31
Volume2 Issue1
|
I
ssues and
P
eople
While recentlygivinga lecture toafinal-year class, I asked the students if they thought access
tocare for personswithdisabilitieswas an issue. Interestingly, about half of them saidno.
“After all,” they replied, “wehavehospitalswhere thesepeoplecanbe treated, andpediatric
dentists can takecareof them.” Clearly, theydidnot perceive this tobean issueat all.
KoneruandSigal found ina recent study
1
that 80%of dentists inOntarioarewilling to see
personswithdisabilities, and theAssociationof CanadianFacultiesofDentistry says in its
introduction tocompetency statements for undergraduatecurricula
2
that all competencies
equallyapply to individualswith special needs. If thiswas true, thenpeople like JoanRush’s
sonwouldnever haveaproblemgettingaccess tocare.
The situationMs. Rushdescribes isunfortunatelynot an isolatedoneandcertainlynot
limited toBC. A12-year-oldgirlwithautismpresented just recently inmyclinic. She
originallycame froma town inOntariowhere shewashelddownby5people inorder to
beadministeredageneral anesthetic for acleaningandexam. She subsequentlymoved
toLondon,where shemanaged toobtainanexaminationand
treatmentwitha “sleepdentist”—againunder general anesthesia.
Her extreme stress inamedical or dental environmentwas
palpablemerelywithher attending theoffice. Even though the
practitioners sheconsultedbeforeperhapshad theexpertise todo
theactual dental treatment, the impact theyhadon thispatient
wasdevastating. Inmyopinion,willingness to treat doesnot equate
access toappropriatecare.
Abigger problemexists in thepopulation transitioning from
pediatric toadult care. There is adearthof practitionersprepared
to treat thesepatients as theyenter intoadulthoodandworseyet
thoseof thegeriatricpopulationwith special needs.
A studybyShermanandAnderson
3
found that of the10 schoolsof dentistry inCanada,
5providedno specificdidactic instructions and5devotednoclinical time to treatment
for patientswithdisabilities. Inmyopinion, our current education system isnot addressing
these issues and fails topreparedentists toappropriately treat thispopulation. Inorder to
becompetent in treatingand knowingone’s capabilities inassessingand treatingaperson
with special needs, I donot believe that even the schoolwith theupper limit comes close
toprovidinganeducational background that allowsdental practitioners toadequately treat
personswith special needs.
Dr.Clive
Friedman
Dr.CliveFriedmanofLondon,Ontario, is apediatricdentist.He is apast president of the International
Association forDisabilityandOralHealth (iADH)and theAcademyofDentistry forPersonswith
Disabilities.Hewas instrumental indeveloping the iADHundergraduate curriculumdocument
on special caredentistrypublished in2013.CDAaskedDr. Friedman forhis thoughts on
JoanRush’s experiences.
By improving educationand
increasing the number of
clinicianswhoare able to treat
this population, thework canbe
spreadamongmany, leaving only
themost difficult to be taken care
ofwithin the hospital or specialist
community.
