title: Social supports and prevention strategies as adjuncts and alternatives to sedation and anesthesia for people with special needs.
abstract: People with special needs are assuming a more prominent place in our society. The number of people living in communities with medical, physical, and psychological conditions is increasing dramatically. In spite of the advances that people with special needs have made in recognition of their right to live in society and access services open to other people, their oral health is still significantly poorer than that of other groups. There are a number of modalities that can complement or replace pharmacological interventions and allow individuals to have dental treatment in a dental office or clinic. These include behavioral or psychological interventions and social support and prevention strategies. Social supports include care management and integration of oral health services with general health and social service systems. Preventive programs using modern "medical model" oral health prevention strategies also have the potential to reduce the burden of disease among people with special needs and therefore reduce the need for dental procedures. A social support system using community-based Dental Hygienists acting as Dental Coordinators, is described along with outcomes demonstrating improved oral health for people with special needs living in community residential care facilities. Combined social support systems and community prevention strategies have the potential to reduce the need for pharmacological interventions in order to maintain oral health in populations of people with special needs. Social supports and modern preventive strategies must be included in the range of options available in communities in order to improve and maintain oral health for people with special needs.
authors.affiliation: University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, USA. pglassman@pacific.edu
authors.forename: Paul
authors.initials: P
authors.lastname: Glassman
authors.forename: Christine
authors.initials: C
authors.lastname: Miller
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental; D032763:Behavior Control; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D016292:Procedural Sedation; D054810:Deep Sedation; D019033:Delivery of Health Care, Integrated; D017742:Dental Care for Chronically Ill; D003730:Dental Care for Persons with Disabilities; D003756:Dental Hygienists; D005260:Female; D006267:Health Education, Dental; D006295:Health Resources; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D020380:Needs Assessment; D009909:Oral Health; D011313:Preventive Dentistry; D012017:Referral and Consultation; D012112:Residential Facilities; D012944:Social Support; D012947:Social Work; D055815:Young Adult