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Tandartspraktijk
Citaat uit interview uit masterthesis R. Kooijman
“Laatst bij een patiënt had ik een plaatje gemaakt met alle kiezen en we hadden samen met pijltjes erbij geschreven welke kanten hij opmoest met poetsen en welke volgorde hij moest houden om niet iets over te slaan, want dat ging mis. Ik had op mijn plaatje alle tanden en kiezen getekend, tot en met de 7ens. Maar dit was een patiënt met verstandskiezen. Toen hij kwam de volgende keer terug kwam was echt alles brandschoon! Dat vind ik dan weer het mooie van het autisme, als je iets uitlegt en het is duidelijk en het komt bij diegene binnen, dan doen ze dat ook echt vaak gewoon echt supergoed. Alleen de verstandskiezen waren dus gewoon nog helemaal nog schoon, onder de plaque en ik dacht ‘hoe kan dat dan, want de rest is gewoon goed en de handigheid zit erin?!’ Toen zijn we samen naar het plaatje gaan kijken van waar zit het hem nou in? En laten zien in de spiegel en toen zij hij van ‘Ja, maar die stonden er niet op!’ Dus toen hebben we gewoon eigenlijk 2 extra rondjes getekend in dat plaatje, wat de achterste kiezen moesten voorstellen en de volgende keer was het brandschoon!”

Handen en voeten geven
Studente MSc Health Sciences, International Public Health, Roos Kooijman heeft onlangs haar onderzoek naar barrières in de preventieve mondzorg bij kinderen met autisme afgerond. Het geeft individuele mondzorgverleners en wetenschappelijke verenigingen handen en voeten.

Titel van het onderzoek luidt:
Barriers in oral hygiene in children with an autism spectrum disorder of various ethnic/cultural backgrounds in the Netherlands. A qualitative study among special dental care providers. Hieronder een abstract:

Introduction
Special dental care providers have indicated that oral care in children with an autism spectrum disorder (ASD) can be challenging especially when their oral hygiene is involved. To date, limited research is conducted on the barriers in oral hygiene of children with ASD. Research shows that culture can play a role in the oral hygiene of children. However, research that includes various cultural backgrounds is unavailable. This study aimed to explore the perceived barriers of special dental care providers in oral hygiene of all children with ASD.

Methods
A qualitative study, through open-ended questionnaires and semi-structured interviews, was conducted among special dental care providers in the Netherlands. A total of forty-eight oral health care providers for patients with special needs filled out the questionnaire; 15 pediatric dentists, 14 dentists specialized in dental care for disabled and 19 oral hygienists. Of this total population sample, six practitioners were selected for a semi-structured interview. A framework analysis was used.

Results
The main perceived barriers for practitioners in professional oral hygienic care in children with ASD appeared to be: Communication/Contact, Sensory perception and Cooperation. In teaching home oral care two additional barriers were identified: Add structure and Motor function. Moreover, the knowledge about ASD of the practitioners emerged as overarching barrier within the oral hygiene of the child with ASD. Additionally, the perceived cultural-related barriers in home oral care appeared to be: Nutrition & Sugar intake and Support & attitude. Additionally, Language was found to be a vital barrier in the professional oral care in children with ASD from various cultural backgrounds.

Conclusion
This study provides preliminary insights in the perceived barriers of special dental care providers in oral hygiene of children with ASD. On the basis of this study, it can be suggested that knowledge expansion of the practitioners about ASD can be the basis for potential solutions to these barriers. Further research is needed to look at the interaction between different perceived barriers. Moreover, the children’s and parents’ perceived barriers in oral care should be explored as well. All persons of this ‘’triangle of people’’ are needed to achieve a proper level of oral hygiene in children.

Concerning ‘’culture’’, it was found that this entails specific experienced barriers. Future research may explore cultural-related barriers in maintaining an adequate level oral hygiene in children with ASD and focus on culture in order to customize solutions for all children.

Overall, it was concluded that the need is evident, but the solution is not simple.


Klik hier voor het Masterthesis

Brochure Mondzorg
Directeur expertisecentrum Advisium schrijft in de brochure lovende woorden over mondzorgverleners:
“Het is voor mij zeer inspirerend om te zien met welke passie en gedrevenheid zorgverleners binnen de mondzorg elke dag op zoek zijn naar een ondersteuning die past bij de individuele cliënt. Door middel van dit boekje willen wij onze ervaringen die we opgedaan hebben binnen de bijzondere mondzorg voor mensen met een verstandelijke beperking graag met u delen. Als uw interesse gewekt is of u heeft een concrete vraag, dan kunt u zich daarvoor altijd wenden tot een van onze medewerkers van de negen mondzorgpraktijken van het expertisecentrum Advisium of contact opnemen met het 0800 nummer van ’s Heeren Loo. Ik wens u veel leesplezier”.

Klik hier voor de brochure

In Dental Tribune Nederlandse Editie Augustus 2016 staat een uitgebreid interview
“Het doel is een veilige stoel” - Een interview met met Jan Elhorst (tandarts-gehandicaptenzorg) en Henk Algra (orthopedagoog) en GZ-psycholoog) over patiënten met autisme

Inleiding
Veertig jaar geleden werkten ze al in dezelfde instelling voor mensen met een verstandelijke beperking. Jan Elhorst kwam net uit de collegebanken en Henk Algra ging tijdens zijn studie alvast praktijkervaring opdoen. Nu, jaren later, werken ze samen om mondzorg aan patiënten met een verstandelijke beperking en/of autisme te verbeteren. Algra werkt voor de Stichting Bijzondere Tandheelkunde op ACTA, Elhorst is gepensioneerd maar onder meer nog nauw betrokken bij de werkgroep Autismevriendelijke Mondzorg. Dental Tribune sprak Elhorst en Algra over de uitdaging van een autistische patiënt in de praktijk, het visualiseren van behandelingen en het vermijden van narcose of dwang. “Niet elke autistische patiënt hoeft naar het CBT.”


Klik hier voor het interview

Who we are
Royal Dutch Kentalis is a national organization in the Netherlands that over the past 225 years became specialized in providing diagnostics, care and educational services to people with a variety of challenges in communication, due to either impairments in hearing or in language processing. 4800 Staff members work in order to offer those with disabilities in hearing or language access to communication, language, and information.
Two products for special care dentistry were develloped
1. Manual: Communication on the subject of, before, during and after a visit to the dentist

Introduction
“A visit to the dentist will generally not be considered pleasant. Furthermore, it is a visit that occurs only occasionally. For people with an intellectual disability a visit to the dentist can entail a lot of tension. For instance, because they don’t exactly know what is going to happen or had a previous experience that has been unpleasant. By supporting the client in a way that fits their needs, the visit can run in a more relaxed way. This manual describes how you can adjust your support to the communication level and experience organisation of the client. Choosing a form of communication (object, photo, pictogram) needs to be adjusted to the individual possibilities of the client.
Besides the use of forms of communication, there are other aspects connected to the clients feeling of security during treatment. For instance the rate of the treatment, whether or not a parent or supervisor is present, who is in charge during treatment, what is calming for the client, etc. Before treatment these aspects can be taken into consideration, discussed and noted on preparation cards (see appendix 1, 2 and 3).
The photos depicting the steps of different dentist treatments can be supportive for some clients. The manual describes how the photos can be used on different communication levels and for different purposes (to prepare a client, to use during or after a dentist treatment)”.

Click here for the manual

2. Serie visualizing different dental treatment
Introduction - Preparation for a visit to the dentist
A visit to the dentist will generally not be considered as pleasant. Furthermore, it is a visit that occurs only occasionally. For people with an intellectual disability a visit to the dentist can entail a lot of tension. For instance, because they don’t exactly know what is going to happen or had a previous unpleasant experience. By supporting the clients in a way that fits their needs, the visit can run in a more relaxed way.
Do you have questions on how to support your child or client when he or she goes to the dentist? Or how you can prepare your child or client for a visit to the dentist?
The Communication Treatment Team (Communicatie Behandel Team in Dutch), with divisions in Amsterdam, Utrecht and Zoetermeer, aims at diagnostics and treatment of individual clients who are deaf or hearing impaired, have a language impairment or autism, combined with other impairments (intellectually, physically, mentally). All clients have Severe Developmental Language Disorders (SDLD). We can help you answer the questions above and others. Possibly the photo series ‘Visit to the Dentist’ can be supportive.
The Communication Treatment Team Amsterdam of Royal Dutch Kentalis in collaboration with the Foundation for Special Dentistry (Stichting voor Bijzondere Tandheelkunde in Dutch) have developed a photo series visualizing different dental treatments. With this belongs a manual, in which is described how you can take into account the communication level of the client regarding communication on the visit to the dentist. The appendices (numbers 1, 2, 3 and 4) of this manual can downloaded as a Word document.
Next to an overview of the treatments and steps that belong to them, the following visualized steps (in photos) are available and can be found here:
• Arrival by foot and arrival in elevator
• Staff
• Spaces
• Standard check-up and with extra options
• Polishing
• Removal of scale
• Fluoride treatment
• Anesthetize
• Treatment drilling: 1. Fill cavities-drilling, 2. Fill cavities-extra option etch, 3. Fill cavities-filling, 4. Fill cavities-grinding, 5. Fill cavities-grinding-extra option
• Rinsing
• Making an X-ray, making an X-ray at the fourth floor of the Foundation for Special Dentistry, making an X-ray at the fourth floor of the Foundation for Special Dentistry without earrings
• Pre-operative consultation
• Narcosis by a drip-feed or a face mask
• Treatment by oral hygienist, including tooth brushing instruction
• Departure
• Instruments
• Making a dental imprint
If you have any questions regarding what we can do for you or if you require more information about the photo series or a part of it, or if you want to order one or more loose photographs digitally, you can send an e-mail to infotandartsfotos@kentalis.nl.

Click here for more information photo’s
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