The definition of disability is the inability to perform basic daily activities that many people can easily do, such as walking, hearing, seeing, breathing, standing, reading, working, speaking, learning, and thinking, due to physical or mental limitations.
According to research conducted by UNESCO, 10% of the Turkish population is thought to be disabled. Disabled people in our country have many problems. Health problems and especially problems experienced in oral and dental health are at the top of these. Research conducted shows that the frequency of oral and dental health problems in disabled people is considerably higher than in normal individuals. Since both the state and private enterprises within the current health system in our country do not do enough work to solve the oral and dental problems of disabled people, disabled people cannot benefit sufficiently from dental services. In order to solve this problem, the issue needs to be evaluated from both the perspective of dentists and the disabled.
Dentists are trying to stay away from the treatment of disabled individuals due to reasons such as the lack of education of dentists on dental treatments of disabled individuals, the idea that too much time needs to be spent on dental treatments (but the return on this is not satisfactory in financial terms), and the need for extra investment for dental treatment procedures.
The difficulties experienced by disabled individuals in accessing dental services are
- Accessibility
- Insufficient number of trained dentists
- Type of Disability
- Families’ or caregivers’ approaches to oral and dental health
- Side effects of the medications they use
- Medical Problems
- Financial Concerns
Many can be considered as a reason.
In addition to all these difficulties, the additional medical problems that the current disability status will bring cause oral and dental health problems to be seen more frequently in disabled individuals. Another factor that makes dental treatments difficult for disabled people is that the dental units (dentist chairs) produced are not designed for disabled patients. Another major problem for disabled people, the difficulties experienced in communication, behavioral guidance and differences in treatment approaches, cause dentists to be inadequate in this regard. It should not be forgotten that disabled individuals have the most natural right to receive the highest level of health service like other normal people. Teamwork is very important in solving the oral and dental health problems of disabled people.
It is the most natural right of all children to have healthy teeth and gums. Disabled children do not have any privileges in this regard. A beautiful mouth and teeth are very important for the general health of the child. Children with beautiful and healthy teeth can chew better, say letters more beautifully and speak more clearly and understandably. The aesthetic appearance of healthy teeth also increases children's self-confidence.
Medical, nutritional, and emotional problems that may be seen in disabled children cause daily oral and dental health care to be inadequate. In addition, taking them to the dentist's office and having their teeth and gum problems treated is also a very difficult task. It is possible to protect yourself from the financial and moral difficulties of all these treatments thanks to preventive dentistry practices. These protective practices prevent the child from being taken to unnecessary dental treatments and from being negatively affected psychologically each time.
There are several reasons why oral and dental health problems are more common in disabled children.
Oral and Dental Structure
Due to certain genetic conditions or past high fevers, disabled children's tooth enamel can be affected and therefore more prone to tooth decay. Congenital (born) tooth loss, tooth deformities and crookedness in the teeth are also frequently seen in many disabled children. In addition, gum disease (for example, in Down Syndrome) is a condition that can be seen in disabled children.
Physical Restrictions
Teeth are naturally cleaned by saliva through processes such as chewing and swallowing. However, sometimes this cleaning feature of saliva disappears in disabled children due to coordination disorders in the lip, cheek and tongue muscles. Children with diseases that affect the muscles (e.g. Spinal cord injuries, muscular dystrophy, cerebral palsy, etc.) may have difficulty performing preventive procedures such as ideal tooth brushing and flossing.
Special Diets (NUTRITION)
Children with chewing and swallowing problems are often fed with soft and sticky foods in the consistency of puree. These foods stick to the teeth and cause the teeth to decay much more quickly. Constantly consuming sugary foods and putting drinks such as milk and fruit juice in a baby bottle while sleeping cause tooth decay to occur more frequently. In addition, people who need someone else's help to drink something cannot benefit sufficiently from the washing and cleaning effect of liquids (especially water) because they consume less liquid than normal people.
Medications
Individuals who have to constantly take syrup-formed medications may be more exposed to tooth decay due to the sugar in the syrups. Medications (Dilantin) that epilepsy patients constantly use may also cause complications such as bleeding in the gums or swelling/growth in the gums. In these patients, problems such as speech, aesthetic problems or nutrition are frequently seen due to gum growth. Sedative drugs (Barbiturates, Antihistamines, etc.) given for the regulation of muscle coordination, allergic conditions or for calming purposes cause a decrease in saliva flow.
A decrease in saliva flow may also cause caries and gum diseases to occur more frequently. In individuals who use aspirin regularly, if the aspirin is held in the mouth before being swallowed, the acidic environment it creates can cause tooth decay. If some antibiotics (e.g. Tetracycline group) are prescribed during the development period of the teeth or during pregnancy, they can cause discoloration and unaesthetic appearances in the teeth.
