Specialist Registrar in Special Care Dentistry, Barts Health, Royal London Hospital, Whitechapel Road, London, UK.
Consultant in Special Care Dentistry, Barts Health, Royal London Dental Hospital, Turner Street, London, E1 1BB, UK.
Br Dent J. 2019 Jul;227(1):19-24. doi: 10.1038/s41415-019-0468-3.
Background When anxious, patients with learning disabilities may display challenging behaviour. The prevalence of obesity in patients with learning disabilities is rising and can increase the complexity of management. Reasonable adjustments are often necessary in order for treatment to be successful.Case report A 41-year-old male patient with a severe learning disability, autism and obesity was referred to the dental hospital for dental treatment. The patient frequently demonstrated physically challenging behaviour, particularly when in unfamiliar environments. In order for the patient to access care, a multidisciplinary team (MDT) approach with a number of reasonable adjustments was required. The patient was then able to receive treatment under general anaesthesia (GA) from not only the special care dentistry team, but also additional medical specialties.Discussion A holistic approach to care is important in this patient group in order to reduce health inequalities. Clinicians should be aware of their role in the screening and referral of patients with obesity.Conclusion Reasonable adjustments and a team approach are essential to the dental management of patients with learning disabilities. Management is becoming increasingly complex as obesity continues to be a growing problem among this group.
焦虑时，学习障碍患者可能会表现出挑战性行为。学习障碍患者的肥胖患病率正在上升，这增加了管理的复杂性。为了使治疗成功，通常需要进行合理的调整。
一名 41 岁的男性患者，患有严重的学习障碍、自闭症和肥胖症，被转介到牙科医院进行治疗。该患者经常表现出身体上的挑战性行为，尤其是在不熟悉的环境中。为了让患者获得护理，需要多学科团队（MDT）的方法和一些合理的调整。然后，该患者能够在全身麻醉（GA）下接受治疗，不仅是特殊护理牙科团队，还有其他医学专业。
在这组患者中，全面的护理方法对于减少健康不平等至关重要。临床医生应该意识到自己在肥胖患者的筛查和转介中的作用。
对于学习障碍患者的牙科管理，合理的调整和团队方法是必不可少的。随着肥胖问题在这一人群中持续增加，管理也变得越来越复杂。
