A dental clinic set up for seniors and people with special needs was officially opened at the National Dental Centre Singapore (NDCS) yesterday. The Geriatric Special Care Dentistry Clinic, located at the Singapore General Hospital's Outram campus, sees patients with complex oral health conditions and who typically also have behavioural issues.
For instance, patients with Parkinson's disease may have trouble brushing their teeth, while many of those with autism get easily agitated by dental care. The new clinic, which started operations last September, is the first of its kind in Singapore. It has seen more than 4,000 patient visits to date. Patients are generally referred from polyclinics or hospitals.
The clinic is designed to make dentist visits as fuss-free as possible for its special clientele. "For example, for the less mobile and frail patients who have difficulty being transferred to a dental chair, the wheelchair tilting system allows the dental team to treat the patients in their wheelchairs," said Health Minister Gan Kim Yong, who spoke at the opening.
Every room is equipped with a dental X-ray machine so that patients do not need to travel to another part of the building. In addition, general dental radiography and surgical procedures that require only local anaesthesia can be done within the clinic.
Madam Theresa Khoo, whose husband had a stroke more than 10 years ago and now uses a wheelchair, started visiting the centre last year. She finds the wheelchair- friendly dental chair a great help. "If he falls when I transfer him to the dentist chair, he might also crack the equipment," she said. "(The chair) is a lot of help, both for him and for me."
Geriatric and special care dentistry is an emerging speciality, but one in which there are many unique needs, said Associate Professor Poon Choy Yoke, who is the director of NDCS. "It's not just the dental treatment delivery, which all of us have," she explained. "These special patients need a lot more explanation and patience, and sometimes maybe multiple visits because you need to win their trust a little bit at a time."
Mr Kiran Raj, 21, has developmental delay due to epilepsy. Before he started monthly visits at the clinic in January, he had never seen a dentist. His mother, Madam Jothi Marimuthu, had heard "nightmare stories" from other parents of special needs children. Even at home, she struggled to help him brush his teeth. "He would refuse to open his mouth and make all kinds of noises, and he used to be so agitated," recalled the 46-year-old.
His dentist at the new clinic took the time to calm him down, and even played his favourite music to help him relax. Madam Jothi is confident that her son is in good hands. "He can't express pain or tell you where the pain is," she said. "But now I know that if there's anything wrong with his teeth, the dentist will let us know."
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AS: My girl has been receiving yearly dental care from Rainbow Centre Margaret Drive. All the while her tooth was ok .... in the care of my ex-filipino maid. Lately, her tooth got from bad to worse care. My current maid only brushed the front and ignored the teeth behind. Yes, I was surprised why every time teeth brushing time is so fast, suspected something fishy so gently reminded her. Also reminded her to brush my girl's teeth twice a day, in case during the struggle with my girl, she failed to do a clean brush after lunch, the second brush in the night could fix things. She kept telling me she brushed in the school, morning. I had to tell her after the Nov dental visit that brushing her front teeth is wrong, I need her to brush well.
child will be wrapped, arms strapped at the dentist chairLast year, my girl's tooth showed decay. Last June, her bottom molar received a filling. 2 weeks ago, my girl had another filling at her upper molar. Dentist asked "did you brush her teeth?" I am aware it is hard to brush my girl's teeth, reminded maid to be slow but she simply wants to get things done fast so that she can spend more time on her tablet. Recently, I have to catch 'brushing time', watch her and ensure she did a better job. Maids these days don't listen instructions, they have their own minds and want job satisfaction at Employers' expense. If you scold them or be bit strict, they may ill-treat, vent her anger or accusing you of not treating her like a family member.
When my girl is in pain, she can't express, point or tell me. Taking good care of her teeth is important but my maid simply doesn't want to spare a thought for her. Last 2 visits cost me S$45 each. Maid probably think spending money is no big deal. What I am worried is having a toothache.... the unknown pain, the pain my girl has to endure. Visiting a normal dentist is not feasible because they can't handle special needs child, don't know how to manage her and get rid of her pain effectively. Also it will be tough pacifying my girl because she can't point out where's her pain. Last time when school dentist didn't have the weighted blanket, there must be at least 4 persons - 1 to hold her legs, 1 for her arms/body, 1 for her head, another to assist in opening her mouth for the dentist to treat/see well.
To get a dental appointment in govt clinic eg National Dental Centre, the normal waiting time can be months to half a year, how to wait that long? Private dentists are easily available. Although costly but has shorter queue time, sometimes immediate appointment. Biggest problem, normal clinic doesn't have the right support, lack of understanding and dentist can be very impatient.
Oral Care 'Need Not Be Nightmare' for Special Needs Kids, December 2014
Brushing Muhd Syamil Abdur Rahman's teeth and getting him to trust dentists used to be a struggle, but the eight-year-old, who has autism, now willingly gets into the dentist's chair.
Muhd Syamil Abdur Rahman, eight, has autism, and brushing his teeth used to be a daily struggle. One family member had to hold him still as his mother cleaned as many of his teeth as possible. Said Madam Norlizan Mohidu, 40, of her son: "He just refused to open his mouth because he didn't like foreign objects in it." Syamil's case is typical of parents who have children with special needs and who often fear taking them to the dentist because of how unruly they can get.
Last month, the National Dental Centre Singapore (NDCS) hosted a public forum for around 70 parents of special needs children for the first time. A survey of the group showed that four in 10 had never taken their child to the dentist, while the vast majority feared that their child would not cooperate while there. About half said that no dentist would see their child, or that they did not know where to look for one who would.
Paediatric dentist Terry Teo of The Dental Studio - a Singapore Medical Group Clinic - said most children visit him for the first time between ages three and five, but those with special needs do so, on average, four years later. "Very often, they have been turned away by (other) dentists," he said. He added that others may bring their children in only when they complain of pain, which may not be detected at the outset in children with special needs, because they might be unable to express themselves.
"It is only when these children get older and have possibly tolerated such pain for a long time do the parents become aware that this is affecting them." But NDCS hopes to drive home the message that dentist visits do not have to be a nightmare if you start them young. "When you go to a stressful environment that is new, children do not know how to cope," said Dr Tan Wee Kiat, a senior consultant at the centre's paediatric dentistry unit.
"You have to teach them coping strategies to get them used to the environment. With each visit, the child gets better at coping with stress and, therefore, behaves better." Ideally, she said, all children - with or without special needs - should start seeing a dentist by age one. In Syamil's case, his mum, a housewife, sought help at NDCS in 2012, after noticing her son's cavities getting worse. There, he underwent an operation to extract eight baby teeth. But getting him to trust the dentist was not easy. She related how the dentist would perform check-ups by making Syamil laugh, then sneaking a peek at his open mouth.
"She was so patient," Madam Norlizan recalled. "She would play games with him, and introduce him to all the equipment." This year, they had a breakthrough when Syamil willingly got into the dentist's chair for the first time. New adult teeth are slowly emerging - and he brushes these on his own.
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