Dental Care for the Patient with a Spinal Cord Injury

Durnan, J. Richard; Thaler, Robert

doi:10.14219/jada.archive.1973.0262

Cited by 9 publications

(6 citation statements)

References 0 publications

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“…There is no reason not to assume that persons with SCI will encounter the same dental fears as the rest of the population; however, there may be additional factors unique to SCI. These may include: access to dental care, difficulty clearing oral cavity secretions, and poor coughing ability due to the deinnervations or impairments of breathing musculature 10,11,26 . Our study did not explore the participants’ underlying reasons for their dental fear.…”

Section: Discussionmentioning

confidence: 97%

“…These may include: access to dental care, difficulty clearing oral cavity secretions, and poor coughing ability due to the deinnervations or impairments of breathing musculature. 10,11,26 Our study did not explore the participants' underlying reasons for their dental fear. Further study should use a qualitative approach to understand this important issue.…”

Section: F a C T O R S L I M I T I N G D E N T A L A C C E S Smentioning

confidence: 99%

“…Compared to the general population, persons with disability exhibit a higher level of dental fear 7,9 . Dental fear among persons with SCI may relate to inaccessible dental office environments, 3,5 and/or experiencing episodes of asphyxiation due to impaired respiratory musculature while undergoing dental procedures 10,11 …”

Section: Introductionmentioning

confidence: 99%

“…7,9 Dental fear among persons with SCI may relate to inaccessible dental office environments, 3,5 and/or experiencing episodes of asphyxiation due to impaired respiratory musculature while undergoing dental procedures. 10,11 Physical access barriers can range from limited/nonaccessible (public) transportation, wheelchair-inaccessible terrain between residence and the dental office, and wheelchair inaccessibility into and within the dental office building. 3,5,6,[12][13][14] Despite passage of the Americans with Disabilities Act in 1990, widespread access barriers, including physical layout or environment for patients with disabilities, still exist within United States healthcare settings.…”

Section: Introductionmentioning

confidence: 99%

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Factors that limit access to dental care for adults with spinal cord injury

Yuen

Wolf

Bandyopadhyay

et al. 2010

Special Care in Dentistry

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Purpose-This study investigated dental care service utilization among adults with spinal cord injury (SCI) and identified barriers and other factors affecting utilization among this population. (n = 192) with SCI participated in an oral health survey assessing dental care service utilization and were compared with respondents from the 2004 Behavioral Risk Factors Surveillance System (BRFSS). Methods-RespondentsResults-There was no significant difference in the proportion of SCI respondents who visited the dentist for any reason in the past year compared to the general population (65.5% vs. 68.8%, P = 0.350). However, SCI respondents were less likely to go to the dentist for a dental cleaning in the past year compared to the general population (54.6% vs. 69.4%, P < 0.001). The three most commonly reported barriers to accessing dental care were cost (40.1 %), physical barriers (22.9%), and dental fear (15.1%). Multivariable modeling showed physical barriers and fear of dental visits were the two significant factors deterring respondents from dental visits in the past year.Conclusions-Physical barriers preventing access to dental facilities and dental fear are prevalent and significantly impede the delivery of dental health care to adults with SCI. Dentists should undertake necessary physical remodeling in their facilities to accommodate wheelchair users and implement appropriate strategies for the management of dental fear among patients with SCI. KeywordsDental care access; Physical barriers; Dental fear; Paraplegia; Tetraplegia NIH Public Access Spinal cord injuries (SCI) have a profound effect on oral health. For persons with SCI, xerostomic side effects of medications (i.e., those used to reduce muscle spasms and regulate neurogenic bladder), 1 impaired manual dexterity, 2, 3 dependence on others for oral hygiene, 3 and access barriers to dental care may adversely affect their oral health. 3,4 The problems of access to dental care encountered by persons with SCI are similar to those for non-disabled individuals (especially those of low socio-economic status without private dental insurance), but are compounded by physical barriers (e.g., wheelchair-inaccessible dental offices), 5,6 limited transportation, 5, 6 lack of dentists specializing in oral health needs of this population, 7 and limited knowledge of oral health issues faced by persons with SCI. 4,8 Stiefel 3 suggested that high cost, dental fear or anxiety, and physical barriers are the three major obstacles to community-dwelling adults with SCI in obtaining regular dental care services. Compared to the general population, persons with disability exhibit a higher level of dental fear. 7,9 Dental fear among persons with SCI may relate to inaccessible dental office environments, 3, 5 and/or experiencing episodes of asphyxiation due to impaired respiratory musculature while undergoing dental procedures. 10,11 Physical access barriers can range from limited/non-accessible (public) transportation, wheelchair-inaccessible terrain between residence an...

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Section: Discussionmentioning

confidence: 97%

Section: F a C T O R S L I M I T I N G D E N T A L A C C E S Smentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Factors that limit access to dental care for adults with spinal cord injury

Yuen

Wolf

Bandyopadhyay

et al. 2010

Special Care in Dentistry

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“…11 Compared to the general population, persons with disabilities exhibit a higher level of dental fear, which may be related to the inaccessibility of dental offices and/or previous experiences of episodes of asphyxiation due to impaired respiratory musculature while undergoing dental procedures. 12,13 Moreover, the aging population is increasing worldwide, which is also increasing the risk for disabilities in elderly people and consequently the demand for prosthodontic treatment in patients with special needs. 14,15 Although many people with disabilities can be treated by a general dentist, there is a demand for specialists in special care dentistry to provide dental treatment to those who need to be treated by dentists with special skills in communication and/or assistance.…”

mentioning

confidence: 99%

Treatment Plan and Challenges in Full‐Mouth Rehabilitation of a Quadriplegic Patient: A Clinical Report

Auerbacher

Kakoschke²,

Hickel

et al. 2021

Journal of Prosthodontics

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Spinal cord injuries lead to physical limitations, and the resulting levels of dependency and emotional distress have devastating consequences on individuals' oral health. A 46-year-old patient with incomplete quadriplegia due to a complicated medical history presented for prosthetic rehabilitation. The patient's ability and tolerance to be treated in the dental chair was assessed. Prosthetic treatment options were discussed considering his dependency on alternating caregivers. The final treatment plan involved restorative treatment, implant-supported crowns, an implant-supported fixed dental prosthesis and, in the upper jaw, an implant-supported overdenture to allow proper oral hygiene. The dental treatment sessions were performed with frequent interruptions in the dental chair, whereas the implants were placed under general anesthesia in the maxillo-facial surgery department. The final treatment plan resulted in a compromise between the prosthetic recommendation and the patient's wish. The decisive factor for choosing an implant-supported overdenture rather than an implantsupported fixed dental prosthesis in the upper jaw was the inability of the patient to maintain adequate hygiene measures by himself and his dependence on the caregivers. This clinical report demonstrates how special care dentistry can improve quality of life, even in people with severe physical and/or mental impairments. We would like to encourage dental professionals to provide high-quality care for patients with disabilities in particular, and this practice is in line with the requirements of the UN convention on the rights of persons with disabilities.

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