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©2013 UpToDate ® Print Email Conditions that can impede the delivery of dental treatment in children Condition Effect on dental care delivery Dental management Cerebral palsy Wheelchair access; immobility; uncontrolled movements; reflex problems Treatment in wheelchair; use of restraints; use of pharmacologic means to manage movement Muscular dystrophy Wheelchair access; immobility; risk of aspiration; lack of muscle control Treatment in wheelchair; use of restraints and supports Mental retardation Inability to cooperate Behavior modification; use of pharmacologic agents to manage behavior Autism Inability to cooperate Behavior modification; use of pharmacologic agents to manage behavior Attention deficit hyperactivity disorder Short attention span Behavior modification; treatment when medicated Sensory disorders Communication difficulties Use of adjunctive communication means/interpreters; use of pharmacologic agents to manage behavior Spinal cord injury Wheelchair bound; pressure sores; autonomic dysreflexia Treatment in wheelchair; positioning/stabilizing techniques Spina bifida Intellectual impairment; wheelchair bound; positioning difficulties Behavior modification; treatment in wheelchair; positioning and stabilizing techniques Reproduced with permission from: Casamassimo PS. Pediatr Clin North Am 2000; 47:1149. Copyright ©2000 W.B. Saunders Co.