· A disability is a mental or physical impairment that substantially limits one or more major life activities such as walking, talking, learning, seeing, hearing, or caring for oneself.

· According to the latest census, approximately 52 million Americans have a disability; 25 million citizens have a severe disability.

· As a result of normalization policies, the trend is for people with disabilities to reside in community settings and to seek health care from community-based private practitioners. Unfortunately, many of these individuals encounter difficulty obtaining comprehensive oral health care in the community.

· The Americans with Disabilities Act (ADA) was passed in 1990. It is, in essence, a civil rights law for persons with disabilities. The ADA sends a clear message about what society's attitudes should be toward persons with disabilities. These attitudes should consist of respect, inclusion, support, and accommodation. It prohibits discrimination against disabled individuals who are seeking services or employment. For example, failure to provide wheelchair access to a private dental office could be considered discrimination per the ADA.

· A Social Worker or Support Coordinator may be helpful in identifying financial resources to reimburse the dentist for services provided to a person with a disability.

· Patient accommodation issues to consider when providing dental care to patients with disabilities include;
    - office accessibility
    - patient's ability to communicate, see, and hear
    - medical consultation
    - informed consent
    - coordination of health care
    - behavior management

· Many people who have a hearing disability can read lips. Therefore, when speaking to a patient who is deaf, the dental staff should be considerate of the person by facing them and removing the face mask to expose their lips.

· The dental staff should demonstrate sensitivity toward a patient who is blind by informing them of their (staff) whereabouts at all times and of what to expect next. Why? An unexpected touch on the face or arm could startle the blind patient and increase their anxiety. In addition, if the staff member walks out of the operatory during a conversation with the patient who is deaf, the patient may continue talking when no one is in the room; this is very embarrassing for the patient.

Service animals are not pets and should not be treated as pets. Do not pet them without the owner's permission. The patient can tell you how to treat the animal.

· A person with cerebral palsy or CVA may not have the manual dexterity necessary to brush their own teeth or to place and remove an intraoral prosthesis. These individuals often require another person (caregiver) to provide daily oral hygiene procedures. The dentist and hygienist must provide oral hygiene instruction to the caregiver.

· "Status Epilepticus" and is an acute medical emergency requiring medical support. It consists of seizure activity manifested by continuous muscular jerking for ten minutes or more.

· When treating the uncooperative/resistant dental patient, the most efficient and effective means of removing tooth-accumulated deposits is the ultrasonic scaler.

· Disease prevention for the person with a disability is essential. Why? Once teeth are lost, many these individuals may be unable to tolerate complex and lengthy procedures necessary to provide fixed or removable prostheses.