
Many organizations provide information and support for special care
patients and health practitioners. The National Oral Health Information
Clearinghouse (NOHIC) is a central resource to help access this
information. NOHIC is a service of the National Institute of Dental
Research, one of the National Institutes of Health.
clearinghouse directs both patients and professionals to the best
sources of information and materials on specific special care topics
in oral health. NOHIC maintains a database that provides descriptions
and ordering information for publications, audiovisuals, and other
printed material. It also has information on organizations involved
with special care. In addition, the clearinghouse produces and distributes
materials including fact sheets, brochures, and information packets.
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with permission from the
National Oral Health Information Clearinghouse
One NOHIC Way
Bethesda, MD 20892-3500
Tel. (301) 402-7364 - Fax. (301) 907-8830