6 things to keep in mind while treating patients with intellectual disabilities

Close up of boy having his teeth examined by a

Does the thought of treating a patient with an intellectual disability make you nervous? Health care providers are often intimidated by the idea that they may not know how to properly coordinate the patient’s care, communicate with him or her, or even manage behavior during the visit. Take a deep breath and look at it from the other side–your patient is just as nervous about you! Dental anxiety is common among many of our patients, and this fear can be magnified in someone with a cognitive delay who is coming to your office for treatments that they may not fully understand. Treating these patients may be a challenge, but it also might become one of the most rewarding patient visits you will ever encounter. Try some of these practical tips to facilitate smooth and enjoyable visit for you and your patient.

  1. Practice active listening. Patients with developmental delays may have difficulty with speech and communicating clearly. But, you might be surprised to find that they can understand much more than they can convey. Stopping your work for a minute and listening intently shows that you care about what they have to say. Your patients may use verbal language, nonverbal language, or a combination of both along with gestures. Be perceptive and sensitive to their efforts to show you are doing your best to understand. This small act of kindness can make the biggest difference in how well the appointment goes. After all, everyone wants to feel heard and understood.
  2. Prioritize clear communication. It’s respectful to talk to your patients directly with eye contact, even when the parent or caregiver is in the room. Make sure to use simple instructions and repeat them often during the appointment. You may need to take extra time, speaking slowly and clearly, to demonstrate what your instruments are prior to using them. Be patient and give one direction at a time, using clear and simple language. Show your patients what you want them to do and remember to encourage them with generous, earnest compliments.
  3. Set appointments early in the day. Do this when possible to keep the patient fresh. It is also recommended to keep appointments short, even if it means scheduling multiple appointments. Doing so can efficiently engage a patient with a cognitive impairment and limited attention span, while avoiding fatiguing him or her.
  4. Keep your team well-acquainted with the patient. Allow patients to take the time to get to know you and your staff so that they feel fully comfortable with their surroundings, especially before you try a difficult procedure. Before each appointment, inform all members of the dental team about your patient. When he or she arrives, ensure that each member of the team helps greet the patient and makes him or her feel welcome and special. Consider even giving patients and their family members a small tour of the office before you begin.
  5. Get the family involved. A patient with developmental delays is often more comfortable if you can incorporate family members into his or her first visit. Showing the patient around the office also gives you an opportunity to explain what all the new sights and sounds are and more importantly, reassure the patient that there is nothing to fear. Consider allowing a parent to stay during the appointment to hold the patient’s hand and talk to him or her. Some patients may even respond well to a friendly staff member holding their hand. Asking a family member to bring in the patient’s favorite stuffed animal or blanket can add an extra sense of comfort and familiarity.
  6. Be mindful of your light. Patients with an intellectual disability are often also sensitive to light. Try to avoid inadvertently shining the light directly into their eyes, especially as you work with loupes on. You can also try using only your loupe lights and forgo the use of the additional overhead light. The patient may also benefit from the comfort of wearing sunglasses during the appointment.

By taking the time to get to know each patient and his or her individual needs, you will find your unease quickly replaced by eagerness each time you see the patient’s name listed on your schedule. Take each challenge as a new opportunity to learn and enjoy the process!

~ Jamie Udell, Utah ’18, chapter newsletter chair

Keeping the patient’s best interest in mind

Patient in chairWith so many factors that go into treatment planning (cost, insurance coverage, time requirements, length of procedures, knowledge of the treatment, fear), sometimes we may lose sight of what is best for the patient. Never make assumptions. Get to know your patients. Make sure that he or she understands what the procedure entails and is clear on the pros and cons of every treatment option. Taking the time to listen to the patient and explain all possible treatment options and ways for future prevention is paramount to treating each person in the best way possible.

Talk less, do more

465520267Mentalis. Buccinator. Risorius. As dental students, we are all familiar with speaking—well, at least we’re familiar with what muscles are used in speaking. Dental students rely heavily on interpersonal communication with our faculty, our peers, and our patients. Our goals for patient care often include a change in habit, whether it is flossing more or quitting smoking. Though the bulk of habit formation relies on the patient, a sizable burden rests on how we communicate those goals to the patient. But when it comes to that communication, our approach is sometimes backwards!

Tattoos in dentistry: self expression or unprofessional?

dental-tattsWhen I tell people I have a tattoo the first thing I see are widened eyes followed by shocked gasps. “What!” they exclaim “you have a tattoo? Where?”Their opinion of me automatically changes within those first few minutes after the revelation. I suddenly transform from the boring dental student to the rebellious night-crawler.

Tattoos have a long history since the first evidence of their existence dating back to 2000 B.C. in Ancient Egypt. In the past tattoos may have served as amulets, status symbols, declarations of love, signs of religious beliefs, adornments and even forms of punishment, today they are a common form of personal expression. But do they belong in dentistry?