Case Management in Vulnerable Individuals and Populations

Kristen Leong

Sujin Yu

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Leong, Kristen, Yu, Sujin
Faculty / Advisor: Sheridan, Olivia
University of Pennsylvania School of Dental Medicine, Department of Preventive and Restorative Sciences

Introduction

Many patients experience fear when visiting a dental clinic. Sources of fear include specific needle fear and less specific fear of ceding control in the dental chair or fear of pain or of the unknown. Vulnerable individuals and populations require additional consideration when receiving dental care due to their past experiences and trauma1. This poster will explore the treatment planning and treatment considerations for one such patient, as well as the flexibility required to accommodate the patient’s wishes while providing evidence-based care.

Methods

This is a case presentation.

Results

As providers, it was important to examine the bounds of good therapeutics and involve specialists early in the discussion for treatment planning and sequencing. Knowing that the care provided had less than optimal prognosis, the providers reinforced the importance of home care and regular dental follow up once the patient left for Arizona. The patient expressed understanding and commitment to regular appointments. The patient also was dissatisfied with  aesthetics of the provisional prosthesis that he went to Arizona with, which while compromised in prognosis, also provides motivation for the patient to seek definitive care in Arizona.

Conclusion

Care for vulnerable individuals must even more intentionally balance the ethical principles that guide the dental profession. As demonstrated in this case, informed consent for treatment does not always initially capture the full scope of what treatment will be rendered, and both the provider and the patient must keep the channels of communication open throughout treatment to ensure that the patient’s chief complaint is being addressed in such a way that satisfies accepted treatment outcomes for the provider and the patient. Coordination of care with specialists to provide the best possible outcomes for care was necessary to balance patient desires.