How to approach the history and possible treatment needs is best sorted out
before they arrive at your office for their first visit, whether an exam may be
possible, or simply a meet and greet to allow them to become familiarized
with your environment to ease their anxiety. 7,8,9
1 Intellectual limitation: These can be mild to severe,
affecting how well they can understand and follow instructions.
2 Congenital heart condition: may require antibiotic
prophylaxis. Consult with primary care physician and/or
cardiologist.
3 Immune suppression: may require antibiotics before,
during, after more invasive procedures.
4 Respiratory problems: may need to watch positioning in
chair, have oxygen available PRN.
5 Vision problems: may need to allow to feel things, and warn
when about to enter mouth
6 Thyroid problems: hypothyroidism is possible, monitor
heart rate and temperature
7 Midface insufficiency: difficulty breathing through nose,
may require more breaks during treatment
Once the syndrome is broken down,
the complications are not that hard
to manage in most dental offices.
I encourage all oral health providers
to access the training modules on the
Pennsylvania Coalition for Oral Health
website for more information regarding
the treatment and management of the
special needs patient’s oral health care
at www.paoralhealth.org/webinars.
These special needs modules (see
Attachment 3) will walk you through
important information and “tricks of the
trade” that I have utilized in my long
career treating the special population. 9
The most important thing needed in
any practice to accommodate these
individuals is patience, kindness, and a
willingness to get out of your box and
into theirs! Treating the special
population will be the most rewarding
part of your practice. Experience the joy
I have had in my career by becoming a
provider to the most vulnerable and
most grateful patients of your career.
decreases airway (Mallampati score) making
8 Megaglossaly:
sedation more risky
9 Congenitally missing secondary teeth: treatment of
retained primary teeth may be needed
10 Atlantoaxial insufficiency: watch positioning, provide
neck pillow for support.
11 Limited dexterity: may require modification of oral health
implements for patient and care giver
MARCH/AP RIL 2020 | P EN N SYLVAN IA DEN TAL JOURNAL
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