Experiences of dentists and caregivers of patients with special care needs–A qualitative study

Author:

Tobis Rachel M.1,Cardoso Elaine O. C.12ORCID,Yarascavitch Carilynne13,Tenenbaum Howard C.14,Azarpazhooh Amir125,Sale Joanna E. M.1567

Affiliation:

1. Faculty of Dentistry University of Toronto Toronto Ontario Canada

2. Centre for Advanced Dental Research and Care Department of Dentistry Mount Sinai Hospital Toronto Ontario Canada

3. Department of Dental and Maxillofacial Sciences Sunnybrook Sciences Health Centre Toronto Ontario Canada

4. Faculty of Medicine University of Toronto Toronto Ontario Canada

5. Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada

6. Musculoskeletal Health and Outcomes Research Li Ka Shing Knowledge Institute St. Michael's Hospital, Unity Health Toronto Toronto Ontario Canada

7. Department of Surgery Faculty of Medicine University of Toronto Toronto Ontario Canada

Abstract

AbstractBackgroundPatients with special care needs (developmental disabilities) have unique and complex needs regarding their oral health and care. This qualitative study aimed to identify the experiences, preferences and challenges of dentists and caregivers regarding behavior guidance techniques for dental care in persons with special care needs.MethodsRelying on qualitative description as articulated by Sandelowski, we conducted telephone interviews with a purposeful sample of five special care dentists and seven caregivers. We analyzed the data using thematic analysis.ResultsFour themes were highlighted: (1) Neither pharmacological or non‐pharmacological behavior guidance techniques was universally suitable, (2) A patient‐centered approach was critical, (3) The dental environment triggered patients’ behaviors and anxiety levels, (4) There was more demand for, than supply of, qualified dentists to treat patients with special care needs.ConclusionsPersons with special care needs are heterogeneous and respond to various behavioral techniques required to deliver their treatment. Behavior guidance planning should be negotiated carefully with patients and caregivers and then individualized based on patients’ capabilities and needs for treatment. The necessity to manage complex behaviors has contributed to the limitation of access to dental care for persons with special care needs. Dentistry as a profession has the obligation to uphold the social contract and meet its responsibility to the dental care needs of this population.

Publisher

Wiley

Subject

General Dentistry

Reference29 articles.

1. Oral health of patients with intellectual disabilities: A systematic review

2. Access to dental care for persons with developmental disabilities in Ontario;Koneru A;J Can Dent Assoc,2009

3. Oral health care for patients with developmental disabilities: A survey of Michigan general dentists

4. Behavior guidance for the pediatric dental patient;American Academy of Pediatric Dentistry;Pediatr Dent,2018

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