Individuals with special needs, namely those whose dental care is complicated by a physical, mental or social disability, often have a higher level of unmet dental need and poorer oral hygiene than the general population, and offer unique challenges to the dental practitioner. This paper outlines the dental management of the three most common groups of individuals with special needs.
NunnJH.The dental health of mentally and physically handicapped children: a review of the literature. Community Dent Health1987;4:157–68.
2.
StabholzJ, MannM, SelaM, SchurD, SteinbergD, ShapieaJ, . Caries experience, periodontal treatment needs, salivary pH, and Streptococcus mutans counts in a preadolescent Down syndrome population. Special Care Dent1991:11;203–8.
3.
NunnJH, GordonPH, CarmichaelCL.Dental disease and current treatment needs in a group of physically handicapped children. Community Dent Health1993;10:389–96.
4.
YilmazS, OzluY, EkukluG.The effect of dental training on the reactions of mentally handicapped children's behaviour in the dental office. ASDC J Dent Child1999;66:188–91, 154–5.
5.
FeldmanCA, GinigerM, SandersM, SaporitoR, ZohnHK, PerlmanSP.Special Olympics, special smiles: assessing the feasibility of epidemiologic data collection. J Am Dent Assoc1997;128:1687–96
6.
Muller-GiamarchiM, Ionesco-BenaicheN, JasminJR.Etat de santé bucco-dentaire des enfants handicapés dans les Alpes Maritimes. Inf Dent1993;21:1539–51.
7.
Academy of Dentistry for Persons with Disabilities.A position paper from the Academy of Dentistry for Persons with Disabilities: Preservation of quality oral healthcare services for people with developmental disabilities. Spec Care Dent1998;18:180–2.
8.
HolmesS.Promoting oral health in institutionalised older adults: a nursing perspective. J R Soc Health1998;118:167–72.
9.
WillershausenB, AzrakA, WilmsS.Fear of dental treatment and its possible effects on oral health. Eur J Med Res199925;4:72–7.
10.
YipHK, SmalesRJ.Glass ionomer cements used as fissure sealants with the atraumatic restorative treatment (ART) approach: review of literature. Int Dent J2002;52:67–70.
11.
YipHK, SmalesRJ, YuC, GaoXJ, DengDM.Comparison of atraumatic restorative treatment and conventional cavity preparations for glass-ionomer restorations in primary molars: one-year results. Quintessence Int2002:33;17–21.
12.
FrenckenJE, HolmgrenCJ.How effective is ART in the management of dental caries? Community Dent Oral Epidemiol1999;27:423–30.
13.
MaragakisGM, HahnP, HellwigE.Chemomechanical caries removal: a comprehensive review of the literature. Int Dent J2001;51:291–9.
14.
DevaniP, LaveryKM, HowellCJT.Dental extractions in patients on warfarin: Is alteration of anticoagulant regime necessary? Br J Oral Maxillofacial Surg1998;36:107–11.
15.
WahlMJ.Myths of dental surgery in patients receiving anticoagulant therapyJ Am Dent Assoc2000;131:77–81.
16.
ScullyC, WolffA.Oral surgery in patients on anticoagulant therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod2002;94:57–64.
17.
NiwaH, SatoY, MatsuuraH.Safety of dental treatment in patients with previously diagnosed acute myocardial infarction or unstable angina pectoris. Oral Surg Oral Med Oral Pathol Oral Radiol Endod2000;89:35–41.
18.
FreymillerEG, AghalooT.Dental management of patients with coronary artery disease. J Calif Dent Assoc1995;23:41–6.
19.
WatersBG.Providing dental treatment for patients with cardiovascular disease. Ont Dent1995;72:24–6, 28–32.
20.
FindlerM, GaliliD, MeidanZ, YakirevitchV, GarfunkelAA.Dental treatment in very high risk patients with active ischemic heart disease. Oral Surg Oral Med Oral Pathol1993;76:298–300.
21.
LuDP, LuGP.Hypnosis and pharmacological sedation for medically compromised patients. Compend Contin Educ Dent1996;17:32, 34–6, 38–40.
22.
Abou-RayaS, NaeemA, Abou-ElKH, ElBS.Coronary artery disease and periodontal disease: is there a link? Angiology2002; 53:141–8.
23.
MattilaKJ, ValleMS, NieminenMS, ValtonenVV, HietaniemiKL.Dental infections and coronary atherosclerosis. Atherosclerosis1993;103:205–11.
24.
SeymourRA, SteeleJG.Is there a link between periodontal disease and coronary heart disease? Br Dent J1998;10:33–8.
25.
BeckJD, OffenbacherS, WilliamsR, GibbsP, GarciaR.Periodontitis: a risk factor for coronary heart disease? Ann Periodontol1998;3:127–41.
26.
MillerCS, LeonelliFM, LathamE.Selective interference with pacemaker activity by electrical dental devices. Oral Surg Oral Med Oral Pathol Oral Radiol Endod1998;85:33–6.
27.
ZappaU, StuderM, MerkleA, GrafH, SimonaC.Effect of electrically powered dental devices on cardiac parameter function in humans. Parodontol1991;2:299–308.
28.
HakebergM, DernevikL, GatzinskyP, EklofC, KennergrenC, JontellM.The significance of oral health and dental treatment for the postoperative outcome of heart valve surgery. Scand Cardiovasc J1999;33:5–8.
29.
CarmonaIT, Diz DiosP, Scully. An update on the controversies in bacterial endocarditis of oral origin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod2002;93:660–70.
30.
SeymourRA, LowryR, WhitworthJM, MartinMV.Infective endocarditis, dentistry and antibiotic prophylaxis; time for a rethink? Br Dent J2000;189:610–6.
31.
Al-KaraawiZM, LucasVS, GelbierM, RobertsGJ.Dental procedures in children with severe congenital heart disease: a theoretical analysis of prophylaxis and non-prophylaxis procedures. Heart2001;85:66–8.
32.
ScullyC.Oral infections in the immunocompromised patient. Br Dent J1992;172:401–7.
33.
CumellaS, RansfordN, LyonsJ, BurnhamH.Needs for oral care among people with intellectual disability not in contact with Community Dental Services. J Intellect Disabil Res2000;44:45–52.
34.
HollandTS, O'MullaneDM.The organisation of dental care for groups of mentally handicapped persons. Community Dent Health1990;7:285–93.
35.
FukutaO, BrahamRL, YanaseH, AtsumiN, KurosuK.The sedative effect of intranasal midazolam administration in the dental treatment of patients with mental disabilities. Part 1.The effect of a 0.2 mg/kg dose. J Clin Pediatr Dent1993;17:231–7.
36.
JonesJA, MashLK, NiessenLC.Restorative considerations for special needs patients. Dent Clin North Am1993;37:483–95.
37.
GrystME, MountGJ.The use of glass ionomer in special needs patients. Aust Dent J1999;44:268–74.
38.
MerryAJ, EdwardsDM.Disability Part 1; The Disability Discrimination Act (1995)–implications for dentists. Br Dent J2002; 193:199–201
39.
BridgmanAM, WilsonMA.The treatment of adult patients with mental disability. Part 1: Consent and duty. Br Dent J2000;189:66–8.
40.
• PorterSR, ScullyC, editors. Oral Healthcare For Those With HIV And Other Special Needs.Northwood: Science Reviews, 1995.
• Report of the BSDH Working Group.Oral Healthcare for People Mental Health Problems: Guidelines and Recommendations. January 2000.
44.
• ScullyC, Diz DiosP, GiangrandeP, LeeC.Oral Care for People with Hemophilia or a Hereditary Bleeding Tendency. The Treatment of Hemophilia Monograph Series [no 27]. Montreal: World Federation of Hemophilia, 2002.
