What is Special Care?
It is an approach to oral health management tailored to the individual needs of people with a variety of medical conditions or limitations that require more than routine delivery of oral care. Special care encompasses preventive, diagnostic, and treatment services.
A person with diabetes who is at increased risk of gum disease, a young child who needs dentures because of a genetic disorder, or a person with arthritis who cannot hold a toothbrush require special care. Standard treatment procedures can be adapted to fit most patients’ needs and abilities. While some patients require more specialized care, most can be treated successfully in general dental practices.
Why Do Patients Need Special Care?
Some patients need routine oral health care, but have medical conditions or limitations that require delivery of care beyond the routine. The dental team, for example, may need to learn to transfer a patient with cerebral palsy from the wheelchair to the dental chair, to use some sign language to communicate with deaf patients, or to adapt oral hygiene devices so a patient can use them.
Other patients have medical and oral conditions that call for extraordinary care and require oral health professionals to have specialized knowledge. Surgical treatment of oral cancer or genetic craniofacial defects, such as cleft lip and palate, often require extensive reconstruction that involves many health specialists. Further, disorders such as ectodermal dysplasia and osteogenesis imperfecta directly affect tooth and facial development and demand specialized treatment.
In addition, many systemic diseases and certain medical treatments have oral health implications. Dental professionals may need to develop a treatment strategy for a patient who has received an organ transplant, determine the best anesthetic alternative for a patient who has heart disease, or develop an oral health plan for a patient who must undergo treatment for cancer.
The oral health of special care patients may be neglected because of a demanding disease, a disabling condition, or limited access to oral health care. The coordination of care and an understanding of special care issues in oral health are essential for all members of a patient’s health care team, including medical and dental professionals and caregivers.