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Tobis RM, Cardoso EOC, Yarascavitch C, Tenenbaum HC, Azarpazhooh A, Sale JEM. Experiences of dentists and caregivers of patients with special care needs-A qualitative study. Spec Care Dentist 2024; 44:584-591. [PMID: 37470722 DOI: 10.1111/scd.12903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/05/2023] [Accepted: 06/24/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Rachel M Tobis
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Elaine O C Cardoso
- 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
| | - Carilynne Yarascavitch
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Department of Dental and Maxillofacial Sciences, Sunnybrook Sciences Health Centre, Toronto, Ontario, Canada
| | - Howard C Tenenbaum
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Amir Azarpazhooh
- 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
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Joanna E M Sale
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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