Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
Centre for Advanced Dental Research and Care, Department of Dentistry, Mount Sinai Hospital, Toronto, Ontario, Canada.
Spec Care Dentist. 2024 Mar-Apr;44(2):584-591. doi: 10.1111/scd.12903. Epub 2023 Jul 20.
Patients with special care needs (developmental disabilities) have unique and complex needs regarding their oral health and care. This qualitative study aimed to identify the experiences, preferences and challenges of dentists and caregivers regarding behavior guidance techniques for dental care in persons with special care needs.
Relying on qualitative description as articulated by Sandelowski, we conducted telephone interviews with a purposeful sample of five special care dentists and seven caregivers. We analyzed the data using thematic analysis.
Four themes were highlighted: (1) Neither pharmacological or non-pharmacological behavior guidance techniques was universally suitable, (2) A patient-centered approach was critical, (3) The dental environment triggered patients' behaviors and anxiety levels, (4) There was more demand for, than supply of, qualified dentists to treat patients with special care needs.
Persons with special care needs are heterogeneous and respond to various behavioral techniques required to deliver their treatment. Behavior guidance planning should be negotiated carefully with patients and caregivers and then individualized based on patients' capabilities and needs for treatment. The necessity to manage complex behaviors has contributed to the limitation of access to dental care for persons with special care needs. Dentistry as a profession has the obligation to uphold the social contract and meet its responsibility to the dental care needs of this population.
特殊护理需求患者（发育障碍）在口腔健康和护理方面有独特且复杂的需求。本定性研究旨在确定牙医和护理人员在针对特殊护理需求患者的口腔护理中行为引导技术的经验、偏好和挑战。
我们依赖于桑德洛维希（Sandelowski）阐述的定性描述，对五名特殊护理牙医和七名护理人员进行了有针对性的电话访谈。我们使用主题分析对数据进行分析。
突出了四个主题：（1）既没有普遍适合的药理学或非药理学行为引导技术，（2）以患者为中心的方法至关重要，（3）牙科环境引发了患者的行为和焦虑水平，（4）有更多的需求，而不是供应，合格的牙医来治疗有特殊护理需求的患者。
特殊护理需求的患者是异质的，对提供治疗所需的各种行为技术有不同的反应。行为引导计划应与患者和护理人员仔细协商，并根据患者的治疗能力和需求进行个体化。管理复杂行为的必要性限制了特殊护理需求患者获得口腔护理的机会。作为一个专业，牙医有义务维护社会契约，并履行其对这一人群的口腔护理需求的责任。
