Read the text carefully. Pay attention to words in the bold print

A patient with special needs is someone with medical, physical, psychological or social needs that require a change in their normal routines. In the field of dentistry and oral health, a patient with special needs will require a change in regularapproach to dental care while treatment.

Dental patients with special needs often – but not always – have poorer oral hygiene. As a result, they also have a higher risk of diseases and cavities. Dental patients with special needs represent people with a broad range of conditions that do not necessarily relate to oral health.

For example, dental patients with special needs include the following:

• Aging and elderly people. These individuals may need more frequent dental visits to monitor tooth wear, pain and the effects of medications that they cannotdetect themselves due to decreased pain sensations. These individuals are often sensitive to glare and have a hard time hearing dental information or instructions.
• Individuals with mobility issues. Patients with mobility issues may needassistance in and out of the dental chair, as well as to and from the dental office.
• Mentally disabled individuals. Those who are mentally challenged or intellectually disabled may need to be accompanied to dental appointments by a caregiver, since they may not be able to understand dental hygienerequirements or homecare instructions.
• Immunocompromised people and those with complex medical problems.People with cardiovascular disease, diabetes, bleeding disorders or other systemic conditions need to have their conditions – as well as their medications – taken into account before receiving dental treatments. Collaboration with their GP is often required.
• People with a mental illness. An individual with a mental illness may have difficulty following proper dental hygiene regimens or obtaining dental care. These individuals may need shorter appointments that are scheduled when they are in a balanced state, as well as be accompanied by a caregiver.
• Children with behavioral or emotional conditions. Children with autism, for example, are against changes of any kind. These patients should be seen by the same hygienist – wearing the same outfit, working in the same dental office – whenever they visit the dentist to receive care.

So while dealing with special needs patients, dentists must remember to make the appointments as short as possible, use help of as many assistants as possible during examinations and treatment procedures to better control and monitor the patient and the appointment, use sedation dentistry to promote patient comfort, be flexible on appointment scheduling, and include caregiver in treatment planning, providing instructions and information, and while performing dental procedures.

GLOSSARY
accompany – towarzyszyć 
aging – starzejący się 
approach – podejście 
assistance – pomoc, wsparcie 
as well as – jak również 
balanced state – stan zrównoważenia 
behavioral – behawioralny 
broad range of – szeroka gama/wachlarz 
caregiver – opiekun 
collaboration – współpraca 
comfort – wygoda 
detect – dostrzec, wykryć 
due to – ze względu na 
flexible – elastyczny 
follow – postępować zgodnie z 
glare – blask, bardzo jasne światło
GP – skrót General Practitioner – lekarz rodzinny
immunocompromised – z obniżoną odpornością
include – uwzględnić
individual – człowiek, osoba
mental – psychiczny
monitor – kontrolować, monitorować
obtain – uzyskać
outfit – strój, ubiór
regimens – schemat
relate – odnosić się, wiązać z
represent – reprezentować
require – wymagać
requirement – wymóg
sensations – uczucie, wrażenie
take into account – brać pod uwagę

Change words in bold print to words from the glossary section

1. Elderly patients may have difficulties with assessing their pain level because ofmedicines they feel or changed pain sensation. 
2. Cooperation between a dentist and other healthcare professionals is oftentimes necessary while dealing with special needs patients. 
3. Dentist must remember that all procedures will take more time in mentally disabled people.
4. It’s common that a patient with special needs will need help of a carer in a dental office. 
5. Autistic patients can’t tolerate changes that’s why changes of uniforms or time of the appointment are not recommended.
6. Mentally disabled patients have problems with following a treatment plan. 
7. In patients with decreased immunity, you should consider all medicines that the patient uses and all symptoms he/she complains of.

Tick only the pieces of advice suitable for dentists treating autistic children

TIPS FOR DENTISTS
• ____ Offer parents and children the opportunity to tour your dental office, so that they may ask questions, touch equipment, and get used to the place. 
• ____ Children with autism like changes. Never use similar uniforms or equipment like during previous visits. 
• ____ Autistic children are hypersensitive to loud noises, sudden movement, and things that are felt; they may flap, move and shake their hands.
• ____ Try to makes as much as you can during the first visit.
• ____ Make sure there are several people around the unit while you’re completing the procedure. The autistic children do not mind crowd.
• ____ There is no need to explain the procedure before it occurs. Praise for acceptable behavior is not useful in this group of patients. 
• ____ Once the dental patient is seated, begin an examination using only your fingers. Keep the light out of the eyes.
• ____ Ignore poor behavior.
• ____ Some children will need sedation or general anesthesia so that dental treatment can be accomplished. Sedation of autistic children who are 8 years and older simply does not work.

Match description with a category of special needs

A. Blindness or impaired vision                        B. Deaf/ Hard-of-hearing
C. Medical disabilities                                       D. Physical/ motor disability
E. Psychiatric disabilities                                  F. Speech impairment
G. ADD/ ADHD

1. These are neurological conditions affecting both learning and behavior. They result from chronic disturbances in the areas of the brain that regulate attention, impulse control motor activity, and social interactions. Hyperactivity may or may not be present. These are treatable, but not curable.

2. This category describes people who lost the sense of hearing or have it impaired due to some illness, accident or medicine use.

3. These disabilities may result from hearing loss, cerebral palsy, learning disabilities, and/or physical conditions. There may be a range of difficulties from problems with articulation or voice strength to complete absence of voice.

4. This category includes conditions affecting one or more of the body's systems. These include respiratory, immunological, neurological, and circulatory systems e.g. cancer, epilepsy, HIV + AIDS, diabetes, multiple sclerosis etc.

5. These refer to a wide range of behavioral and/or psychological problems characterized by anxiety, mood swings, depression, and/or a compromised assessment of reality. These behaviors persist over time; they are not in response to a particular event.

6. A variety of these disabilities result from congenital conditions, accidents, or progressive neuromuscular diseases. These disabilities may include conditions such as spinal cord injury, cerebral palsy, spinal bifida, amputation, muscular dystrophy, cardiac conditions, cystic fibrosis, paralysis, polio/post polio, and stroke.

7. This group consists the condition of lacking visual perception due to physiological or neurological factors.

Lesson 22 answers