Friday, 19 December 2014

DENTISTRY ACCESSIBILITY


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.

STATISTICAL DATA

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.

ERGONOMICS

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.

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