One size fits all?

I am sure we all have patients who are an irregular shape and don’t fit into the dental chair very well; perhaps they have a hunched back or curvature of the spine.

The old black and chrome Rathbone units may have been ugly but you could fit the headrest right into the neck of the most unwieldy patient and click it in place to provide support.

Modern chairs are almost impossible to adapt since the back is flat and the headrest merely a small bump, yet if the spine is not supported a visit to the surgery of 20 minutes or more can be extremely unpleasant and highly uncomfortable.

I have several patients whose clinical notes include the word ‘blanket’ or ‘towels’, and I am prompted to trot off to collect these from the cupboard before calling the patient in.

We always laugh as I attempt to fit the padding into the spaces so they are comfortable. I often stand to work with the chair forward so I can access their mouths, but they always appreciate my efforts.

Holistic dentistry

A friend of mine with a severe spinal disability said her visits to the dentist are very painful because she doesn’t receive this care and I felt somehow responsible.

Surely the term ‘holistic dentistry’ could be applied here for we should treat the whole person and not just the mouth. It is important for the patient to be comfortable, even if it means we don’t do as much of the work.

Recently I’ve been doing a domiciliary for a patient whose wheelchair has no headrest. I asked his wife for some steps so I could climb up behind him, support his head against me while I peered in his mouth.

I wonder how my colleagues manage; perhaps we could exchange tips.

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