An impairment refers to a functional limitation of a person’s ability; examples are reduced visual acuity, diminshed hearing capacity, lack of muscular control, decreased learning ability, or an inability to concentrate.

By contrast, the following conditions are not considered as impairments, however, some are in dispute:

  • illiteracy
  • prison record
  • financial problems
  • homosexuality
  • transvestism
  • exhibitionism
  • blue eyes
  • black hair
  • left-handedness
  • impatience
  • kleptomania
  • compulsive gambling
  • normal deviations in height, weight, or strength
  • pregnancy (complications may be impairments)
  • age
  • illegal drug use


A person is considered to have a disability if he or she has a mental or physical impairment which “substantially” limits one or more major life activities.  These activities include, but are not limited to:

  • caring for oneself
  • walking
  • hearing
  • seeing
  • breathing
  • reading
  • working
  • speaking
  • lifting
  • learning
  • thinking
  • concentrating
  • interacting with other
  • performing manual tasks
  • standing
  • reaching

If, for example, you have a spinal cord injury that “substantially” limits your ability to walk, then you are considered to have a disability.  If you have dyslexia that substantially limits your ability to read, then you are considered to have a disability.

The Americans with Disabilities Act identifies three categories or persons who are considered to have a disability:

  1. A person who has a physical or mental impairment that substantially limits one or more of the major life activities.
  2. A person who has a record of such impairment.
  3. A person who is regarded as having such an impairment.

Types of Disabilities

Disabilities may be labeled and categorized in a variety of ways, the following is one way:

  • Physical disabilities
    • mobility impairments
    • respiratory impairments
  • Sensory disabilities
    • visual impairments
    • hearing impairments
  • Mental disabilities
    • emotional impairments
    • social impairments
    • impulse control disorders
  • Cognitive disabilities
    • learning impairments
    • attention deficits

“Developmental Disabilities” are caused by impairments that occur during the years of development (birth to age 18).  The impairment can occur prenatally, perinatally or postnatally.  Disorders that may cause developmental disabilities are chromosomal abnormalities, autism, cerebral palsy, fetal alcohol syndrome, post-natal infections, birth anoxia, and epilepsy.

“Acquired disabilities” are caused by impairments sustained after the developmental years, e.g., traumatic head injury, spinal cord injury, multiple sclerosis, and arthritis.

Special Care

“Special Care” is  patient treatment which involves increased awareness, attention and accommodation by the dentist and dental staff, which includes but is not limited to:

  • medical consultation
  • coordinating dental treatment with other care providers
  • accommodating a person who is deaf or blind
  • communicating through an interpreter
  • treating a person who uses a wheelchair
  • managing/accommodating the behavior of a resistant patient
  • proper airway positioning
  • conscious sedation
  • proving care under general anesthesia
  • obtaining informed consent via guardian or court petition
  • modifications to routine treatment procedures
  • referral for treatment and consultation by specialists
  • providing oral hygiene instruction to a person who has an intellectual disability

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