Working on the patient in the Wheelchair

One of the simplest ways to overcome the problem of patient access to the dental chair is by providing the treatment in the wheelchair itself, without transferring the patient. Conventional wheel chair based dentistry usually does not permit sitting down dentistry. The wheelchair is wheeled close to the instrument tray of the dental chair and the safety brakes are applied. The operator then stands behind the patient and is able to perform the necessary procedures.

Though greatly convenient to the patient this form of dentistry presents certain challenges to the operator. It may not always be possible to get adequate access because of constrains of space. The positioning of the suction may present a problem as the suction apparatus of a conventional chair is in the direction opposite to that of the patient. Similarly, alternate arrangements have to be made for the provision of a spittoon as the patient will not be able to reach the spittoon attached to the chair. Lastly the positioning of the patient is upright; this may pose a problem, especially when working on mandibular teeth where a more reclined position is favorable.

 The adjustable dental platform, the ramp allows the reclining of the wheelchair

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Many of these problems may be overcome by the use of specially designed mobile dental platforms. Platforms such as Diaco^TM are used routinely by the NHS in the UK and by certain clinics across the US, Asia and Australia. The unit consists of an adjustable ramp and an attached dental unit. The patient remains in the chair at all times. The chair is wheeled on to the ramp and the brakes are applied. The ramp is then adjusted to the optimal angulations permitting the dentist all the benefits of a conventional dental chair. These units however are expensive and thus their use in the Indian scenario is limited. Thus in most cases the dentist; in order to render optimal dental care is compelled to transfer the patient from the wheel chair to the dental chair.