Contributors

Prof.  L. Papagiannoulis (moderator)

Lecturer D. Emmanouil

Lecturer S. Gizani

Assist. Prof.  G. Papavasiliou

Country - Intitution

School of Dentistry, Kapodistrian University of Athens, Greece

Title

Oral care for persons with intellectual impairment and behavioural problems

Summary

The purpose of this symposium is to describe the most common oral health problems, the difficulties in providing prevention and/or dental treatment, and the behavioural as well as the sedation techniques that are used in this category of patients.

Various studies have shown that persons with special health care needs have poor oral health and great need for treatment. Studies in Greek children and young adults have shown that 41.44% of the children and 60.56% of the young adults with intellectual and/or physical impairment (PPII) examined needed periodontal treatment. More than 80% of their carious teeth were untreated. The data from a simple random sample of 534/614 dentists who participated in a recent  Annual Conference of the Hellenic Dental Association showed that professional cleaning is the most frequently performed type of treatment while orthodontic treatment was extremely rare. As it was expected dentists reported that any kind of dental treatment for PPII demands more time and is harder to be accomplished than any corresponding treatment for healthy patients. The treatment of PIIBP requires an interdisciplinary approach from medical and dental specialities. Also a very good knowledge of behaviour management techniques and pharmacological methods for controlling their fear and anxiety is of paramount importance. The most common pharmacological methods used, are inhalation sedation (with nitrous oxide/oxygen) and oral or intravenous sedation (usually with Midazolam). Sedation techniques will allow the dentist to treat these patients in a stress-reduced state, without their fear and anxiety impeding their ability to seek and maintain proper oral health care. However, the administration of sedatives in the private office is prohibited in some countries (e.g. Greece) and is allowed only in hospitals and universities. The quality of treatment in this category of patients should not be compromised that is why an interdisciplinary approach is important.