The challenge of oral health care for persons with disabilities

For Philippe Aubert, 42, seeking oral health care has been a challenge. Philippe, from France, has athetotic cerebral palsy (CP), which causes involuntary movements that prevent him from walking, talking or using his arms.

"Many simple details including the texture of the seats... the light, the noise of the dental drill, and even the typical smell of a dental clinic could easily trigger spasticity, anxiety or other symptoms for a patient with CP," Philippe explains.

Some visits have made him feel unsafe and reluctant to return. "Once I almost choked on a dental x-ray film put in my mouth and nearly destroyed the dental chair... because of the involuntary movements triggered by the procedure."

His teeth were a problem for a long time. "Due to pronounced bruxism (habitual teeth grinding), I had almost ground down all my teeth. I had serious difficulties chewing and eating."

Philippe strongly believes that the attitudes and skills of dental staff - who usually know little of his needs - are crucial to successfully addressing the needs of persons with disabilities. He called for effective training and "respectful relationships" borne from "taking time to hear [patients] out and understand their needs."

Philippe finally found a non-profit organization, Handident, where he was warmly welcomed. "I had to go to the extreme of full mouth rehabilitation so that I could claim, and finally appreciate, my mouth and teeth," he says. These dentists "changed my life".

Philippe's book Rage to exist has led to him becoming a public figure highlighting the experience of persons with disabilities. His words are "spoken" via a speech synthesizer controlled by his gaze. "I have not spoken since birth! My mouth and teeth helped me to eat, not communicate. Today, my mouth plays an essential role in my communication and my aesthetic," he says with a bright smile.

This story first appeared in the WHO Global report on health equity for persons with disabilities.