Orthodontic treatment for the special needs child

The prevalence and severity of malocclusion is especially high in Special Needs individuals. Many have medical limitations to the various procedures that are often needed in the pursuit of excellence from orthodontic treatment and almost all have moderate to severe behavioural problems that make treatment delivery difficult or even impossible to achieve, with any degree of reliability. Nevertheless, the parents are highly motivated to "do the best for their child" and are prepared to become integral members of the treatment delivery team. The present article analyzes the difficulties involved and makes recommendations as to how these may be overcome, based on the authors' published studies in this area and on their broad experience in treating these compromised individuals. Emphasis is placed on the use of pharmacological modalities as the means to providing therapeutic access to many of the more difficult patients. Two case reports are provided to illustrate many of the important principles that pertain to these cases.