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March 5, 2015

Dental center serves special-need patients

Members of the University Senate benefits and welfare committee toured the School of Dental Medicine’s Center for Patients with Special Needs (CPSN) as part of the group’s Feb. 19 meeting.

Committee chair Angelina Riccelli, who is a dental school faculty member, called the center “a little jewel in this dental school that people don’t know about.”

Lynne Taiclet, director of CPSN, said that dental care is the most common unmet health care issue for special-needs patients. CPSN students and faculty see patients with developmental disabilities they’ve had since birth as well as those who develop debilitating injuries or illnesses such as dementia that impair their ability to cooperate with dentists in regular practice. CPSN is especially helpful to those who need sedation, restraint or behavioral modification to accept dental treatment.

“The dentistry is the same, I tell my students,” Taiclet said. “The delivery of the dentistry changes.”

She said the CPSN uses “a lot of sedation” and was the first dental school clinic in the nation to train students to do dentistry beside anesthesiologists, who today use intravenous, nitrous oxide and general anesthesia on CPSN patients. She called such patients “the largest minority” in the country who need a steady dental practice to go to — a “dental home,” she labeled it.

“Patients come from closer to Temple and Penn, and they drive all the way over here” for treatment, she added. While it is common for dental schools to offer training about medically complicated dental patients and those with disabilities, Pitt is unique in offering training for students to work with the administration of anesthesia. “We’ve had six new patients this week. It’s constant. We don’t have to look for patients.” Websites for families of those with specific disabilities also have spread the word about CPSN.

CPSN is a required rotation for third- and fourth-year dental medicine students; dental hygienists also have a required course in the facility. Dental residents are taught in CPSN as well.

“A Down’s patient is your typical special-needs patient” coming to the clinic, Taiclet said, although there is a long list of other specific illnesses and disabilities for which CPSN students receive training. The goal is to help dentists learn how to treat such patients in their regular practices.

“Our special-needs patients are living longer too,” Taiclet noted, and so dentists may see CPSN patients throughout the lifecycle. The clinic has six treatment rooms, including two with general anesthesia capabilities, a recovery area and a conference area. Specialized equipment includes a handheld X-ray machine as well as devices to lift patients to and from dental chairs and to tilt wheelchairs for easier patient access. CPSN students also are trained in behavioral guidance and protective stabilization, from simple hand restraints to what Taiclet describes as “a big mummy wrap” with Velcro closures, used mostly for uncooperative children. While patients are under sedation, family members sometimes even step in to cut patients’ hair or nails under these easier circumstances.

Taiclet said she gets calls from her former students who, as residents, find that they are now “so much more prepared” than their fellow residents.


In other committee news:

• John Kozar, assistant vice chancellor for Human Resources and a chancellor’s liaison to the committee, reported that he will be meeting with his medical advisory committee concerning fiscal year 2016 medical insurance coverage for faculty and staff. “I don’t expect significant changes in any way,” he said.

• Sachin Velankar, a Swanson School of Engineering faculty member, replaced Riccelli as chair after a committee vote. Riccelli had completed three years as chair,  the maximum allowed.

—Marty Levine