SPECIAL NEEDS DENTISTRY

Special Care Dentistry (SCD) is an actively involved in the provision and enablement of delivery of proper oral care for the vulnerable group in the society. The vulnerable in this case include the disabled and the elderly. This review deals patently with special needs dentistry; in reference to three different articles each basing their factual arguments and ideas about people with special needs in dentistry. One cites on how the age of an individual predisposes one to be affected by dental diseases such as bad breath, gingivitis, loose tooth, ill-fitting dentures. This may lead to reduced ability to eat.

Second coverage of analysis if the majority of people with disabilities involving dental cases and in the context of normalization in that they are not in chronic stages that cannot be reversed to attain the stage of normalcy. Despite this fact that there are medical improvements. People who are seen as awkward often have oral bad oral health (Razak, Richard, Thankachan, Hafiz, Kumar, & Sameer, 2014). Due to this condition involving the individual with social problems such as those who have less income thus cannot access proper medical care raise an alarm on how to improve. Over the past ten years, there has been an improvement in oral health for both adults and children. This trend has a fore bearing on the total average health status of the entire population showing a trend of having better oral health.

According to the World Health Organization, the world population gradually growing at 1.7% every year, whereby their demography of those above 65 years of age is growing at a rate of 2.5%. With such population increase, both the developed and third world countries projections are to have significant shifts in the age demography in the near future (Salamone, Yacoub, Mahoney, & Edward, 2013). levels of adults from 50-70 years with poor and care support is increasing. In my opinion, this is brought about by factors such as low-level income, ignorance as a number one factor. Poverty levels, few hospitals with incompetent and others with few dentists to watch overmedication of individuals (Razak, Richard, Thankachan, Hafiz, Kumar, & Sameer, 2014).
Teeth variation while ageing

There is a gradual change in the teeth of an individual as they become older and this gradual change is known as age changes most of these teeth show changes but others parts such as the enamel does not show variation. Abrasion and wear cause changes in the form of the tooth. In older individuals, there is a change in the surface and this pattern on the tooth surface gives a certain reflection, which can be responsible for the colour observed. Changes in the dentin are a two age-dependent change which includes; continual growth, also known as the physiological secondary dentin formation and secondly, the steady obturation of the dentinal tubules known also as dentin sclerosis. These changes reduce the quantity (thickness) and quality of the enamel hence results in a steady reduction in the transparency. Pigmentation defects that are observed in the anatomical, and lack of sufficient oral can lead to the browning on the colour of the tooth. As an individual becomes older the permeability decreases while the brittleness becomes more and more (Pradhan et al., 2016).

The adult or older persons dental pulp is very different from that of the younger person in that, the first has less fibre and fewer cells and this, therefore, results in a lower volume of the teeth. There is also a reduction in the supply of blood in places such as the capillary loops in the subodontogenic region receiving a lower supply. The pulp does not have equal reparative capacity in old adults as that in younger individuals, this is why these processes are very important. The lab study of there teeth has shown a reduced healing capacity of the pulp as a consequent of the same processes. With the increase in age, there is observed, a trend in the root canal of narrowing and at the same time calcification. With deferent age, there are different morphology in the teeth. This morphology is important as it has vital clinical implication with a fore bearing on how the tooth responds to treatment and affecting the reparative response. In regards to the reports that have been done concerning people with disabilities, the has been an interesting statistic that a quarter of the adults will be affected by an infirmity in their lifetime The statistic from people reporting health problem/disability has been increasing significantly the past 10 years in reference to the world’s population. The society has been impacted in a way that cannot be ignored since the large percent hits the working class age bracket of 16 to 64yrs for men and 16 to 59yrs for women

Cases that have come up of oral cancer, which is an old age disease, has been a great pandemic to the world since most of the aged people are affected by oral cancer after they tend to get older. This has been influenced by factors I touched on at the introduction of ignorance as a key factor and other minors such poverty. What has raises eyebrows is the chance that it might not just be one case but a systematic case of the oral disease. These are concerning since it will affect a patients ability to become hygienic orally and improving their oral health. The effects of these diseases are not life-threatening but they have a very critical impact on the continued quality of life the individual gets to live. Therefore, when a dentist is going to prepare a system of treatment, he or she must look well into the daily lives and daily changes the patient faces and understand the chronic diseases

In categorizing health of the aged we group them in the following calibres

Those people aged between 65 to 74years are the young or otherwise considered as new elderly, have a tendency to be more active and yet much more healthy
Those whose ages are between 75-84 years vary from those being active to those are ailing from different chronic diseases.
Individuals who are above 85 years and above are the very old, who tend to be physically frail. Despite their frail nature, it appears to be the fastest growing group of the older population.

Skills mix and facilities

For a long time, there has been a belief that consultants should focus on hospitals and be there actively but it is now clear that there is a need for a change and if they have to be present they have to place their specialist skill in the provision of certain care in the clinics. SCD can be prided on the basis of a community and this may remove the walls of inequality in two ways:

Directly – this is by the provision of their services to the people directly other than the traditional hospital set up.
Indirectly- they may provide access to the health services by supporting another generalist who will participate in providing the dental care

In their normal setting, the community should work together with hospitals to ensure that a specialist is available and where there is a provision for immediate treatment for any cases of complications that may arise. In an ideal situation there should be on the dental team, well qualifies professionals like, the dental hygienist and the dental therapist and may ask for collaboration with promoters who will be able to take care of the preventive side of the healthcare services for beat support of people with the disabilities that will require this services the most. This way or approaching the problem will go a long way in prevention which is always better than cure. This reduces dental disease by a substantial fraction and further reduces any future incurred costs. Such an approach allows a proactive move to reduce and prevent dental disease rather than the currently common reactive approach to the treatment of disease.

In my opinion, in regards to the skills mix and facilities the government should stretch their hand in influencing development of infrastructures such as hospitals, roads relaying to those hospitals,[provision of ambulances for immediate attention required, also engage adequate capital that will fund procedures, specifically objected to subsidizing cost thus relieving cost to the people of the country. This will improve people’s lives and enhance better living standards amongst community members (Salamone, Yacoub, Mahoney, & Edward, 2013).
Improving access to dental care

There should be a more efficient way to increase the number of people who can get the dental care needed. In the care of the older adults, they may opt for linking them to a process of linking them together to provide the necessary dental care at a local level. The approach can not only benefit the old but can be extended to the adults who have disabilities enabling their access to dental care much more conveniently. It is true that most old people live in their homes and do not take part in many activities actively and same goes for the people with disabilities. The ages who require delicate and extensive care are I the care homes (Razak, Richard, Thankachan, Hafiz, Kumar, & Sameer, 2014).
Promoting primary dental care

There should be a mechanism that allows all people who have disabilities to access the national health service (NHS) and especially the dental care. Because more often than not, the voices of these people go without being listened to, there should be a more proactive way that these services are provided. Regular check-ups with the dentist and assessment and backing of the required specialist, when asked for, will be the right option for most of the people with these special dental care. When there have decided to create a treatment plan for the patients, there should be cognizant of the fact that some of the patients will require lifelong attention from the specialist because their current state is very critical and will continue to be so. Other complexities that accompany these conditions are; the collaboration with other professionals, challenges in getting permission for doing procedures and multifaceted need for the process of sedation or the broader scope of other anaesthesia services. The resultant requirement for liaison with other health and voluntary sector professionals; difficulties in obtaining consent; and the multifaceted requirements for sedation or general anaesthesia services (Pradhan et al., 2016).

This review has been looking for ways to give a view on the basic roles of primary dental care and the services of the specialist in providing all the services for the special needs dentistry

The biggest challenge in providing oral health care to the elderly and special needs patients would be the disregard for the need of oral health care by the same people.The services that they will attend to is the emergency care. Rarely do they come forth looking for ways to retain their teeth. The way forward for them would be to seek a home dentistry where the dentist would visit the patient other than the vice versa. It is, however, a new practice that is not being applied in many nations. There should be a study done in this specific sector ever so often so as to find out who are the people in need or special dental care.
Evaluation and validity of articles

Purpose

Article 1. Pradhan et al., (2016) states the purpose of the article clearly as the abstract explains the article is written to address the dentistry needs of geriatric patients. The abstract precisely explains the need for special dental treatment because it involves challenges of systematic and oral problems. The article attempts to inform the challenges faced by elderly people during dental treatments. The article persuades the elderly and disabled people for taking special care during oral and systematic examinations.

Article 2. Razak et al., (2014) presents the purpose of the article in the abstract. The abstract provides information about the reasons and matter of concern. The article states the complexities of dental care in case of older people needing special assistance.

Article 3. Salamone et al., (2013) clearly state the purpose health risk problems associated with the oral treatment of older people.

Type of journal

Article 1. The article is published in scholar journal involving high-quality research conducted by experts themselves engaged in a field of dentistry. The credentials of the authors reflect validity and authenticity of the article.

Article 2. It is published in ‘Journal of International Oral Health’ recognized as one of the renowned journals in the field of medicine.

Article 3. The article is published in Nursing Research and Practice, highly recognized in medicine.

Organization and content

Article 1. The article is presented in a well-organized manner starting from a concise abstract and identifying argument in the beginning. The presentation makes the argument understandable emphasizing the seriousness of dental care for elderly people. The article also considered previous researchers on the topic.

Article 2. Effective organization of the content makes the article more valid as it includes separate sections such as abstract, introduction, oral health status in aged, challenges and conclusion. Constructing different sections adds more validity.

Article 3. Clear abstract, introduction, literature and conclusion makes the article more credible.

Bias

Article1. The article lacks inherent bias as the researchers are practising dentistry. The results of the study rely on the responses obtained from the sample. The article presented solutions in light of existing research.

Article 2. The authors managed to minimize the bias by comparing the results with previous studies available on the topic. The inclusion of statistics and facts from various sources adds more credibility.

Article 3. It includes analysis of different articles obtained from meta-analyses thus minimizing chances of personal influence.

Bibliography

Article 1. It contains comprehensive bibliography including 14 sources. The article includes the short list of references but all are authentic and taken from well-known publications. The bibliography includes scholarly journals and books thus adding more validity.

Article 2. The article includes a detailed bibliographical list comprising of books on dentistry and scholarly articles. Most of the articles are obtained from PMC and PubMed, highly acceptable in a field of medicine and dentistry.

Article 3. It contains a long list of 42 articles retrieved from PubMed and PMC thus adding more credibility.

Usefulness

Article 1. The article is useful for understanding the significance of taking adequate measures for eliminating risks involved in dental treatments. It relies on the findings of other studies obtained from data analysis. However, the use is limited as the article does not include graphical depiction and survey.

Article 2. The usefulness of the article is apparent in the inclusion of facts and evidence. Different figures on the number of aged people undergoing dentistry issues result in more validity.

Article 3. The usefulness of the article is apparent as it identifies the complications faced by elderly people in the oral examination and dental care.

Authority

Article 1. The authors of the article have affiliations with the VSPM Dental College and Research Centre adding credibility to the article. The authors are themselves associated with a dental profession that adds more validity.

Article 2. The authors of the article are associated with the dental profession. Razak and Richard are specialists in dental periodontics. Direct affiliations of authors with dental professions makes the source more credible.

Article 3. Affiliation of authors with dental profession makes the article more valid. Authors have completed medical degrees.

Scope/ coverage

Article 1. The article has an extensive scope as it provides a brief overview of the conditions related to dental treatment and examination. It provides future scope for researchers to assess the significance of hygiene and other preventive measures of enhanced dental health.

Article 2. It has extended scope as it provides analysis of different issues faced by aged people such as poor hygiene, lack of visits and impact of diseases. It allows researchers to conduct further research on enhancement of dental care for elderly.

Article 3. The article has substantial scope for future researchers as it provides an in-depth view of the complications associated with the dental treatment of elderly.

Audience

The authors of all articles address the researchers and students associated with the field of dentistry. The articles provide information related to the risks involved in dental treatment and what measures can be taken in case of elder and disabled people.
References

Pardhan, M., Sonarkar, S., Shenoi, P., Uttarwar, V., & Mokhade, V. (2016). Geriatric Dentistry-an Overview. International Journal Of Oral Health Dentistry, 2(1), 26. http://dx.doi.org/10.5958/2395-499x.2016.00004.6.

Razak, P. A., Richard, K. M., Thankachan, R. P., Hafiz, K. A., Kumar, K. N., & Sameer, K. M. (2014). Geriatric Oral Health: A Review Article. Journal of Int Oral Health, 6 (6), 110–116. DOI: 10.5958/2395-499X.2016.00004.6

Salamone, K., Yacoub, E., Mahoney, A.-M., & Edward, K.-l. (2013). Oral Care of Hospitalised Older Patients in the Acute Medical Setting. Nurs Res Pract. DOI: 10. 1155/2013/827670.

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