Special Needs Dentistry

Special Smiles with Special Needs

Special Care Dentistry is our way of taking care of individuals who have a physical, developmental, mental, sensory, behavioral, cognitive or emotional impairment or liming condition that requires medical management, health care intervention, and/or use of specialized services programs. Dental care for special needs patients is beyond that considered routine and requires specialized knowledge, increased attention, and accommodation. Children and Adults with special needs are at increased risk for developing oral diseases. It is important to understand your child’s specific oral and dental needs early in order to maintain optimum oral health.

We are very proud to have made every effort to accommodate our friends with special needs who require specific attention. Our office is a street level, free standing building with available parking and a wheelchair ramp. The space was entirely renovated according to the American Act of Disability (ADA) guidelines. We are trained to allow the patient a safe and comfortable dental visit and hope to be part of the team that helps care for your family. Good communication between our office and your health care providers caring for the patient is essential. We work with therapists in developing a collaborative approach for each treatment visit.

Starting early dental visits not only allows for prevention of dental problems but also helps desensitize the patient to the multitude of stimulants in the dental office. Please feel free to share with us any techniques that help calm the patient or make them more comfortable prior to their dental visit. An assessment of the risk for developing dental disease will allow us to create an oral hygiene plan that addresses the patient’s individualized needs. An individualized treatment plan can include sedation techniques and behavioral techniques to address any existing problems while planning for future preventative care.

There are wide variety of barriers in implementing preventative oral care by caregivers and parents. One of main challenges is anxiety. There are relaxation techniques that can be introduced to reduce anxiety and fear of the unknown. Consideration as to the patient’s emotional and physical development is an important component. Sensory challenges can also be a barrier to care. It is important to understand the patient’s verbal and nonverbal communication.

Adults and Children with physical and/or developmental disabilities are at a high risk for enamel irregularities, gum infections, delays in tooth eruption, moderate to severe misalignment between the upper and lower teeth when the jaw is closed, resulting in a faulty bite poor bite, and oral infection. To achieve and maintain good oral health, people with physical or developmental disabilities, Dr. Haque and her associates require a special approach to dental care. Proper diagnosis and treatment of the dental patient presenting with anxiety and behavioral issues may be challenging.

The initial examination may be very difficult to perform, and the medical history may present a variety of issues that can impact on the materials that can be used. Dr. Haque and her Associates have experience treating adult and children with special needs or disabilities. With some adaptation of the skills dental professionals use every day, most people with special needs can be treated successfully at Market Place Dentistry.

Obsessive routines, repetitive behaviors, unpredictable body movements, and self-injurious behavior may all be symptoms that complicate dental care. Communication and behavioral problems pose the most significant challenges in providing oral care. The assessment of the patient’s diet may also present a complex resolution between adequate nutrition, medical complications, and prevention of tooth decay. Above all people with autism experience few unusual oral health conditions.

Sensory Triggers

The actual office visit is probably one of the main areas that may trigger a large amount of anxiety for an adult or child with physical or developmental challenge. One of the areas being tactile (sensitivity to touch) and auditory (heighten sense to noise). Mouths are extremely sensitive places and for a person with special needs, someone putting cold instruments into their mouth could be very painful. In addition the noise of the drills and the cleaning of the instruments could also be a problem. Sometimes the taste of the mouthwash or the paste used may be an issue.

Dentists are one of the few professionals who invade everyone’s personal space. Most people find this uncomfortable but are aware of why the dentist has to be so close, to examine your teeth. For individuals with Physical or Developmental Disabilities, they may find this close proximity extremely distressing. A common issue for many Adult and Children with Physical and/or Developmental Disability is oral sensitivity around the face and the mouth. This sensitivity can affect eating, nutrition, speech, tooth brushing, dental check-ups and oral health. Some adult and children with special needs, especially those with autism, have an oral sensitivity that makes tooth brushing difficult. They may resist having their teeth brushed by a parent or caregiver and refuse to brush their own teeth.

Adult and Children with autism have greater difficulty accessing dental care. Some of the risk factor for children with autism includes:

Sensitivity around the face and mouth which can make tooth brushing and dental check-ups more challenging.
Use of candy as reinforces or feeding issues which may lead to more frequent consumption of sticky and sweet foods.
Sensitivity to light and sound common in the dental office and sensitivity to touch that may make obtaining regular dental care more difficult.

Anesthesia for dental procedures

There is no evidence that anesthetic drugs have cause or worsen the diagnosis. Local Dental anesthesia is usually performed at Market Place Dentistry. If the adult and/or child has serious medical problems (e.g., heart problems, breathing problems, seizures, or airway problems) it is sometimes unsafe to give local anesthesia care in the dental office, and we will need to do the procedure in a hospital setting. When Sedation is done by an experienced anesthesiologist with modern monitoring equipment and medications, risk of complications are minimized.

Visiting the Dentist

Dental visits can be a challenge. Some amount of preparation is recommended for your child to have a positive experience with the dentist. We have a detailed intake form that helps us prepare for the visit. The amount of preparation depends on your child’s particular emotional and physical needs.

When you call for a dental appointment, ask for an appointment time when the child is most rested.
Go at a time when the office is least crowded.
Inform the dental office of your child’s special needs.
Describe any behavior problems.
Develop a social story about visiting the dentist.
Take favorite toys, music or books.
Daily brushing helps prepare the child for the dental visit.

When making your dental visit try asking that the appointment is the first of the day. We recommend visiting us informally prior to the first visit in some cases. This way the patient can get meet the staff and get familiar with the surroundings . Our team at Market Place Dentistry would like to explore some of the patient’s individual barrier’s to care and offer some solutions in regaining good oral health.

Desensitization Visits

Our mission is to promote good oral health for our patients by creating a friendly and positive experience when receiving dental services. Our staff understands the unique needs of Special Needs patients and emphasizes patience and continuous positive reinforcement. The desensitization process is based upon the ‘Tell-Show-Do’ method and uses a series of appointments designed to familiarize patients with the dental surroundings and procedures. Our desensitization program provides relaxation techniques while constructing a progression of stimuli for the patient. Each step of the target goal is gradually introduced to the patient, followed by positive reinforcement which includes making one more familiar and comfortable in the dental treatment setting.

Reinforcers vary depending on what motivates each patient. They can include listening to a preferred song, watching a favorite television shows, toys, or verbal praise. We welcome therapists to accompany the patient on their first visit and tour our practice. Once the patient tolerates one step, the next one is introduced gradually until the treatment goal has been reached. This concept, known as behavior shaping, is used to plan treatment where the goal is broken down into small steps. This can be helpful in transitioning from a simple to a more complicated procedure. If a patient is unable to cooperate during treatment, the appointment is not immediately terminated as this could negatively reinforce the undesirable behavior. Back tracking, engaging the patient in a calm manner followed by positive reinforcement is ideal, so the appointment will end constructively. This can be completed, for example, with a simple fluoride treatment or exam. Some patients require interventions that go beyond the scope of routine behavior management techniques. These techniques can include oral desensitization, therapeutic and protective stabilization and anti-anxiety medications. Therapeutic and protective stabilization (MIPS) can be helpful in some patients.

General anesthesia in an ambulatory care setting should only be considered if our attempt to provide care are unsuccessful or determined necessary by the doctor. This is usually a last resort to provide necessary treatment.