Volume 9 • 2022 • Issue 2

People with special needs live with a varietyof challenges, and they are our most vulnerable citizens. Their needs are many and complex, and they are often forgotten. References 1. Holden, R. Better Access to Oral Health Care Makes a Better Nation. CDA Essentials . 2021;8(5):7. 2. Canadian Dental Association. Dental Care for Persons with Special Needs . Available at: cda-adc.ca/en/oral_health/cfyt/ special_needs (accessed 2022 Feb 25) When my brothers received restorative care, it was challenging to maintain. Among this population, there is a high incidence of repair amid ongoing periodontal problems. Where does all this lead? Often, to tooth loss. Partial dentures for many of these patients are not practical, they function as a plaque trap, and can lead to further breakdown. Full dentures for many of these patients also don’t work well. After I graduated from dental school, I was able to provide my brothers’ dental care for a few years. I wish I could say that their oral health was perfect during this time, but because basic oral care and plaque removal continued to be marginal at best, restoration continued to be required. I moved to the West Coast for graduate school and ultimately settled there, so further care was entrusted to dentists who were willing to take the time and make the effort to meet my brothers’ needs. To these dentists, I am most grateful. One of my brothers still has most of his own teeth, while the other has not been so fortunate. Yet, he manages to enjoy his food and function well. There isn’t a single cause for lack of access to care, nor a simple, single solution. People with special needs live with a variety of challenges, and they are our most vulnerable citizens. Their needs are many and complex, and they are often forgotten. Families and caregivers do their best. My thanks and admiration go out to the dedicated professionals who accept the challenges of treating people like my brothers in their offices, in hospitals, or on site in institutional environments. As a profession, there are some goals that we can only accomplish together. It will take resources, planning, and a shared sense of purpose, but I believe it is possible. And we can keep our goals simple. We can help these patients stay pain free. Help them keep their teeth, despite the challenges and the high incidence of repair. Help them continue to enjoy the basic benefits of a healthy mouth: the enjoyment of food and a smile they can take pride in. I appreciate the efforts of CDA, provincial and territorial dental organizations and other groups who advocate for people like my brothers. I’m thankful to see programs continue to evolve in education, prevention, and treatment that will benefit them. The work on this issue on a national scale is similar to the work of caring for these patients on a daily basis: it isn’t easy, it never will be, but it makes a world of difference. Individuals who live in a group home or institutional environments have even greater oral health problems, despite the best efforts of staff and caregivers. Maintaining a program of adequate daily oral health care is hard and it competes with other aspects of health care for time and resources. ~ Dr. Markey is a retired orthodontist living in BC and served as CDA president in 1987–88. 18 | 2022 | Issue 2 News and Events