Benefits of teamwork: the importance of dental professionals and caregivers working together to reduce oral health disparities and positively impact oral care of special needs patients
Morales, Michelle Valerie
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OBJECTIVE: Within the U.S. population approximately 20 percent of individuals are diagnosed with some type of disability and another 12 percent are considered severely disabled. Many times special health care needs (SHCN) patients with one condition are burdened by more than one disability. A variety of conditions such as behavioral issues, developmental disorders, and cognitive, congenital or systemic diseases have been proven to increase the risk of oral heath disease in individuals with SHCN. These conditions may affect the ability to communicate and limit dexterity for proper oral health maintenance, which is why caregivers must become advocates for these patients to insure their oral health needs are met. By communicating effectively with caretakers, dentists will be able to establish a positive impact on patients to make dental visits easier and less traumatizing. Unfortunately studies have found that dental and hygiene students graduate without feeling adequately prepared to treat patients with SHCN. With the proper education and training, more dental students and future dentists will take on the challenges that are brought by these individuals to provide the best care possible. Establishing a strong support system could potentially decrease oral health disparity in SHCN patients and improve overall care. The goal of this study was to assess whether or not there was a positive impact on the oral health of SHCN individuals when caregivers and oral health professionals worked together in a team treatment effort to fight against oral disease. METHODS: Study used a systematic review approach of literature where a PICO question was formed and the article selection process included a review of title, abstract, and application of inclusions and exclusion criteria. Printed-text and online databases such as Pubmed/MEDLINE, Google Scholar, and Web of Science were used to conduct a review of literature where a total of 210 papers were collected. After selection process, only four papers were eligible for systematic review. Pre-determined questions were used to determine the how involved caregivers and oral health professionals were during each study followed by an assessment using a point system, which scored caregiver and oral health professionals involvement during intervention. RESULTS: Selected studies showed heterogeneity in study design and sample size but all used multidisciplinary approach, which included some degree of caregiver and oral hygiene provider (OHP) collaboration. Two out of the four studies totaled nearly perfect scores in both caregiver and oral health professional involvement, which resulted in a positive effect on oral health care of SHCN patients. Case reports that included an interdisciplinary team approach to oral care procedures on patients, showed the benefits of teamwork and how collaborative practice between dental and medical professionals increased successful patient outcomes. Results illustrated the significant role that caregiver’s play in the dental team and how their absence during intervention treatment significantly lowered study scores for the overall success of patient care. CONCLUSIONS: Results demonstrated that studies with a well-rounded dental team, which included caregivers, OHP, health care professionals accompanied by social support systems, saw the greatest success and improvements in oral health care of SHCN patients. Nevertheless, a dedicated dental team where most members were present did not guarantee intervention success if caregivers did not show a significant involvement. Caregivers alone could positively impact oral health care of a patient more than if OHP worked alone. In conclusion, we found that each member of a dental team had the ability to impact change to an almost equal degree. For this reason, it is important for caregivers, OHP, dental staff and health care professionals to work together, support one another and communicate effectively to decrease oral health disparities in SHCN patients.