Blindness:

It is not an all or none phenomenon, and a person is considered affected by blindness if the visual acquity does not exceed 20/200 in the better eye, with the correcting lenses, or if the visual acquity is greater than 20/200 but accompanied by a visual field of no greater than 20 degrees.

Dental considerations:

  • We evaluate the intellectual and physical potential of the individual accordingly.
  • Blind children frequently require special help in learning to master oral hygiene needs.
  • The child will develop at his own pace and should not be pushed.
  • Blind children and children with reduced vision often do not develop dexterity as rapidly as sighted children
  • We use teaching models to demonstrate the relationship of the different teeth and the relative sizes and shapes.
  • Complete medical history along with the degree of visual impairment is ascertained prior to treatment.

 

Auditory disability/ Hearing loss:

Etiology:

  • Prenatal: viral infections (rubella and influenza), ototoxic drugs- aspirin,streptomycin, kanamycin, neomycin, congenital syphilis, heredity disorders- Crouzon,Treachers Collin, Alport, Klippel-Feil syndromes, etc.
  • Perinatal: causes like toxemia late in pregnancy, prematurity, birth injury, anoxia, erythroblastosis foetalis
  • Postnatal factors: viral infections, such as mumps, measles, chicken pox, influenza, poliomyelitis, meningitis, injuries

 

Dental considerations:

  • We prepare the patient and parent before the first visit with a welcome letter.
  • Let the patient and parent determine during the initial appointment how the patient desires to communicate (i.e. interpreter, lip reading, sign language, note writing, or a combination of these)
  • We assess speech, language ability, degree of hearing impairment
  • We enhance visibility for communication, watch the patient’s expression, write out and display information
  • We reassure the patient with physical contact
  • We employ tell-show-feel-do approach, they might be very sensitive to vibration
  • We display confidence
  • Make sure the parent or patient understands explanation of diagnosis, treatment

 

Learning disabilities

This term does not include any learning problems caused due to visual,hearing, motor handicap, mental retardation, emotional disturbance or environmental conditions.

Definition:

The term is applied to children who exhibit a disorder in one or more of the basic psychological processes, involved in understanding or using spoken or written language

Incidence

Affect 3 to 15% of the population and is four times more common in males.

Etiology

  • Mimimal brain injury or damage to CNS
  • Genetic

Severe emotional disturbances can develop as a result of learning disabilities.

Learning disability can be manifested in disorders of thinking, listening, talking, reading, writing, spelling, arithmetic. It includes conditions like minimal brain dysfunction, dyslexia, developmental aphasia.

Dental treatment

  • Most accept dental care willingly and do not cause any unusual management problems.
  • In resistant patients, analgesia, sedation or general anaesthesia may be used.