Smiling child in his wheelchair with support pillows around his neck

How to Provide Dental Help for Disabled Patients

Date: Nov 12, 2018

Author: Jamie Collins, RDH

Patients with physical disabilities often face challenges to their oral care, both at home and in the dental office. Changing the way you provide care without compromising quality can be challenging. With a few adaptations, however, you can provide dental help for disabled patients in an empowering and effective way.

Check for Accessibility

The first step to making your office welcome to patients of all physical abilities is assessing how patients enter the building. Do you have ramps and elevators for people who have difficulty walking? Do patients have to pass through large, heavy doors that an arm weakness or tremor might prevent them from opening? Many regions have regulations for making buildings accessible for physically impaired individuals, so check to make sure that your office is both welcoming and compliant.

Next, think about how patients of different physical abilities climb into and out of the dental chair. A patient who uses a wheelchair, for instance, may be able to transfer to the dental chair alone or with help from a caregiver, or they may need help from you and your staff. Ask the patient what you can do to facilitate. Checking with them first avoids assuming they are incapable of transferring themselves.

Be Flexible

Providing dental help for disabled patients may mean that you need to alter your usual treatment position. In some cases it means standing while working if the patient is unable to recline. The Parkinson's Foundation notes that the swallowing and coordination difficulties associated with the disease make it safer and more comfortable for patients with Parkinson's disease to remain sitting upright. The foundation also notes that appointments for patients with physical impairments should be kept short, with a maximum length of 45 minutes if possible.

If shorter appointments are important for your patients' comfort, schedule more frequent recall visits rather than relying on a lengthy twice-yearly treatment time. You should also ask your office staff to offer disabled patients appointment slots first thing in the morning or when the office is quieter and easier to navigate.

Anticipate, but Don't Assume

Ability is expressed in different ways. Achieve Australia notes that a physical disability can affect a person's "mobility, physical capacity, stamina or dexterity," so your patient's personal obstacles may not be readily visible. A condition may not even affect them every time they visit your dental office. If you notice a condition, such as multiple sclerosis, cerebral palsy or a spinal cord injury on a patient's medical record, take time to research the symptoms and needs that patient might face. Then, ask them to talk you through what might be difficult for them in a dental setting and what can make it easier.

As you get to know the patient, you can begin to customize home care instructions to their needs. The ability to hold a toothbrush properly can be next to impossible for some patients with arthritis or after a stroke. Your customized instructions for patients may include using a thick-handled Colgate Smart Electronic Toothbrush E1. This toothbrush works with an app on your iPhone or iPad to help you manage your oral health more effectively. If a patient has a caregiver, you can go over instructions together and provide written copies.

Keep in mind that a patient's abilities can change over time. Amputee patient may switch to a prosthetic that gives them a greater range of motion, or a person with amyotrophic lateral sclerosis (ALS) may slowly lose the ability to speak and brush their teeth. Dental care for disabled patients should keep a close watch on their changing needs.

Note Down Instructions

Many of us, special needs or not, often forget instructions and can use a reminder from time to time. Part of providing dental care for disabled patients is sending a patient or caregiver home with a printed list of instructions and recommendations that they can incorporate into a daily routine. For visually impaired patients, consider recording your instructions on a phone app or sending an email that a patient can access on a Braille reader.

Adapting your care routine to serve a greater range of patients can be complicated but is often extremely rewarding. When a patient or caregiver is excited about a new product or technique that makes home care easier, it may seem like a small difference, but it can be a great help in daily life. Listen to your patients and challenge yourself to meet their broad range of abilities and needs.

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