News Article

The National Post: Dental care for persons with special needs

This article was also published in the: Ottawa Citizen Newspaper, Calgary Herald Newspaper and the Montreal Gazette Newspaper

Dental care for people with special needs

Iris Winston, Postmedia News · Tuesday, Feb. 22, 2011

Many people with physical or mental disabilities are not receiving the oral care they need or have to wait for treatment for a year or more.

“Approximately 4.4 million people in Canada have disabilities. Ensuring that they receive proper oral care is a major issue,” says University of Toronto dentistry student Alison Sigal, the founder of Oral Health, Total Health (OHTH).

“We know that people with certain disabilities don’t have the hand function or ability to clean their teeth and that they are among the populations most affected by poor oral care,” says Canadian Dental Hygienists Association board member Sandy Lawlor. “It is really important for them to see a dental hygienist to get the plaque off and the teeth scaled so that the gums remain healthy.”

To address the problems facing people with disabilities, Sigal created the non-profit organization OHTH in 2008.

“The primary reason behind founding OHTH was to raise awareness about issues that persons with special needs face with regard to access to oral care,” Sigal says. “As well as getting information out to the public, it is important to have an impact on future generations.”

She says she became aware of the extent of the problem in 2006, while she was involved in a summer research project at Toronto’s Mount Sinai Hospital, where her father, Dr. Michael Sigal, is dentist-in-chief.

In researching the files of deceased special-needs patients, she found “the primary cause of death was sudden cardiac arrest” and noted the close (95%) correlation with aspiration pneumonia, which, she points out, is “due to inhaling bacteria in the mouth.”

“Had these patients had more frequent visits to a dentist or dental hygienist or even had improved daily dental care in their homes, they would have had a reduced amount of bacteria in their mouths. We are really looking at a quality-of-life issue, not just an oral-health issue.”

She also discovered that of the 3,500 or more patients with special needs seen annually at the Mount Sinai dental clinic dedicated to this group, some travelled up to eight hours for a 15-minute routine checkup. One reason for referring these patients to Mount Sinai is that while they receive some financial support through provincial disability insurance, it doesn’t always cover fees charged by dentists in private practice.

“We are known as the biggest program for these types of patients, so we are a catchment for referrals — some appropriate and some not,” Dr. Michael Sigal says. “The wait list to get into the program is about six months. If the person with special needs requires anesthesia, it is a year to a year-and-a-half. If a child with special needs is uncooperative with the dentist in the community and the only way to treat him is for him to be asleep and he is referred to us, it could be up to two years before the surgery is done. This is for something that is causing pain and suffering all along.”

Efforts are being made to make dental care more accessible, say oral health practitioners. “A lot of effort is being put in in non-traditional settings,” says Dr. Anthony Iacopino, the dean of the faculty of dentistry at the University of Manitoba. “Health care professionals are out in the community or in other clinics. We’re also seeing a lot more programs for non-dental health professionals, so that they can participate in screening and referring patients to oral health professionals.”

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