Dental treatment for handicapped adults

Handicapped adults can be grouped into those who are mentally subnormal, those with major organic disease, those who are emotionally disturbed and those for whom local anaesthesia is unsuccessful. At the first visit the degree of handicap and the state of the mouth are assessed and a plan of treatment is formulated. In most of the patients, satisfactory conditions for operating can be achieved by the use of intravenous diazepam and local anaesthesia, though some may require a full general anaesthetic. The results of treatment of a group of 139 patients are analysed and it is shown that the average DMF score in handicapped adults is appreciably higher than in normal adults of the same age. The reason for the inability of some of these patients to seek and accept dental treatment under normal surgery conditions is discussed and it is shown that with suitable initial treatment many of them become able to accept treatment in the ordinary circumstances of a dental surgery.