Behavioral Management of the Mentally Retarded

Abstract

The terms “handicapped child” and “mental retardation” stir a wide variety of negative emotions in different individuals, most of which are not justified. For the dental profession to properly manage handicapped individuals empathy is needed —an understanding of how much they are like “normal” people and an understanding of the conditions with which they present to you the dental practitioner. The practitioner's goals should be: (1) To secure the friendship, confidence, and trust of the patient. (2) To educate individuals to accept dental treatment in a pleasant frame of mind. (3) Maintenance of good oral dental health. These goals can best be accomplished if you: (1) Understand the growth and development characteristics of the child. (2) Understand that every child, normal or mentally retarded, presents unique individual personalities, emotional states and fears. (3) Know in advance what you wish to accomplish. (4) Do not lie to the child. (5) Do not keep the child waiting. (6) Keep instrumentation to a minimum. (7) Flattery and rewards are appropriate for the individual child and are valuable aids in modifying the child's negative behavior and in promoting more positive behavior. (8) Be firm and friendly but maintain authority. (9) Beware of parental and sibling influences on the child's fears. (10) See the world as the child sees it and at his individual level of intelligence and comprehension (empathy). Providing dental care for handicapped individuals can be a challenging and demanding exercise, particularly in the area of human relations. The core of the proper approach to management must be the feeling on the part of the dentist, as well as the parents, that dental care for the mentally retarded is a normal, healthy, and vital experience for his mental and emotional development, as well as for his physical well-being. The key to making the situation as mild and easy as possible for both the operator and the individual is proper preparation. A child's pediatrician or family physician is the most reliable source of information, along with the health history; however, the dentist who treats handicapped and mentally retarded individuals should also become aware of and familiar with associated health problems. This is extremely necessary so as to enable the practitioner to better understand the unfamiliar patient reactions with which he might be confronted. If one is familiar with what to look for, one can take precautions and approaches to make the task more simple by preventing many of the problems that confront inexperienced and unknowledgeable practitioners. If one takes precautions and approaches the task with a proper frame of mind, these unfortunate individuals will not appear to be little monsters, but will become a new and rewarding challenge.