Sedation Dentistry for the Disabled

The Special Needs Dental Patient

Are you one of the 49 million Americans with a disability? If the answer is yes, regular dental care is especially important to avoid the serious dental problems that often are associated with disabilities. A healthy mouth can contribute to your overall physical health and can increase your sense of well-being.

For persons with disabilities and medically compromised individuals regular dental care is vital to health and function. Dental neglect can have serious consequences, including increased costs and risks associated with hospitalization, and needless pain and suffering.

If you have a disability, you are among the 15% of the population who often have difficulty finding a dentist, particularly one skilled in care of persons with complex medical and oral problems. People with disabilities frequently have serious dental problems and have difficulty in accessing dental services.

Approximately 70 percent have severe developmental disabilities:

• Down Syndrome
• Cerebral Palsy
• Autism

The remaining 30 percent have extensive acquired disabilities such as:

• Spinal Cord Injuries
• Traumatic Brain Injuries
• Multiple Sclerosis
• Psychiatric Disorders

As a family member or caregiver of a person with disabilities, you know how essential it is to find the right dentist. Patients with severe disabilities often need care above and beyond that provided by the local dentist who may be untrained in anesthesia for special needs patients.

Dr. Grizzaffi has expertise in treating several patients such as those mentioned above as well as patients with:

• Alzheimer’s
• Parkinson's
• Cerebral Palsy
• Multiple Sclerosis
• Autism

These diseases as well as other physical and developmental disabilities require an extremely high level of skill, expertise, and state-of-the-art equipment. Genuine compassion for the individual is another hallmark of our care.

Our team understands the challenges of treating the mouth, teeth and gums of someone who no longer maintains good oral hygiene. The disabilities these types of patients are stricken with often interfere with their maintenance of daily dental care; brushing is sometimes difficult due to the individual's inability to understand and accept assistance from others. For these reasons, these types of patients often need more frequent professional cleanings, and twice the number of dental visits to prevent decay that might lead to tooth loss.

Other conditions that complicate dental care for the special needs patient, such as a severe gag reflex and Xerostomia ("dry mouth') which is often the byproduct of medications or other medical conditions. Symptoms of Xerostomia include: mouth dryness, burning sensations, difficulty eating, difficulty swallowing and/or speaking, sore throat, irritation of the tongue and painful ulcerations.

To learn more about xerostomia click here (pdf file).

Xerostomia can significantly diminish a person's quality-of-life, causing intense discomfort and eating problems, nutritional status, speech, and taste. An increase in tooth decay can be devastating in many patients and therefore special care is needed to control this condition.

Patients with certain of the neurological disabilities suffer complications which are just on the opposite side of the spectrum where they either produce excess saliva or are unable to swallow their saliva. Due to poor oral hygiene and the overabundance of saliva this leaves an excess of harmful bacteria in the mouth. Coupled with the challenges of using a toothbrush, the teeth and gums may deteriorate. Caregivers must include regular trips to the dentist in patients' health plans.

As the population ages, with increased retention of the natural dentition, there is a greater responsibility for dental professionals to maintain the oral health of medically, behaviorally, cognitively, and physically impaired adults. Dr. Grizzaffi can administer oral and or intravenous sedatives and nitrous oxide analgesia frequently and successfully for dental treatment in these patients. However, many compromised older adults cannot safely tolerate dental treatment with these sedative techniques in a typical “office” setting. Therefore the use of general anesthesia in a hospital environment, coordinated with medical and anesthesia specialists is a viable, safe, and effective treatment tool for providing comprehensive dental and oral surgical treatment for the older patient. Dr. Grizzaffi is on staff at Robert Wood Johnson University Hospital. As an attending staff member of Robert Wood Johnson University Hospital Dr. Grizzaffi has admitting privileges which allow him to admit such patients to the same day facility at Robert Wood. The treatment can be rendered in the safety of an operating room setting with an anesthesiologist administering the anesthesia along with an entire hospital staff at the patient’s disposal. Definitive dental treatment is carried out and all of the treatment is completed in one visit. For the severely medically compromised patient this is the safest way for their dental needs to be carried out.