Dental Care for Special Needs Patients and Elderly

How often should geriatric and special needs patients visit the dentist?
This largely depends on the patient’s dental health. If the patient has not seen the dentist in a very long time and has multiple dental problems, more visits would be required in a shorter span of time. Patients should expect a longer treatment duration if more complex treatment is required. In cases where a patient cannot tolerate long treatment durations, the dentist may recommend more dental visits of shorter duration each time. A 3-6 monthly review is recommended in most cases once a patient’s dental condition has stabilised.

How can I tell if my loved one is in pain or discomfort?
Patients suffering from progressive cognitive impairments may not be able to communicate their discomfort when a dental condition arises. These are some signs and symptoms to look out for:

1. Facial swelling
2. Sudden behavioural change
3. Inability to sleep
4. Appetite loss
5. Repetitive pointing or hitting at the same area in the head and neck region
   

What are the common conditions to look out for?

Look out for:

1. Loose teeth
2. Gum swelling
3. Blood or pus in the mouth
4. Red or white patches in the mouth
5. Broken or fractured teeth
6. Black holes in the teeth

What should I do in a dental emergency?
Dental emergencies requiring urgent care include severe dental pain, uncontrolled bleeding, facial swelling due to infection and trauma resulting in loosened or dislodged teeth, broken teeth or jaw, or severe cuts to the gums and lips. In such cases, the patient should visit NDCS on weekdays during opening hours for urgent treatment.

If the emergency occurs during a weekend or after office hours, please take the patient to a private dental clinic or the 24-hour Accident and Emergency (A&E) dental service at Singapore General Hospital where a dentist will assess the patient’s condition at the clinic and carry out any necessary emergency procedures. Temporary pain relief may be offered. Patients may also be referred to NDCS for follow-up care the next working day.


How do I care for the patient’s oral healthcare needs at home?
Allow the patient to brush their own teeth if they are able to do so. If you feel that they are unable to brush thoroughly, you can help them. Remember to brush all teeth surfaces, especially at the gum line. If possible, try to clean the tongue with a brush or a tongue scraper. If the patient does not have any teeth, it is still advisable to clean the oral cavity with a cloth or gauze. Mouth rinse may also be recommended by your dentist.

Special Tips for Caregivers or Patients

Don't:

1. Give up on the patient's oral care. Encourage the patient to attend regular dental reviews and perform oral care practices as demonstrated by the dentist as far as possible for the patient
2. Communicate your own fears to the patient
3. Bribe the patient into going to the dentist or use dental visits as a form of punishment

Do:

1. Be patient when providing oral care for your loved ones
2. Be attentive to your loved one's dental and medical conditions and needs.