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LETTER: IN March, the government implemented the Movement Control Order (MCO) to contain the rising cases of Covid-19.

Further to the announcement, all elective, non-urgent dental procedures were advised to be postponed.

As a result, all dental clinics across the country were temporarily closed, limiting their practice to emergency cases. To date, our country has seen areas that were subjected to different MCOs, such as Enhanced MCO, Semi Enhanced MCO, Targeted Enhanced MCO and Conditional MCO. Throughout the MCO period, dental services remain limited to urgent, non-aerosol generated procedures.

The cessation of routine dental services was felt by children with medical comorbidities and disabilities.

This delays the required treatment and worsens the oral health of the child.

The consequences of untreated caries and unmet treatment needs will emerge in our dental healthcare system in the near future, possibly with poor prognosis, non-restorable carious teeth and odontogenic infection. This situation will further widen the existing child oral health inequalities.

A report by United Nations Children's Fund (Unicef) Malaysia published in 2017, said there were insufficient centres and trained specialists available for children with disabilities and the healthcare settings and physical facilities were not appropriately tailored for them. This adds further limitation for access to healthcare, of which they often require extensive dental and medical attention.

Accessing oral health services for children with disabilities is a complex challenge. Children with disabilities often require support and assistance when undergoing dental examination and treatment. Studies reported that children with disabilities are more likely to have poorer oral health status than their healthy peers.

This is due to difficulty in providing oral care at home, limited access to dental care, parental conflicts and complexity of the medical conditions. Children with physical disabilities often have limited or uncontrolled motor coordination. This poses a challenge for tooth-brushing and during dental treatment on the dental chair.

Children with delayed speech development and communicative disabilities may not be able to tell their parents or dentist of a toothache, which can often manifest as children throwing unexpected, frustrated tantrums. Behaviourally-challenged children often have limited, short-span attention and may not cooperate during dental visits.

This demands continuous cooperation both from parents and dental healthcare personnel. Children with medical comorbidities require a multidisciplinary team effort and often require multiple visits to healthcare centres.

While the national prevalence of dental caries showed a reducing trend among pre-school and

schoolchildren, it continues to stagnate among children with disabilities.

The unmet dental needs compounded by social barriers and limited access for dental services will cumulatively contribute to broader health inequalities for children with disabilities.

When Covid-19 restrictions have been lifted, priority for access to oral health services should be given to these children. It has been a year since Covid-19 was first reported and became a public health emergency.

Unfortunately, it took a pandemic to teach us our societal responsibilities and the importance of humanising healthcare. This pandemic also reminds us that children with disabilities need particular care.

DR AHMAD FAISAL ISMAIL

Kulliyyah of Dentistry, International Islamic University Malaysia (IIUM)

Source: https://www.nst.com.my/opinion...