Читать книгу A Practical Approach to Special Care in Dentistry - Группа авторов - Страница 11

Special Care Dentistry (SCD) was previously defined by patient characteristics, such as their medical condition or behavioural issues. However, it has changed in recent decades to reflect the complexity of providing holistic oral care for patients with multiple comorbidities which may lead to physical and/or intellectual, sensory, mental or social impairment. Although it commonly relates to adults, in some countries it also includes the oral care of children with disabilities.

There is a significant geographical variation in access to SCD related to lack of training, appropriate infrastructure and financial factors. Nevertheless, it is rapidly growing due to increased demand and is now acknowledged as an essential field of dentistry across the world. Dramatic improvements in medicine, mainly in areas related to early diagnosis and new therapeutic approaches, have resulted in increased life expectancy and the quality of life of chronically ill patients and individuals with severe disability. Hence, individuals requiring care are not limited to hospitalised patients and more commonly include those living in the community, either independently or with support.

As a consequence, it is essential that undergraduates, postgraduates and general dental practitioners acquire specific knowledge in the field of SCD, so that they can integrate this discipline into their daily practice. To enable this, we have created this book, which contains 61 topics based on clinical cases from across the world, reflecting the most common clinical conditions which may present in general dental practice. This scenario‐based approach enables the application of elements of problem‐based learning and structured clinical reasoning, allowing the reader to appreciate that patients rarely present with a single medical condition or risk factor, and that multiple factors must be taken into consideration when providing care.

Each case includes the application of a risk assessment framework of medical, social and dental risk factors. This allows the systematic consideration of appropriate modifications that should be implemented prior to commencement of dental treatment, thereby reducing complications and treatment planning errors.

Subsequently, the main oral findings and the specific considerations for dental management for each condition/disease are discussed. The ACCESS mnemonic is utilised to ensure that six domains which address different aspects of care are considered:

1 Access

2 Communication

3 Consent

4 Education

5 Surgery

6 Spread of infection

Lastly, each chapter concludes with background information on each condition/disease, with updated medical content on their definition, aetiopathogenesis, clinical presentation, diagnosis, treatment and prognosis.

In 2006, under the guidance of Professor Crispian Scully, we published the book entitled Special Needs in Dentistry (Handbook of Oral Healthcare). A few years later, in December 2015, we received an email announcing that ‘The Special Care Dentistry book will be 10 years old next year! I am intent on producing something that focuses on the younger generations and that can be regularly updated’. The tragic and premature loss of Professor Scully deprived us of his academic guidance, editorial experience and enormous knowledge. We have therefore put all our efforts into this new publication, which launches today thanks to the contribution of a group of relevant collaborators. We hope it will serve as a tribute to our master, mentor and friend.

Pedro Diz Dios and Navdeep Kumar