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The Patient with Special Needs: General Treatment Considerations (AGD 750)

Presenter: Janet Jaccarino, CDA, RDH, MA; Contributing Author: Natalie Kaweckyj, BA, LDA, RF, CDA, CDPMA, COA, COMSA, CPFDA, CRFDA, MADAA



When you hear the term patients with “special needs” or “special care treatment” what comes to mind? As dental professionals we learn that every patient is an individual with their own set of special needs. A patient’s gender, age, race, culture, language, economic status, values, beliefs and past dental experiences all affect their treatment. The first dental visit for the pediatric patient, the emergency radiograph for the pregnant patient, or seating the geriatric patient with arthritis will not follow the same protocol.

While most dental patients can receive oral health care in private practice settings, some patients have medical, physical, developmental or cognitive conditions that require adaptations to treatment beyond routine. Patients with disabilities, who make up a large segment of the population, are often overlooked when it comes to oral health care for a variety of reasons. However, it is our responsibility as dental health care professionals to meet the needs of this very special group of patients.


Janet Jaccarino, CDA, RDH, MA, was an Assistant Professor in the Department of Allied Dental Education in the School of Health Related Professions at Rutgers University in New Jersey. She taught dental hygiene and dental assisting students starting in 2000 and is now retired.

Contributing Author: Natalie Kaweckyj, BA, LDA, RF, CDA, CDPMA, COA, COMSA, CPFDA, CRFDA, MADAA - began her dental assisting career almost 30 years ago after graduating from the CODA accredited program ConCorde Career Institute. She spent twelve years working in a private practice where she worked clinically nine years and administratively the remaining three. She then moved onto teaching dental assisting and eventually became director of that program. Over lapping with teaching, Natalie began her tenure with Children’s Dental Services in 2007 in management and currently serves as clinical coordinator responsible for the day-to-day operations at over 600 locations where services are provided throughout Minnesota. Natalie enjoys the challenges of the public health sector and is gratified in serving those that are underserved, especially in a hospital setting under general anesthesia. With over two decades of restorative functions experience under her belt, she enjoys working with professionals new to dentistry as her love for teaching comes into play with the utilization of clinicians to the full scope of their licenses. The clinic keeps Natalie busy with billing management when not at the hospital. Natalie also graduated with a BA in Biology and Psychology from Metropolitan State University in 2005.

Ms. Kaweckyj served two terms as ADAA President (2017-2018; 2010-2011). She remains active on several councils, and serves as a Vice President of the Professional Dental Assistants Educational Foundation (PDAEF) and is one of the founding members of the PDAEF. She served as a three-term president for MnDAA and remains as the state business secretary. Natalie has been recognized with several ADAA awards, was one of the first ADAA Fellows in 1999 and became the first ADAA Master in 2004. She has published numerous continuing education courses, several chapters, over 300 articles in various publications and lectures on a variety of dental subjects internationally as well as domestically. Natalie is considered a key opinion leader in dental assisting and has helped various international dental assisting groups become active. Organized dentistry gave Natalie the insight that you can make a difference as a dental professional, and she was instrumental in seeing licensure for dental assistants come to fruition in MN in 2009, as well as several expanded functions. Her dream would be to see mandatory credentialing become a reality in all states for protection of the public and maintaining integrity of the dental assisting profession.


At the completion of this course, the dental professional should be able to:

• Define disability.
• Recognize the “patient with special needs.”
• Discuss deinstitutionalization.
• Identify reasons why preventive dental care is important for the patient with special needs.
• Describe the problems associated with access to oral health care for the special needs patient.
• Define the role of the dental team in providing care for the patient with special needs.
• Define special care dentistry.
• Consider physical factors in the office that influence provision of dental care for the special needs patient.
• State design characteristics of a barrier–free or universal design environment.
• Discuss simple design changes to an existing facility to improve access for disabled individuals.
• Discuss issues that may impact appointment scheduling and treatment planning.
• List methods that will help desensitize the patient to dental treatment.
• Describe the rationale, methods and contraindications for use of protective stabilization during dental treatment.
• Describe the rationale and precautions for use of a commercial and office–fabricated mouth prop.
• List the information that is necessary for proper record documentation.


The ADAA has an obligation to disseminate knowledge in the field of dentistry.  Sponsorship of a continuing education program by the ADAA does not necessarily imply endorsement of a particular philosophy, product or technique.

The ADAA cautions participants taking this course on the hazards of using limited knowledge when integrating new techniques into their practices.

Credits earned upon completion of the course may be used to meet DANB’s Recertification Requirements.


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