‘GOING to the dentist’ is a familiar phrase, and, hopefully, a regular habit whenever and wherever the opportunity exists. However, there are people who, even if they wish to ‘go to the dentist’, are unable to do so because of ill health, handicap or frailty. But what is to become of the housebound patients, or those confined to medical institutions who are physically incapable of visiting a dental clinic? Should they be denied the privilege of dental attention? The maintenance or improvement of dental health for the frail and functionally dependent, including the mentally retarded, can be an especially challenging and difficulty effort. This is particularly true for the growing number of chronically ill elderly who reside in nursing home settings. For these individuals, the provision of quality dental care goes to the root of tremendously important issues surrounding chewing function and the enjoyment of meals, aesthetics, social interactions, and the pathological and sensory concerns associated with poor oral health.

Due to the widely observed difficulty of creating and operating an alternative dental delivery system for the less ambulatory, creative solutions are often required. The present trend is to have a mobile dental clinic specifically intended to target those who are permanently helpless. The dentist would then go to visit the patient wherever he or she resides.

There are two methods of delivering dental treatment to institutionalized patients. There is the mobile approach, whereby the specially built mobile dental van travels to the home, is parked on the street outside, and the patient is brought out for treatment in the van. Then there is the portable system, whereby the dentist takes his equipment, even in the bedroom of the patient. Clearly, the option of a mobile dental van could be very expensive and inappropriate in Guyana’s context.

Whenever a dentist treats a patient outside the dental office, even when full facilities are at hand, treatment solutions can be limited or modified. In home visits, many techniques have to be conditional, and procedures may vary from those taught to the dentist in dental school, and those read in textbooks.

This adaptive approach by the dentist in treating patients at home is due, in large part, to the patients themselves rather than extant conditions. Statistics show that institutionalized persons have a high incidence of clinically diagnosed dementia (a mental disease), and bladder or bowel incontinence. Twenty-five per cent are spoon-fed, nearly 10 per cent are abusive and aggressive, and approximately seven per cent are bedridden.

The average cost for a portable dental clinic being sold in the United States is the same as what the average car from an auto dealer would cost here (about US$5,000). The entire equipment can easily fit in the trunk of a car.

Developments in portable dental system technologies have produced a variety of effective options for the dental provider to serve patients outside of a traditional dental office. It is only for those concerned to take advantage of these opportunities.