Don’t think twice about special child dentistry!

Professor MS Mutthu graduated in Pedodontics from the Nair memorial dental college 12 years ago and was one of the first exclusive practitioners in pediatric dentistry in Chennai. He has a keen interest in special needs dentistry and his exclusive pediatric dental practice Pedo Planet in Chennai is a special experience for all children. He shared his experiences on his long and often lonely foray into the field of Special Care Dentistry

DCSN: Where do you see special care dentistry in India?

Dr MSM: I think it has a long way to go, because the training in Special Care Dentistry in India is very very limited in a rather well established Pediatric Dental training programme.

DCSN: Do you feel that dentistry for Special needs children is an instinct or is it something that can be developed over time?

Dr MSM: You definitely need an aptitude but there is so much that can be done to improve the field, and make it more attractive to a young post-graduate. In the last few years I’ve made a couple of trips to developed countries and I find that their whole approach to special needs dentistry is different. They have separate buildings or wards, the students are trained separately in the treatment of such individuals. We will have to change our Pediatric Dentistry programme to include perhaps one module or exam in special needs dentistry, only then can we move forward.

DCSN: When you started out you were one of the few people practicing special needs dentistry; over the years have you seen things change or do you feel that things are just as bad as they were?

Dr MSM: No things have definitely changed over the years. When I started out people were not even aware of the concept of a pediatric dentist, or that we had better training to deal with children with special needs. Now with the greater number Pediatric dentists coming out awareness is slowly. Having said that I have to point out that the creation of awareness is our job. We as pediatric dentists have to go out and tell parents of children with special needs about the work we do, and why we can provide better care for these children. We cannot sit back and cry about the lack of awareness.

DCSN: In the west the field is Special Care dentistry and not just restricted to special children but also adults with systemic disorders or disability. In India who do you see filling that gap?

Dr MSM:Well as you pointed out Special care in the West refers to not just children but also medically compromised patients, but I don’t feel that as Pediatric dentists we should feel restricted, we can provide care to medically compromised patients of all ages: IF we have the necessary training.

DCSN: Would you prefer to treat a child with special needs under LA or Ga?

Dr MSM: First of all we must try under local anesthesia or physical restraints; this is greatly influenced by the quantum of care required. For a single extraction or a restoration we can always do it under local anesthesia, but if it is a question of full mouth rehabilitation then we may probably have to post the patient under general anesthesia. As a pediatric dentist working with special needs children for the past 12 years I can say with confidence that I have only used it only when it has become necessary. An attempt was always made on the dental chair, even if the patient was three years or two and a half years old we always tried first on the dental chair. You never know which patient will co-operate; there have been instances when children have cooperated irrespective of their age or underlying condition. I believe that as a pediatric dentist you can assess what the child’s behaviour is going to be like and then it is our duty to inform the parent that if we continue with attempts under Local Anesthesia then the quality of work will suffer.

DCSN: Any Advice to parents?

Dr MSM: Take care of your child’s teeth. I can understand that with all the underlying conditions you have probably been rushing in and out of hospitals for the greater part of your child’s life and those teeth have a low priority. But do consult a pediatric dentist as early as possible so as to prevent dental disease in the child. I also believe that only a pediatric dentist has the training and the skill required to provide dental care to a special child.

DCSN: Where do you see the future of special care Dentistry in India?

Dr MSM: I definitely see a great improvement in this area, as the field expands the number of people who are going to want to specialize into an area of special interest such as this will also increase. Furthermore as we have seen in the west, I can see specialty programmes for the care of individuals with special health needs in India as well.

DCSN: If any young dentist came up to you and said he wanted to specialize in special care dentistry what would your advice to him/her be?

Dr MSM: Don’t think twice. Go ahead and do it, because when you will look back at your career 10 years from now you will be glad you made the choice.