The use of glass ionomer in special needs patients

Placement of restorations for patients who are physically or intellectually disabled or mentally ill can pose considerable difficulties for the genera l practitioner. Access to the oral environment is often limited and patient tolerance and concentration may be reduced to rather brief periods of time . Oral hygiene routines may be less than ideal leading to a high caries rat e. Enamel surfaces which do not normally become carious can develop broad b ut shallow lesions with a poorly defined outline. Selection of the most suitable restorative material will be important, with longevity of the restoration as the prime consideration. Other factors suc h as access, isolation of the lesion and patient cooperation must also be t aken into account. Also, forces acting on restorative materials may be less than usual due to poor occlusion, teeth opposing dentures or being complet ely unopposed. Restoration by indirect techniques will often not be possibl e so the choice will be limited to the three plastic restorative materials normally used in restorative dentistry: amalgam, resin composite and glass ionomer. As a result of clinical experience it is suggested that glass ionomer will often be the material of choice. This paper describes five years experience with the resin-modified glass ionomers in an institutional practice which is limited to patients with special needs. Clinical significance Placement of restorations, with a reasonable expectat ion of longevity, can pose considerable problems for the patient with speci al needs. Resin-modified glass ionomer is a useful alternative material and has been placed with a high degree of success over a period of five years.