According to the Centers for Disease Control and Prevention, developmental disabilities are “a set of disorders resulting from an impairment in one or more of the following areas: physical, cognitive, communicative, or behavioral.” Maternal actions, problems at delivery, and genetics are among the several factors that lead to developmental impairments. Children aged three to seventeen who have one or more developmental disorders account for over 15 percent of this population. Autism spectrum disease, cerebral palsy, and intellectual impairment are among the most common developmental problems. The possibility exists that the aforementioned persons will have oral disorders as a side impact of their impairment. Also, more worse periodontal disease and bruxism are on the list.
In comparison to the population as a whole, those with developmental impairments are much more likely to face worse health outcomes. Oral health issues, especially those which relate to developmental impairments, go untreated in many cases, since individuals with developmental disabilities have less access to health care. The Surgeon General’s report that dealt with the health issues of the disabled noted that these individuals were more likely to have poor dental health than people without disabilities.
Special-needs individuals suffer from poor dental health because of several variables, including socioeconomic, health, and behavioral issues.
- comprehensive medical histories
- limits of the physical body
- an increased dependency on guardians and carers
- insufficient access to dental treatment
To be more accurate, however, maybe the biggest obstacle to dental treatment for this group is a lack of development and a bad image among dental professionals about people with developmental impairments.
the ability to access dental care
This happened in 1990, when the Americans with Disabilities Act was implemented. This is a civil rights legislation that outlaws the discrimination of those with disabilities in order to allow them to participate in the same activities as the general population. It consists of all of the many kinds of jobs, building design, transportation, governmental and private entities, organizations, and medical care. According to the legislation, it is illegal to discriminate against persons with disabilities because of their programs or financial help.
A variety of factors limit the quality of treatment that persons with developmental disabilities get, including the number of persons with developmental disabilities in the dental clinic as well as the availability of accessible facilities and qualified personnel. One of the factors that limits access to dental care is the limited number of dental providers that accept Medicaid. Safety concerns are also a barrier to receiving dental care.
Approximately 20% of all practicing dentists engage in Medicaid programs in the United States in 2012. Approximately 10.4 million children and adults in the United States who are Medicaid-eligible due to their disability have some sort of developmental impairment. In the case of Medicaid coverage for this group, preventative care, specialized care, prescription medicine, medical equipment, and long-term care services are provided. Sadly, the fact that few Medicaid-covered dental providers take on clients with developmental disabilities means that many persons with developmental disabilities will go without dental treatment.
Dental treatment for individuals with developmental impairments is often delivered with the use of techniques of medical stabilization, as it is necessary to guarantee the safety of the clinician and patient. It should be noted that when falling into this category are mechanical devices such as rubber mouth props, papoose boards, and arm restraints. Furthermore, sedation methods are often employed to help minimize anxiety and agitation before the procedure, and for this reason preoperative sedative medicines are sometimes employed. Approximately half of all dental practitioners do not have appropriate training in these approaches, resulting in discomfort in dealing with this patient group. 4 A significant number of dental practitioners in the United States have been unwilling to give regular and emergency dental treatment to persons with developmental impairments. This is more typically connected with poor training resulting in the potential for safety issues.
There is also an issue of inadequate training of medical stabilizing staff, which sometimes exacerbates the idea that persons with developmental impairments are less worthy of care. A significant number of individuals with developmental impairments are seen as “uncooperative,” “violent,” and “aggressive.” Additionally, with a sufficient amount of training and the proper equipment, it is feasible to treat individuals with developmental impairments without fear of violent outbursts or uncooperative tendencies. The persons with developmental impairments should not be seen by their impairment, but instead as distinct persons with the same needs as those who do not have a disability. When you think about it, it’s just common sense that with our current environment, there has to be an improvement in readiness to deal with patients who have developmental impairments. This includes requesting organizations that provide training on how to treat this group of patients.
Studies show that learning more about the unique needs of patients with developmental disabilities, as well as about the interventions available to help, will result in a greater desire and comfort on the part of healthcare providers to engage with these patients. There would be a greater number of dentists who have received training in the treatment of persons with developmental impairments, as well as a more positive attitude on the part of providers.
Even though there are several training materials designed to offer dental clinicians with expertise in special-needs dentistry, there are few training options that allow for practical hands-on learning. Expanding on the role of dental hygiene students, dental assistant students, and dental school students as part of the general population, offering students additional opportunities to interact with people with developmental impairments is a good method to improve their interest and raise their chances of serving those persons in the future. Licensed providers who are no longer in the educational context will need to generate more demand for continuing education in order to serve the rising number of special-needs patients. It is important to note that increasing demand for dentists with more favorable views toward individuals with developmental impairments is necessary for increasing demand to be present.
There is no significant difference in the health care demands of persons with developmental impairments as opposed to those of other persons. Conducted as a call to action, this study stresses the need of improving the mental attitude towards those with developmental disabilities, motivating leaders and educators to enhance dental training programs for people with special needs, and above all, increasing the quality of life for this group of people.
- Facts about developmental disabilities. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/developmentaldisabilities/facts.html. Published 2015. Updated July 9, 2015. Reviewed August 31, 2016. Accessed October 25, 2015.
- Salama F, Al-Balkhi B, Abdelmegid F. 2015. Dental students’ knowledge of oral health for persons with special needs: a pilot study. The Scientific World Journal. Vol. 2015. Article ID 568464, 7 pages. https://www.hindawi.com/journals/tswj/2015/568464/.