CDA Essentials 2019 • Volume 6 • Issue 6

9 Issue 6 | 2019 | CDA at W ork W e’ve all encountered situations in our practices where following your usual routine just isn’t going to work. Making a dental visit easier for patients from vulnerable population groups, including children with autism or seniors with Alzheimer’s or other forms of dementia, can require a different approach to how we provide care, but feelings of doubt may surface when we lack the training or experience to do so. Although some people with special health care needs require interventions that can only be provided in a hospital or other specialized setting, most can be seen in a general dentist practice. In my practice, I treat such patients as I would any other, except I slow down and take the time to explain what I’m doing and encourage cooperation. One of my patients is a teenager with autism who is constantly moving, can’t sit still in the chair for very long and asks questions non-stop. But we’ve developed a bargaining system that works well for both of us—I promise to answer each question if he’ll first allow me to perform one task. His dad always sits with us in the operatory and is a reassuring presence. Our visits go smoothly because I understand this patient’s individual needs; however, what works for one patient may not work for another. Last year, CDA commissioned research to examine the issue of access to care for people with intellectual or cognitive disabilities more closely (see p. 11 ). Dentists participated in focus groups, in-depth telephone interviews and an online survey. Researchers asked dentists across the country what challenges they perceived and where they felt they lacked knowledge or needed more training. The data showed that the majority of dentists surveyed treat patients with special health care needs as part of their regular practice. But it also revealed that more than half of participants (like me) had not received any formal training in treating these patients. Many study participants saw risk management as a potential challenge and indicated they would like to be trained in strategies for managing a variety of situations, including the safe transfer of a patient between a wheelchair and dental chair, managing aggressive or violent behaviours, or helping a patient cope with dental anxiety and stress. The research results reinforced that dentists are looking for more guidance in these areas, espe- cially best practices for preparing to welcome and care for patients with specific conditions, such as Autism Spectrum Disorder, Down syndrome, and Alzheimer’s and other types of dementia. They are also looking for guidance on when to refer versus when to treat, and on how to interact with patients and caregivers, including communicating treatment plans, obtaining information on medical history, and obtaining informed consent before starting treatment. CDA is working with experts in the field to develop these resources and will share them on the CDA website and CDA Oasis when ready. The key to improving the availability of oral health care for patients with intellectual and cognitive disabilities is to keep working to ad- dress barriers and misconceptions about these patient populations. Resources and training will go a long way towards meeting this goal, but we can begin by treating all patients with com- passion and empathy—skills that aren’t always taught, but learned through experience. From the President Alexander (Sandy)Mutchmor, dmd president@cda-adc.ca Dental Care for Patients with SpecialNeeds