Oral rehabilitation to maintain independence.

A child born with missing or deformed upper extremities must learn to develop alternatives for the activities of daily living (ADL). To assure an independent existence, substitutes for nonfunctioning arms and hands must be developed. Teeth can replace hands for all activities that require pinch and grasp, as well as to support adaptive devices for turning pages, typing, drawing and painting. However, without carefully planned dental care, teeth, particularly incisors and canines, will show excessive wear if used for hands over the years. Loss of teeth threatens independence in self-care and in ADL, and loss of self-esteem. Oral health can be restored and retained to maintain function, independence, and esthetics. This case presentation illustrates a challenge and obligation of dentistry in rehabilitation.