Dental care and dental treatment are paramount to health. However, the provision of routine dental care can become quite complicated for patients with medical comorbidities and special needs, with increasing consideration the more complex the patient’s medical history and behavioral considerations are. The increasing prevalence of diagnoses of autism, coupled with the increasing prevalence of chronic diseases such as diabetes, obesity, cardiovascular disease, and chronic infectious diseases, to name a few, has necessitated increased communication of dentists with physicians, as well as increased medical involvement by the dentist. The aging population, as well as the growing population of patients with special needs (intellectual and developmental disabilities), has contributed to the increased medical management of patients for dental care. Many medications for these diseases also carry significant dental implications. Appropriate and routine oral and dental care contributes to improved health outcomes, but this care must be rendered in a manner that is safe and attentive to patients’ tolerance as well as systemic health concerns. Such considerations include the necessity for anxiolysis and sedation, behavior management, as well as antibiotic prophylaxis, pre-procedural lab value verification, evaluation for patient optimization, and reduction of post-procedural complications. Patients may also require modifications to medication regimens.
1. Critically assess a patient’s medical history and assess the need for further evaluation or information.
2. Review the implication of several common medical diagnoses of special needs on patients’ physiology and function.
3. Recognize the oral and dental implications and effects of several common medical diagnoses.
4. Describe best practices for how to communicate with the patient, caregivers, and medical team to optimize dental care and management.
5. Discuss varying levels of a patient’s behavioral tolerances and medical history in order to better anticipate and avoid dental treatment complications.
6. Provide 2-3 example methods to manage patients who have difficulty tolerating dental treatment.
7. Identify 2-3 modifications and accommodations that can be made to provide appropriate and clinically sound care for complex patients