To pursue a dental
excellence and provide a differentiated service, it is not enough to
master the technical and scientific part, but also offer the patient
a pleasant experience, accessible and minimally comfortable.
In many countries the
oral health needs of the population with mobility restriction and
uses a wheelchair, is hampered by numerous accessibility problems,
whether in the public or the private sector. The office must be
adapted to the patient wheelchair can move his wheelchair into the
office. However, the dental chair still stands as a barrier, it is
necessary to take the wheelchair patient and accommodate you in the
dental chair, and at the end of the work, put it back in the
wheelchair.
According ALEXANDRE and
ROGANTE, the dental care of patients with reduced mobility and
wheelchair users, is performed in the conventional dental chair. And
the transfer technique is used to position the patient in the dental
chair. In this transfer process it emphasizes the physical and
psychological discomfort, the risk of falling, the need for a person
(companion or nurse) to assist the professional in accomplishing this
task, which can, depending on the patient's disabilities and
psychological aspects cause you greater or lesser degree of
embarrassment and feelings of inadequacy.
This technique has the
following drawbacks:
Security: dentist
and patient are fearful regarding the accidents that may occur in
this small displacement;
Need for help: we
need more people, beyond the dentist, are present in the room to get
the patient on his lap and exchange the chair, which makes the
patient feel as if he had little autonomy in that environment, that
idea shown totally opposed to the philosophy of assistive technology;
Increased working
time: it takes to achieve positioning the patient in the dental
chair.
Ergonomics:
difficulty in achieving an ergonomically acceptable working position
for both the dentist and the patient. Especially in obese patients.
Thus, currently, in the
dental office, the treatment of patients with reduced mobility (with
or without disabilities) and using a wheelchair, requires health team
technical knowledge, physical strength and proper training for the
management of patients during step transfer from the wheelchair to
the dental chair.
According to Ministry of
Health data from Brazil, the WHO estimates that, in times of peace,
10% of the population of developed countries are made up of people
with a disability. In the developing countries it is estimated this
value from 12% to 15%. Of these, 20% were physically disabled.
Considering the total of patients with any disability, only 2% of
them receive specialized care, public or private.
In Brazil, according to
data collected in the last census (IBGE 2010), there are 45.6 million
people with some degree of disability, and 13.3 million have physical
disabilities. In São Paulo this number reaches 2.5 million people
with some degree of disability. These data, according to some
organizations representing people with disabilities, are
underestimated.
Brazilian company data
Insurance Leader, responsible for the administration of
compulsory automobile insurance DPVAT show that official
statistics on traffic accidents in Brazil have important data.
According to a report published by DPVAT daily 596 people are
disabled, or nearly 25 victims per hour, however the reality is
underestimated because not all claim the insurance and do not appear
in the statistics. During the period January to March 2013 were paid
85,286 compensation for permanent disability, an increase of 33% over
the previous year when there was 64,220 compensation for disability.
According to the data of
the Statistical Bulletin DPVAT - 2013 numbers are impressive,
first by the fact that the Brazilian traffic is a major cause of
death and disability in the country. Second, it indicates that every
six months 107,000 people are disabled, implying a high social and
financial cost.
Another factor that we
must consider is the increase in the elderly population due to the
problems inherent to age, especially elderly people, end up needing
wheelchair for mobility.
As a consequence, the
number of people who use wheelchairs tends to increase.
Procedures
that involve movement and transport of patients are considered the
most painful and dangerous to the health of workers, and the
implementation of training and retraining is required part of
prevention of musculoskeletal disorders in schools and health
facilities programs. The larger ergonomic hazards relate to patient
transfer process which requires great physical effort and overhead of
the spine of the operator (dental and auxiliary), one of the causes
of injury and absence from work. This withdrawal can vary from days
to years, and the time off is given by the degree of injury.
