2018 Volume 39 Issue 1 Pages 8-15
It is important to help intellectually disabled persons understand behavior management in their dental treatment so that they may be involved in the decision-making process.
Legally, patients themselves are allowed to choose their medical treatment. Decision-making by a patient is important in dental treatment for people with intellectual disabilities, but they need to be supported in the decision-making process；the decision-making process is the patient’s right. Currently, intellectually disabled persons have not been supported in choosing the method of behavior management in their dental treatment；rather, the parents have decided the method. The intellectual level at which people with intellectual disabilities can understand behavior management techniques during dental treatment is unclear. Videos, illustrations and photos are used to help patients understand behavior management. If patients are able to understand the options, there is a possibility that decision-making support at the time of dental treatment of persons with intellectual disabilities will be provided.
The purpose of this study was to investigate the ability of patients to understand and select the type of behavior management. The methods were general anesthesia and physical restraint. These methods were explained to the patient using videos, illustrations and photos.
Ninety people with intellectual disabilities were studied （24 intellectually disabled patients, 54 autistic patients and 12 Down syndrome patients）. General anesthesia and physical restraint were explained to 90 subjects using videos, illustrations or photos. After the explanation, they were asked five questions：1） “Which method uses medicine?”, 2） “Which is the method where I sleep during treatment?”, 3） “Which is the method where I am physically controlled during treatment?”, 4） “Which do you like?”, 5） “Which do you dislike?” The first group answered all three questions correctly （question 1） to 3））, the second group mistook at least one question. It is suggested that patients with intellectual disabilities equivalent to a developmental age of 4 years and 6 months in basic life and understanding of language are able to understand general anesthesia and physical restraint using videos, illustrations or photos. There was no significant difference in ease of understanding among using videos, illustrations and photos. The proportion of those who agreed with the answers twice was 90.9％ for videos；92.3％ for illustrations；and 100％ for photos. 88.6％ of the subjects of the first group answered that they preferred general anesthesia rather than physical restraint.
