pediatric special needs patient management in dentistry case report

Who are the authors of case reports in pediatric dentistry?

Case Reports in Pediatric Dentistry Edited by Evert van Amerongen Maddelon de Jong-Lenters Luc Marks Jaap Veerkamp Quintessence Publishing Co Ltd London, Berlin, Chicago, Tokyo, Barcelona, Beijing, Istanbul, Milan, Moscow, New Delhi, Paris, Prague, São Paulo, Seoul and Warsaw Foreword

What is the dental condition of children with special health care needs (SHCN)?

The dental condition of children with special health care needs (SHCN) may be directly or indirectly related to their disabilities. Children with SHCN relatively have poor oral hygiene and increased prevalence of gingival diseases and dental caries.

Are oral problems more common in children with special needs?

This paper reviews commonly seen oro-dental problems in children with special needs and causes of their increased prevalence, various barriers to accessing dental care, and management of oral diseases in this population of children.

Should parents of disabled children seek dental treatment?

Parents of disabled children usually do not seek dental treatment as they also have the burden of medical treatment. In the past, the emphasis was based on providing basic dental care, but in recent years, the dental profession has shown increased concern in providing complete oral health care to the mentally- or physically-challenged children.

Abstract and Figures

This report presents a case of an eight-year-old girl affected by a progeroid syndrome of unclear genetic origins. The patient’s dental history included oligodontia, premature deciduous exfoliation and roots abnormalities. She was treated with comprehensive oral rehabilitation using dentures.

References (8)

Protocole National de Diagnostic et de Soins (PNDS) "Agénésies dentaires multiples : Oligodontie et Anodontie". Authors : CRMR O-Rares et Filière TETECOU

What is special needs in health care?

The AAPD defines special health care needs as “any physical, developmental, mental , sensory, behavioral, cognitive, or emotional impairment or limiting condition that requires medical management, health care intervention, and/or use of specialized services or programs. The condition may be congenital, developmental, or acquired through disease, trauma, or environmental cause and may impose limitations in performing daily self-maintenance activities or substantial limitations in a major life activity. Health care for individuals with special needs requires specialized knowledge, as well as increased awareness and attention, adaptation, and accommodative measures beyond what are considered routine.” 3

Who should be informed of oral findings?

When appropriate, the patient’s other care providers (e.g., physicians, nurses, social workers) should be informed of any significant findings. Medical consultations.

What is SHCN in dentistry?

The American Academy of Pediatric Dentistry ( AAPD) recognizes that providing both primary and comprehensive preventive and therapeutic oral health care to individuals with special health care needs ( SHCN) is an integral part of the specialty of pediatric dentistry. 1 The AAPD values the unique qualities of each person and the need to ensure maximal health attainment for all, regardless of developmental disability or other special health care needs. These recommendations were intended to educate health care providers, parents, and ancillary organizations about the management of oral health care needs particular to individuals with SHCN rather than provide specific treatment recommendations for oral conditions.

What should the receptionist determine when a child is a SHCN?

Along with the child’s name, age, and chief complaint, the receptionist should determine the presence and nature of any SHCN and, when appropriate, the name (s) of the child’s medical care provider (s).

What should a dentist do?

The dentist should coordinate care via consultation with the patient’s other care providers. When appropriate, the physician should be consulted regarding medications, sedation, general anesthesia, and special restrictions or preparations that may be required to ensure the safe delivery of oral health care.

What is the purpose of scheduling an appointment with a dental practice?

Scheduling appointments. The parent’s/patient’s initial contact with the dental practice allows both parties an opportunity to address the child’s primary oral health needs and to confirm the appropriateness of scheduling an appointment with that particular practitioner.

Is a dental office a public place?

The Americans with Disabilities Act (AwDA) defines the dental office as a place of public accommodation. 11 Thus, dentists are obligated to be familiar with these regulations and ensure compliance. Failure to accommodate patients with SHCN could be considered discrimination and a violation of federal and/or state law.

What is the development of oral health programs?

The development of effective oral health programs is recommended as well as a specific education program for their parents. Children with intellectual disability have a greater chance of requiring advanced management techniques during dental treatment. The development of effective oral health programs is recommended as well as a specific education ...

Is there an association between dental treatment and intellectual disability?

There was no association between the type of disability and dental treatment needed. Children with intellectual disability were 3 times more likely to need general anesthesia and 7 times more likely to need physical restraint for dental care than the other group.

Why is it important to provide access to dental care?

Providing access to dental care services to these patients is essential to maintain adequate oral health as they have an increased risk of oral diseases throughout their life , and these oral diseases may directly affect their quality of life and general health [ 1.

What are the features of a 14 year old girl with Cdls?

She had common craniofacial features for CdLS such as microcephaly, short neck, synophrys, arched eyebrows, long curly eyelashes, downturned angle of the mouth, high arched palate, micrognathia, microdontia, delayed tooth eruption, and partial anodontia. The patient’s mother sought the dental service at the Basic Health Unit (UBS) in Sacramento, Brazil. However, there were no specialized dentists that treat PSHCN. Therefore, the patient was referred to our Pediatric Dental Clinic at University of Uberaba, Uberaba, Brazil. In the first appointment, we tried to talk and persuaded the patient to open her mouth, although we did not succeed due to her aggressive behaviour. After the first attempt, we proposed to use physical restraints to undertake the treatment, though her mother did not agree with it. Owing to the patient’s behaviour, we were not able to conduct any intraoral examination as well as radiographic examination. Thus, we referred her to the Mário Palmério University Hospital, Uberaba, Brazil, for dental treatment under general anesthesia. Firstly, she underwent preanesthetic assessment, such as complete blood test and chest X-ray. Thus, she had an appointment with an anaesthesiologist who authorised her for the dental treatment under general anesthesia.

What is the purpose of the Cornelia de Lange Syndrome?

The purpose is to report the dental management of a patient with Cornelia de Lange Syndrome (CdLS), which was classified as PSHCN due to physical, behavioural, cognitive, and emotional impairment.

What is the dental condition of children with special health care needs?

The dental condition of children with special health care needs (SHCN) may be directly or indirectly related to their disabilities. Children with SHCN relatively have poor oral hygiene and increased prevalence ...

What is the oral examination of a child with special needs?

The oral examination of a child with special needs is similar to the routine child oral examination. Oral defensiveness, increased gag reflex, and oral motor hypotonicity may make the examination more difficult and should be documented.

What are the health problems associated with SHCN?

Children with SHCN generally have increased prevalence of poor oral hygiene, compromised gingival and periodontal health, and increased prevalence of dental caries than the general population. Dental diseases and its treatment present several problems in this group of patients.

What is SHCN in dentistry?

Management of children with special health care needs (SHCN) in the dental office#N#Charan Kamal Kaur Dharmani#N#Department of Paediatric and Preventive Dentistry, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India

What is dental treatment?

Treatment or elimination of existing untreated disease. Planning for prevention of further disease. Treatment of dental diseases in special children is the same as carried out in other children except that they may require sedation even for routine cleanings, restorative procedures, and minimal oral surgery.

Why can't children get dental sealants?

Children who severely brux their teeth (e.g., because of cognitive disabilities, cerebral palsy, or autism) may not be candidates for dental sealants because of the flattened occlusal surfaces . Wet bond dental sealants can chemically bond to moist teeth and do not require dry field for application process.

When should a child go to the dentist?

AAPD Guidelines recommend that all children should be referred to a dentist 6 months after the first tooth erupts or by age 12 months (whichever comes first) for establishment of a dental home. All children with SHCN fall into a high-risk category and should be referred to a dentist by 1 year of age.