From the Editor

Gerard Kugel, DMD, MS, PhD

Dear Readers,

This month, the Inside Dentistry cover feature addresses what the dental profession at large should be discussing when its members engage in a conversation about treating “special needs” patients. While clearly access to care remains an important factor in the delivery of treatment to patients with special needs, more significant is removing barriers to their care stemming from misunderstandings about their unique conditions and any challenges to dentistry that they may present.

The Impact of Special Needs on Oral Health. Many of us chose to pursue a career in dentistry as a means to help people. Now, more than ever before, we know that people aren’t healthy unless they have oral health. It’s a shame that so many citizens of the world suffer with poor oral health because they are disabled and/or have special needs. They may be unable to comprehend or follow through with a regimen that would allow them to maintain healthy teeth and gums. They may be unable to receive regular preventive or restorative treatment without medical complications. Or, they may not have the financial resources that would enable them to afford even the basic dental care that could prevent more invasive treatment. This situation will only get worse as federal government support for some of these services is shrinking along with state budgets.

Special Needs are All Different Needs. I am especially concerned about this topic, having been raised in a family very involved in helping the “special needs” community. As a child, my family adopted an abandoned “special needs” foster child with a number of medical and dental complications. We were a poor family, and trying to get my foster brother dental services was always a challenge. Fortunately, we were able to find a caring dentist nearby that was willing to help.

When we are approached by a caregiver for a patient with special needs, or perhaps even by the patient with special needs themselves, it’s imperative that we de-program our mind and forget “the worst case scenario.” This is the stereotype we have ingrained in us of what this patient will be like and what it will be like to treat him or her based on what little information we may have about their condition. Or, it could just be based on what we envision treatment of a "special needs" patient to entail. As our interviewees explain, every patient, every case, every condition, and every visit is unique. We must get to know the patient first. We must get to know their needs. We must get to know the best way to provide treatment. This includes educating and preparing our staff to handle these cases. We cannot assume the “worst case scenario” is what defines that individual’s special needs.

Do It for the Right Reasons. It’s an interesting fact that an increasingly large percentage of the population will one day fit into a specific “special needs” category—that composed of people who are geriatric or elderly. Each of us will some day fall into that mix. Will there be a caring and compassionate dentist available to provide us with quality dental care when we need it? What if we’re hard of hearing or don’t like the lighting in the office, or if we need a little extra assistance getting in and out of the dental chair? If you’re interested in treating patients with special needs, be sure you’re passionate about it. Be sure you’re ready and willing to exercise the patience and interpersonal skills necessary to get to know your patient—perhaps a little more than usual—so you can cater to not only their unique dental needs, but also their special needs.

We hope you enjoy this issue and find that it opens your mind and heart to the possibilities of providing care to a segment of our population that desperately needs our skills and expertise.

Please send us your feedback to letters@insidedentistry.net. As always, your thoughts, opinions, and reactions are our motivations to continually enhance our clinical content and coverage of today’s topics of interest. Thank you for reading and, most of all, thank you for your continued support.

With warm regards,

Gerard Kugel, DMD, MS, PhD
Associate Dean for Research
Tufts University School of Dental Medicine
gkugel@aegiscomm.com