The main role of this article is to describe dental assistants and the dental department’s role in the dental delivery system for Special health care needs (SCHN) by creating a structure to educate the dental assisting profession and project factors that have a significant impact on the dental assistant. The dental assisting management of SCHN patient’s profession including dental Assistance general responsibilities, regulation credentialing, and education. The SCHN patient’s management creates a challenge in all area of the dental department. Handling patient with a SCHN is underexplored throughout the dental staff especially when there is not enough theoretical foundation, education and training to deal with this category of patients. SCHN patients are defined as individuals who have abnormal behavioral impairments, mental conditions or/and chronic disease or abnormal laboratory results. Thus, the aim of this article is to guide all dental assistance staff in the best dental management choice for SCHN patients. All health care teams are part of patient care in most medical settings. A work environment supportive ensures positive outcomes for patient care. This article was considered as those categories of patients required more care and special way to deal with, moreover language, age, gender and education level of the patient are also considered significant parries. Not Many studies were found to support the care of SCHN patients in dentistry department. Taking experience from other area help to design a system to handle the SCHN even if it requires hiring a Dentist who is specialized in that filed.
Dental assistants are specialized health care workers who provide direct support to the dentist. Well Educated dental assistants may be delegated to do other procedures that do not require the professional skill and judgment of a dentist. Dental assistants may require a minimum education which includes two academic years [
A Dental Assistant can work with different dental professional categories. A Dental Assistant can cover duty with Dentists, Hygienists, Prosthetists, Specialists or oral Health Specialists. Generally, any professional working in dentistry may need a Dental assistant during their daily clinic. Dental assistant usually has the most diverse role in a dentistry practice, and really need to stay on their toes [
● Update and maintain client’s dental records and take and process X-rays of patients.
● Perform routine dental cleanings and assist the dentist with any procedure.
● Schedule patient appointments and help to advise patients on recommended oral hygiene.
The job description of the dental assistant like other medical health workers involves direct contact with the patient and their legal grading. It is easy to do the job if you deal with an educated patient, more difficulty rise when there is a gap in the explanation either from the dental assistant’s side or the patient side. The dental department may hire a coordinator to deal with the patient who will have significant benefits to the department and the patient [
SHCN patients are defined by any physical, developmental, mental, sensory, or behavioral, condition that requires specialized services or programs. The condition may be congenital, developmental, or acquired through disease, trauma, or environmental cause and may impose limitations in performing daily self-maintenance activities or substantial limitations in a major life activity [
PubMed®/MEDLINE search using the terms: special needs patient, disability, disabled patients/persons/children, Special patients/Dental treatment dentistry, Special care health needs and oral health; fields: all; limits. Papers for review were selected from the result list of articles and from references within the selected search. The article search was done during the period of 2009-2021. When data did not appear sufficient or were inconclusive, recommendations were based on expert and/or consensus opinions by experienced researchers and clinicians. Systematic and non-systematic reviews, studies on a series of cases and research articles were considered to structure this article.
Passed on the National Survey of Children’s Health in 2017-2018, approximately 13.6 million children (18.5 percent) had a special health care need [
SCHN patients at childhood age increase the risk of having urgent medical care including oral health care [
SHCN patients rely mostly on free government coverage to pay for their medical and dental care. Lack or delay of treatment may lead to an increase in the need for costly care health issues [
Language and cultural considerations and other barriers may interfere with the oral health care of SCHN patients. Communication skills are essential for SCHN patients and can be accomplished by trying different methods which may include interpreters, written materials, and lip-reading [
SHCN patients significantly require additional considerations for behavior guidance which include the patient’s mental development, level of education, patient cooperation in medical procedure, type of therapy or procedure as these can complicate or delay the delivery of the needed care. The use of basic behavior guidelines may help to recognize and manage SCHN patients [
The management of SCHN may include several steps which need to be implemented and consider. Steps may include the Evaluation of the General Health issues of the patient and then the Evaluation of the Oral Health process. Evaluation of behavior difficulties of the patient, Planning and establish the best dental treatment case by case. The evaluation of General Health issues help the dental assistant to provide a complete health history which can be obtained or fulfilled by the parents of the patient this information may include medical history, medications in use, abnormal laboratory test or any health problems. Clear medical history is essential before moving to the treatment process plan. Evaluation of Oral Health process and the reasons of consultation must be considered before performing the clinical examination. X-ray or At least one panoramic must be taken before the exam. Evaluation of Behavior difficulties of the patient is the most relevant aspect in this protocol. For that, So we suggest that the behavioral will be based on the amended Frankl scale (
| Category 1 | Clearly Negative | Total lack of cooperation |
|---|---|---|
| Category 2 | Negative | Signs of lack of cooperation |
| Category 3 | Positive | Accepts treatment with caution. May require reminders (open mouth, hands down, etc.) |
| Category 4 | Very Cooperative | No sign of resistance. Very cooperative |
| 1. Violent movement constantly interrupting examination |
|---|
| 2. Constant movements that hinder examination |
| 3. Controllable movements that do not interfere with the procedure |
| 4. Lack of movement |
This article is made to set the challenge that dental assistants face when dealing with s SHCN patients. Like other parts of the community, a system must be designed for this category of patient. A Well trained dental assistant can handle the multi task and perform a significant role in the dental department. The number of this category of patients significantly increased every day with new and rear cases. The dental assistant must keep herself self-updated about the patient’s situation and adopt a technique to deal with SCHN patients.
The authors declare no conflicts of interest regarding the publication of this paper.
Al Enazi, A.M.G., Al Enazi, D.K., Al Duaida, H.N., Al Bakheet, A.B., Al Ghobain, M.M. and Al Harbi, A.S. (2023) Managements of Special Health Care Needs Patients from Dental Assistant Point. International Journal of Clinical Medicine, 14, 59-64. https://doi.org/10.4236/ijcm.2023.142004