Dental Assisting for Special Needs Patients

Learning Outcomes

• Upon completing this chapter, students will be able to define, pronounce, and spell key terms related to special needs and medically compromised patients.
• Students will understand the role of a dental assistant in patient care for special needs patients.
• Students will be able to describe the stages of aging and the oral conditions affecting older populations.
• Students will know how to evaluate the importance of medical history for special needs patients.
• Students will identify medical disorders that impact oral health and the appropriate dental management for medically compromised patients.
• Students will demonstrate correct wheelchair transfer procedures.

Key Terms

• Alzheimer's disease: A progressive mental disorder affecting older adults.
• Anemia: A deficiency of red blood cells or hemoglobin, causing weakness and paleness.
• Angina: Severe chest pain due to insufficient blood supply to the heart.
• Arthritis: Inflammation of one or more joints, causing pain and swelling.
• Asthma: Respiratory disorder, often allergy-related, with recurring breathing difficulty.
• Atrophy: Wasting away or deterioration of tissue.
• Bacteremia: Presence of bacteria in the bloodstream.
• Bronchitis: Inflammation of the bronchial tubes.
• Dementia: Mental impairment characterized by memory loss, concentration difficulties, and judgment problems.
• Diabetes mellitus: A metabolic disorder involving high blood sugar levels and insufficient insulin production.
• Emphysema: Abnormal enlargement of air spaces in the lungs, impacting breathing.
• Endocarditis: Inflammation of the inner lining of the heart.
• Epilepsy: Neurological disorder characterized by recurrent seizures.
• Hemophilia: A blood disorder affecting blood clotting.
• Hyperglycemia: High blood sugar levels.
• Hyperthyroidism: Overactive thyroid gland.
• Hypoglycemia: Low blood sugar levels.
• Hypothyroidism: Underactive thyroid gland.
• Leukemia: Cancer of the blood, producing too many immature white blood cells.
• Myocardial infarction: Heart attack; damage to heart muscle due to obstructed blood flow.
• Rheumatoid arthritis: A chronic joint disease causing inflammation, pain, stiffness, and joint damage.
• Seizure: Uncontrolled electrical disturbance in the brain, causing spasms or convulsions.
• Stroke: Loss of brain function due to a blood vessel blockage or rupture in the brain, also called cerebrovascular accident.
• Xerostomia: Dry mouth; lack of saliva production.

Role of the Dental Assistant

• Assistants assist dentists in treatment, especially for patients with special needs.
• They provide information about preventive care to patients and families.
• Assistants help create a calm and comfortable environment to reduce patient anxiety.

The Aging Population

• Older adults (65+) comprise the fastest-growing segment of the U.S. population.
• Aging involves inevitable changes; differentiating between age-related conditions and disease-related issues is crucial for diagnosis and treatment.
• Older adults are categorized into functionally independent, frail, and dependent categories based on health status.

Oral Health of the Aging

• Xerostomia, periodontal disease, tooth decay, dark brittle teeth, and bone resorption are common oral health issues among older adults.
• Factors like medication profiles and co-morbid medical conditions are vital for treatment planning.

Specific Patient Disorders

• Developmental disorders (e.g., intellectual disabilities, autism, cerebral palsy) may impact a patient's functioning and communication.
• Neurologic disorders (e.g., Alzheimer's disease, seizures, stroke, MS) cause changes in brain function influencing oral health.
• Cardiovascular disorders (e.g., hypertension, congestive heart failure) require modifications to treatment plans.
• Neuromuscular disorders (e.g., muscular dystrophy) affect voluntary muscle function impacting dental treatment.
• Musculoskeletal disorders (e.g., various types of arthritis) limit mobility and oral hygiene routines.
• Blood disorders (anemia, hemophilia, and leukemia) present unique dental risks affecting treatment planning.
• Endocrine disorders (hyper/hypothyroidism and diabetes) impact metabolism affecting treatments and medications.
• Pulmonary disorders (allergies, asthma, COPD) influence respiratory functions requiring adjustments in protocols.

Clinical Considerations in Treatments

• Multiple Sclerosis (MS): Treatment modifications need to be made.
• Stroke/Cerebrovascular Accident: Patients require accommodation adjustments.
• Seizures: Recognizing triggers and using appropriate sedation strategies are essential.
• Anxiety/Depression: Short appointments, comfort measures, and potentially using drugs as needed.

Legal and Ethical Implications

• Patients have the right to information about treatment options and alternatives and to informed consent.
• Maintaining patient privacy is crucial.
• Consideration of medical history, conditions, and medications is vital.