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The oral health of those with learning disabilities can sadly often be put at risk because of poor communication and a lack of understanding of their needs.
By Naomi Todd
An individual with a learning disability may not understand the importance of keeping a healthy mouth, which can be difficult when trying to get the individual to maintain a healthy day-to-day routine. In addition, people with special needs may become overanxious at the thought of going to the dentist, while people suffering from severe medical problems may need additional care.
Improving oral health for people with special needs is possible through community based dental care systems. Patients, carers and parents need to be educated to understand how to prevent and treat oral disease.
On 28 March 2016 ITV reported on the introduction of a scheme in the South West, targeted at adults with learning disabilities which highlighted the importance of healthy eating and reducing sugar intake.
A team of adults with learning disabilities completed a training course as part of a pioneering dental ambassador scheme in Plymouth. Among other things, the team were taught proper brush technique and the importance of cutting down on sugar. The idea is that they will then act as “dental ambassadors”, passing on their knowledge of oral hygiene to other teenagers with learning disabilities in the community.
The course was devised by the Peninsula Dental Social Enterprise team, and has had a huge impact on people’s well-being. It was reported that as a result of the course, one ambassador is now able to control his diabetes a lot better because he understands the impact of sugar in his diet, and another is now brushing his teeth independently, which he has never done previously in the whole of his adult life.
It is hope that this initiative will be introduced to other areas across the West Country.
In order to assist people with learning difficulties to manage their dental hygiene, the dental profession should ensure that people with learning disabilities have the opportunity to learn about their oral health and that information is provided in ways that take communication difficulties into account. Picture-based books, videos and visual support are of great assistance to those with special needs and this, along with carefully monitored supervision can help them to understand about oral health.
Dentists should also try to ease the situation by keeping appointments short and offering oral or intravenous sedation when required. The dental team may also offer advice to care givers about the dental care of others. It is very important to build a relationship between the dental team, the patient and their care giver. This can help greatly with people who have severe learning difficulties. Short but regular appointments can work better at building trust between the patient and the dentist rather than long appointments at irregular intervals.
Although many dentists will treat people with special dental needs in their own surgery, some people may find it hard to get to the surgery. The practice should therefore make alternative arrangements such as home visits or referrals to special health centres.
Usually the patient’s dentist or doctor is responsible for referring them to the clinic best suited to their needs. The dentist or doctor will write a referral letter and send this, along with details of any relevant medical history, hospital letters and x-rays, to give the dental team an idea of the patient’s dental history.