Gender differences in special needs populations.

The August 2000 Surgeon General's report confirmed that neglected, vulnerable populations in the United States are not adequately receiving oral health services. The silent epidemic of dental and oral diseases in population groups such as persons with MRDD and the geriatric population results in a diminished quality of life. This article presents a study and research design intended to gather data and report the results as related to the needs of a population with MRDD. The Surgeon General stated that oral health issues in relation to gender have not been explored adequately. The data that were collected add information on health, [table: see text] disease, and health practices in a neglected population, helping in part to address this important concern. The analysis of study data statistically confirmed certain differences between women and men in this special needs population. Women and men experienced a similar number of filled surfaces and missing teeth. Reports of oral pain and daily tooth cleaning were also similar. The rates of fluorosis and the need for urgent treatment differed by gender, as did the number of persons missing a combination of anterior and posterior teeth. In this population men exhibited a greater frequency of past oral injury than women and a greater burden of untreated caries. Men also exhibited a greater frequency of gingival signs, indicating a possible lack of attention to proper oral hygiene; this finding was coupled with their greater frequency of need for urgent dental treatment. Although some reasons for these findings can be postulated, more research into the causes is warranted. Those findings can then form the basis for sound policy decisions that will improve the oral health of both men and women with special needs. Barriers to improved oral health, whether they result from problems with access to providers, from attitudinal problems inherent in the providers themselves, the patient, or the patient's caretakers, or from a possibly gender-biased database, must be effectively addressed. Such barriers can be removed through increased knowledge that takes into account any physiologic and psychosocial differences in men and women, particularly in the long-neglected segments of the population--the elderly and the developmentally disabled.

The role of the dental hygienist in mass disasters.

The authors examine the specialty of dental hygiene and address its role in the identification of mass-disaster fatalities. Very little exists in the literature on what dental hygienists can often and what they have contributed as members of dental-identification teams. To encourage forensic dentists to seek out the valuable assistance of these highly trained professionals, the authors illustrate how their services can be used in mass disasters.

Dental neglect: definition and prevention in the Louisiana Developmental Centers for patients with MRDD.

When dental services and appropriate use of restraints are used for persons who are severely and profoundly mentally retarded and developmentally disabled (MRDD), oral health is enhanced and dental neglect is controlled or even reduced. This paper defines dental neglect and examines the consequences to persons who are MRDD when appropriate restraints and preventive dental home care are not used. Oral health outcome assessment data of this MRDD population indicate the presence or absence of dental neglect. The outcome assessment measures the level of oral health within the developmental center. The Louisiana Department of Health and Hospitals (DHH) operates nine developmental centers, where approximately 2000 individuals with severe to profound mental handicaps reside. Two-thirds (66%) of this population are resistive to the delivery of clinical and preventive dental services. The responsibilities and roles of dental health professionals, long-term-care facility administrators, and direct service staff are discussed to help reduce dental neglect in these centers. For these individuals to receive quality and comprehensive dental care, appropriate use of restraint/physical hold is necessary. The Dental Health Resource Program (DHRP) developed guidelines for delivering preventive and clinical dental services to reduce confusion and misinterpretation of the definition and use of restraint in the Louisiana Developmental Centers (LADCs).

Dental treatment guidelines for use of restraints within the nine Louisiana developmental centers. Louisiana State University Dental Health Resources Program.

There are approximatively 2000 mentally retarded or developmentally disabled (MR/DD) individuals in Louisiana's nine developmental centers (LDC). Two-thirds resist the delivery of preventive and clinical dental services. Therefore, for these patients to receive quality, comprehensive dental care, some form of restraint is necessary. Physical holds, mechanical and/or chemical restraints allow caregivers and dental professionals to provide medical/dental services. However, prior to the use of restraint, a clear understanding and acquisition of informed consent are needed. The dentist, developmental center and its administration are responsible for developing a plan to obtain informed consent and to express the importance of restraint to each resident's guardian. This article defines the types of restraint based upon resistance encountered and defines informed consent according to the Louisiana Medical Consent Law.