Guidelines for Medical Immobilization/Protective Stabilization for Your Practice.

Many patients with special healthcare needs present to medical, dental, and other health visits with behavioral, emotional, postural, and psychological issues. According to the American Academy of Developmental Medicine and Dentistry (AADMD) guidelines from 2017: "Clinical dental treatment is the most exacting and demanding medical procedure that persons with special needs undergo on a regular basis throughout their lifetime." Moreover, dental treatment is basically surgical in nature, usually requiring controlled placement of sharpened instruments in intimate proximity to the face, airway, and highly vascularized and innervated oral tissues. When medically necessary healthcare must be provided and the patient's inability to accept or cooperate will compromise the quality of care the clinician will be able to deliver, interventions may be indicated and implemented.

From Restraint to Medical Immobilization/Protective Stabilization.

Clinical dental treatment is the most exacting and demanding medical procedure that persons with special needs undergo on a regular basis throughout their lifetime. Dental treatment is surgical in nature, usually requiring controlled placement of sharpened instrumentation in intimate proximity to the face, airway, and highly vascularized and inner aged oral tissues. Although approximately 90% of patients with special needs can and should be mainstreamed through any general dental practice, without significant behavioral guidance, techniques, or medical immobilization/protective stabilization, there has been a drastic shift toward pharmacologic management of these patients using various forms of sedation and general anesthesia.

The Largest Minority Population With Unmet Oral Health Needs? Individuals With Disabilities.

People with disabilities develop the same health problems that affect the general population. Some may be more susceptible to developing chronic conditions because of the influence of behavioral risk factors such as increased physical inactivity. In addition, people with disabilities are more likely to be overweight or obese and to smoke. People with disabilities are at a greater risk of being a victim of violence than those without disabilities. The oral health of many people with disabilities is poor, and access to dental care is limited.

Pediatric Dentistry Specialty as Part of a Longer Continuum of Care: A Commentary.

The transition of teenagers with special needs to young adulthood is a complex period for the children and their families. This transition is especially difficult when it comes to securing needed oral health care. The teenager is forced to transfer from the services of an age defined pediatric dental specialist with training to provide care for individuals with special needs, to 1) general practitioners with limited formal training and often unwillingness to provide care and 2) at a period when most states provide limited or lack of adult dental Medicaid programs. These issues and the need to expand pediatric dental specialist involvement in the general transitional period are reviewed. "Pediatric dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs."(1) "Our system of preparing and maintaining our abilities to provide oral health services for an increasing diverse population must be brought up to date to meet the challenges posed by the treatment of young adults with disabilities."(2) "Most responding dentists (to a national study of pediatric dentists) helped adolescents with and without SHCNs (Special Health Care Needs) make the transition into adult care, but the major barrier was the availability of general dentists and specialists."(3).

Tennessee Dental Establishments: 2007-2012 Economic Survey.

OBJECTIVE: To document the evolving economies of dental establishments in the State of Tennessee during a period of significant growth of the number of establishments before and after the "Great Recession." METHOD: Published results from the five-year economic surveys by the U.S. Census Bureau on business receipts and salaries of employees (including dentists) for the State of Tennessee and its counties were used to construct a review of these developments. RESULTS: Between 2007 and 2012, there were continued increases in average current dollar business receipts and employee salaries. However, in terms of standard dollars, removing the effects of inflation: 1) business receipts increased in 19 counties but decreased in 37 counties; 2) employee salaries increased in 13 counties but decreased in 30 counties. CONCLUSIONS: Results are in line with the reports by the ADA Health Policy Institute, which indicate that nationally the percentage of dentists who report they are not busy enough has increased and dentists' earnings are stagnating. The need is to expand the delivery of care to underserved populations, including the poor, individuals with disabilities, minorities and new immigrant populations, for whom oral health services may not be a priority commodity.

Hardships of raising children with special health care needs (a commentary).

Providing health care services for youngsters with special health care needs (SHCN) requires understanding of the medical circumstances that impact on the particular youngster, as well as an increased awareness and sensitivity to their particular family setting, and the issues that impact on the child, his/her parents, and siblings. To this end a review was carried out regarding the variable affects on these youngsters, such as poverty, parental, and family issues, as well as considerations of who is at risk for SHCN and demographics of individuals with SHCN who have unmet health needs. The particular need for dental services, the health service most commonly reported as needed, but not received, is highlighted.

Health related issues for individuals with special health care needs.

More than 50 million individuals in the United States with developmental disabilities, complex medical problems, significant physical limitations, and a vast array of other conditions considered under the rubric of "disabilities" live in our communities, many as a result of deinstitutionalization and mainstreaming. Children and adults with special health care needs have become a much more integral and visible component of everyday life. This process represents an ongoing change in perceptions about individuals with disabilities and subsequent reform of policies concerning the rights and the principles of care for people with special needs. The reform was built upon an increased role for the family and community health practitioners in providing needed care.

The emergence of the American Academy of Developmental Medicine and Dentistry: educating clinicians about the challenges and rewards of treating patients with special health care needs.

Expanding the exposure of medical students and residents to persons with special health care needs has been a challenge. The purpose of this paper was to describe the development of the American Academy of Developmental Medicine and Dentistry, its principles, and its 5 essential concepts.