By Sara Lindberg
Oftentimes patients with special needs, such as physical or developmental disabilities, require extra care, compassion and attention to help ensure they feel comfortable during their dental visits. But how does that care look different than the services you provide for any other patient?
“Children and adults with disabilities make up a significant portion of our population, yet dental providers are often anxious about providing care to these patients,” says Dr. Travis Nelson with the University of Washington Department of Pediatric Dentistry.
After implementing some small changes and learning a few best practices, dentists will find it’s easy and rewarding to work with these folks. “Treating geriatric or developmentally or physically disabled patients does not require special training, but it does require the dentist to have a special interest and enthusiasm for it,” explains Dr. Britt Bovio with Children’s Dentistry of Wenatchee in Washington.
Based on their extensive experience working with special needs patients, these dentists offer the following strategies to help you, your staff, and the patient and family members feel more comfortable before and during an office visit.
“If possible, have the patient’s caretaker complete all intake forms before scheduling an initial appointment,” Nelson says. Make sure office forms have areas for the caregiver to write about how the patient communicates, what has/has not worked well at the dentist’s office in the past, and if the patient has any specific dental needs. Review these forms yourself before scheduling the visit.
When the caregiver sets the first appointment, make sure you have the answer to three important questions: who consents for the patient, who takes care of the patient and how the patient will arrive at the appointment. People without transportation may have to arrange for a driver, which can cause delays in arrival, Bovio says.
She also likes to have the patient’s medical history and diagnosis in advance. It gives her a chance to research dental-related conditions as well as side effects any medications may cause. “I find that when I can let the caretaker know I am familiar with the condition we can immediately move in a more positive direction.”
Help the patient prepare
Nelson suggests that caregivers review photos of the staff, doctors and office with the patient before the first visit. “This can help take away the fear of the unknown. Also, take the pressure off yourself and the family by letting them know you don’t have to do an exam at the first visit. It can simply be an opportunity for the patient to visit the office and everyone to become acquainted.”
Encourage parents who are existing patients to bring older children with special needs to routine hygiene appointments. The parent models behavior during the cleaning, and the staff gets to know the potential new patient.
“Consider placing disabled patients in the first and last appointments of the day, or other times when you are less likely to be running late. Waiting can be very difficult for patients with special needs,” Nelson says.
Bovio stresses to her staff that they should never run late for appointments with these special clients. “The patient’s normal daily schedule will be changed, and we must remember this will cause anxiety for them,” she says. “I remind myself and my staff that the appointment really started for the patient from the moment they got in their vehicle. Some patients will drive several hours to see their dentist, and they are exhausted from the travel. Sitting too long in a waiting room may make the caretaker or patient self-conscious or create anxiety.”
Have the correct staffing
When performing treatments, Bovio always tries to work with two assistants in the room. “I find this really relieves my staff’s stress when one can focus on the patient and the other can help with the dentistry. Our appointments move along faster this way,” she says.
She also tries to keep the patient with the same staff members and the same room, so they can move past the reintroduction phase faster at each appointment. This helps create a pattern of care that lets the patient know what to expect.