Special care dentistry (2007)
Authors: Janice Fiske, Sobia Raifque, Carole Boyle, Mary Burke and Chris Dickinson
Publisher: Quintessence Publishing Co. Limited, London, UK
Price: £28.00, 
42.00
ISBN: 978-1-85097
This pocket-sized book aims to offer a shortcut for the dental practitioner in the United Kingdom (UK) to be able to approach the occasional special needs patient, who may require caution to be exercised in his/her handling. Most dentists are not aware of many of the aspects that this small book covers and it offers a simple, handy, and user-friendly way for clinicians to acquire background information, in the dental environment, without needing to plough through large medical texts and Internet sites.
The book is divided into 10 chapters, dealing with the management of various clinical conditions. It has been written for the UK dental profession, as may be gleaned from the wording in several places in the text and is very much a ‘hands-on’ practical guide obviously based on the experience of the authors. There are very few references to support many of the statements made and those that are quoted are largely and rather myopically limited to the UK literature. Little or no recognition is accorded to European or North American colleagues, many of whom have much to offer both in their clinical experience and in their published work, in this specialized field. The customizing of toothbrush design is dealt with, with the declared intention of encouraging self-involvement of the patient in oral hygiene. However, there is no advice offered regarding those individuals whose mental or physical state may make even their best efforts totally inadequate and the need to actively involve a parent or carer in this routine procedure. While management to enable access for the patient to the provision of dental treatment is discussed with each of the conditions described, active prevention with the use of fissure sealants, fluoride rinses and varnishes, mousse etc. is not mentioned.
The chapters dealing with the medically compromised (requiring antibiotic cover), the immunocompromised, those with bleeding disorders, and those undergoing radiotherapy are excellent sources of information. Nevertheless, and given its fairly common occurrence within the special needs population, it is perhaps surprising that cerebral palsy, in its varying degrees of severity, has not been singled out for wider discussion. Do the authors prefer to treat these patients under general anaesthesia? In chapter 10 and relative to their discussion of other issues, the authors go into great length and offer an interesting analysis of (exaggerated) gagging. They illustrate some novel and rather unorthodox solutions to its control, whose justification is largely based on an ‘it-works-in-my-hands’ attitude.
There is an unnecessarily long discourse on the various conditions that lead to visual impairment, without practical guidelines with regard to the ways of conveying the necessary reassuring environment that will permit the provision of dental treatment. Regarding the hearing impaired, the need for warm and comforting facial expressions in place of soothing words of encouragement should be emphasized and there is no advice given regarding the high-pitched sound emission of the high-speed drill and the need to reduce the hearing-aid amplification.
The authors quote verbatim from the National Institute of Dental and Craniofacial Research publication on Practical Oral Care for People with Autism of the US Department of Health and Human Services (www.nidcr.nih.gov), without giving it deserved recognition and omitting to mention it in the suggestions for ‘further reading’ at the end of the chapter.
Orthodontic treatment is not mentioned in relation to disabled patients in this book, despite the relatively greater need and increased awareness of the affected population and their parents/carers. It is probably also true to say that dentists in general, and orthodontists, in particular, may not relish the prospect of attempting to satisfy this need. Nevertheless, this is an aspect which has achieved prominence over the past few years or so and, as such, should find its rightful place in a book on this subject and for it to deserve reviewing in an orthodontic journal.
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