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Treating hearing-impaired patients

An unfortunate number of patients have a fear of the dentist. But imagine going to the dentist and having no warning when treatment is about to begin, not getting full explanations of what to expect during treatment, and being more sensitive than most to the vibration of a handpiece. This is a reality for many deaf and hard-of-hearing patients. Although a hearing patient may hear the handpiece and understand that work is about to begin, deaf patients lack such warning and are often taken by surprise. Deaf patients also tend to be more sensitive to vibration, so they find dental treatment to be particularly unpleasant. In addition, it is often incorrectly assumed that deaf patients can sufficiently communicate and be part of their dental care using lip reading and written notes. When dental practitioners wear facemasks hard of hearing patients can’t read their lips, and most practices are not equipped with methods of non-verbal explanation and communication.

Many dentists make an effort to treat underserved populations but typically fail to recognize deaf and hard-of-hearing patients as one such population. More than 28 million Americans are considered deaf or “hearing disabled.” The deaf and hard-of-hearing population is often overlooked and under served, particularly when it comes to dental treatment. While certain simple changes can be made to improve the deaf patient’s experience, technology has allowed patient care to be taken to the next level.

Making your practice more deaf friendly starts with the front desk.  It is important to have good lighting and be sure the staff understands that their face must be visible if the patient’s primary form of communication involves lip reading. The practice must also consider how a deaf patient might make an appointment or ask questions about insurance or their bill. Email, relay calls with a third party interpreter, and an AOL Instant Messenger account can be used for communication during office hours. In case of an emergency when the office is closed, deaf patients can reach the doctors directly via text message. Graphic communication is particularly important when discussing treatment. Photos can be taken before and during procedures and used along with nonverbal, graphic explanations of treatment and procedures to make sure that the patient is an active part of his or her own dental care. Computer programs that convert speech to text on a monitor overhead maintain patient involvement during procedures. The converter translates the doctor’s words, which are spoken into a microphone under the mask, into text on a monitor above the patient’s chair. This allows the patient may be in constant communication when lip-reading and sign communication is not possible due to masks and busy hands. Technology such as air abrasion and lasers can often be used to treat caries instead of a handpiece in order to eliminate the uncomfortable vibration associated with the drill.

According to the Americans with Disabilities Act, dentists “have a duty to provide appropriate auxiliary aids and services when necessary to ensure that communication with people who are deaf or hard of hearing is as effective as communication with others.” To learn more about your obligations as a health care provider, visit the National Association of the Deaf’s Q&A’s for health care providers.

Although providing these services takes investment and effort, the rewards of treating deaf and hard-of-hearing patients is more than compensated by the knowledge that you are providing a unique service to this population.

~Dr. Sabrina Magid

Sabrina Magid

Dr. Sabrina Magid-Katz is a practicing dentist and partner at Advanced Dentistry of Westchester. Dr. Sabrina Magid-Katz is a clinical instructor of Honors Esthetics at NYU College of Dentistry. Dr. Magid-Katz has been committed to addressing the needs of deaf and hard-of-hearing patients throughout her career. She began spreading awareness and teaching her peers about Deaf culture and American Sign language throughout high school and college. During dental school at University of Pennsylvania and residency at New York Presbyterian-Methodist Hospital she treated deaf patients, taught her colleagues, and extended their community outreach to include a school for the deaf for oral health education and dental screenings.

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