Caring for the Oral Health of Individuals With Special Needs
(Continued)
Each person, regardless of age or ability
level, needs an oral care plan.
Identifying the physical, behavioral,
emotional, and social limitations that
may prevent participation in and/or
execution of an oral care plan is the first
step in creating a workable plan. Once
limitations are identified and a plan is
created, the entire health care team can
work to overcome these limitations and
successfully treat the special patient.
Identifying physical limitations includes
knowing the medical history,
ambulation, dexterity, and other traits
of the individual. Our office personnel
and the primary care provider need to
communicate and clarify the patient’s
current medical condition, medical
history including surgeries, and all
medications including over the counter
and herbal medications. Reviewing a
comprehensive medical intake form
(see attachment 2) with the primary
care person for and/or an individual
and with the primary care physician
(PCP) is the best assurance that this
information is complete. Consulting
with a pharmacist about medications
that the person is taking and that you
may want to prescribe is also a
necessary step for many of the
complex patients we care for. I have
always found this type of
communication is welcomed by our
medical colleagues and appreciated by
the care givers of the people I serve.
Reviewing and updating this
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MA R CH/A P R I L 2020 | P EN N S YLVA N IA D EN TA L J O UR N A L
information on a regular basis is also
imperative. Simply asking if there have
been any changes is not adequate. We
have all been to our physician and had
a staff person take our vital signs and
read through our list of medications
and ask if it is accurate and complete.
As oral health providers, we need to be
following the same protocol. After all,
we are physicians trained to
understand the medical conditions of
our patients and the potential risks
associated with those conditions in the
dental care setting. 5 The best time to
obtain this information is before the
person has their first visit to your office.
This not only gives you time for
consultations, but time to investigate
developmental diagnoses you may not
be familiar with. Many individuals and
their care givers do not have the
information needed with them when
they come for the first appointment.
Many cannot tolerate waiting the time
it takes to fill out these forms. Being
prepared will make the first visit more
efficient and enjoyable for everyone.
Breaking down the information
regarding syndromes and the medical
history makes treating the individual
less intimidating and allows you to be
adequately prepared to provide dental
care and develop an oral health plan.
For example, many individuals with
Trisomy 21, also called Down
Syndrome, can have numerous
complications of varying degrees.