Peoples college of dental science and R.C. ,Bhopal
Handicapped child and management of bleeding disorder
◆ The term special child or disabled child are often reserved for those who are impaired thus restricting their daily activites in some manner.
◆ These handicapped children can be broadly divided into
-MEDICALLY COMPROMISED CHILDREN
-DEVELOPMENTALLY DISABLED CHILDREN.
◆ The world health organization  has defined a handicapped person as “ one who over an appreciable period id prevented by physical or mental condition from full participation in the normal activities of their age group including those of a social, recretional, educational and vocational nature”.
◆ A. Frank and Winter,  have classified handicap as
.Blind or partially sighted
.Deaf or partially deaf
.Defective in speech
◆ Treatment factors to be considered
◆ 1. understanding the condition
Before planning any treatment ,the dentist must eveluate the handicapped patient’s dental needs and his ability and willingness to cooperate durint treatment.
Management tecniques must be TLC [tender ,love, care]
2. The attitude of the parents toward particular problem
◆ The attitude of the parent influences the dental service based on two types of behaviour, namely, overprotection and underprotection.
◆ 3. Attitude of the society :
these children are not well accepted by the society and this may have a psychological imapct on the childs mind.
◆ 4.Attitude of the patient:
the dental management technique must be carried out with tender loving care.
5. Attitude of the dentist toward thee particular condition:
the attitude of the dentist must be positive but it is negative most of the time because of the following reason-
a) lack of education and experience on the part of dentist to deal with such children
b)fear of the patient
c)feeling incompetent to trat
d)inability to develop relationship
f) Substandard fees
g) Need for special equipment and dental office architecture
◆ Plaque control: these children have a poor standard of oral hygiene along with a higher prevalance of periodontal disease. The brushing technique should be carriedout by the parents.
◆ Diet: A balanced diet is essential for nutrition as well as a part of the preventive program.
◆ Fluoride: systemic fluoride through the ingestion of optimally fluoridated water should be advocated for handicapped children.
◆ Preventive restoration: These include the application of pit and fissure sealent, preventive resin restoration and even stainless steel crown.
◆ Mental retardation is defined by the American academy of mental deficiency as “ significantly sub average intellectual functioning, existing concurrently with deficit in adaptive behaviour and manifested during the developmental period.”
◆ Characteristic of mental retardation
◆ 1) Dental problem
◆ Present with multiple anomalies of facial structure, eruption time, sequence, number, presence of malocclusion and enamel hypoplasia.
◆ Higher prevalance of dental caries and periodontal diseases.
◆ Treatment consideration
◆ Short attention span, restlessness, hyperactivity, and erratic emotional behaviour characterize MR patients undergoing dental treatment.
◆ Speech must be slow and simple.
◆ Only one instruction at a time should...
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