Providing Quality Dental Care for Patients with Special Needs

Treating Patients with Special Needs - Key Points

• The population of people with intellectual and developmental disabilities (I/DD) is increasing, and people with I/DD receive dental evaluations 17% less often than the population as a whole.
• People with I/DD often face long delays for dental care, and untreated dental disease is found in at least 25% of people with cerebral palsy, 30% of those with head injuries, and 17% of those with hearing impairment.
• The life expectancy of a person with Down syndrome has increased from 12 years to 60 years (as of 2009), which puts more responsibility on general and family dentists to provide quality care to individuals who have ‘aged out’ of pediatric practices.
• Dentists should develop qualities such as empathy, patience, compassion, and additional training to function in healthcare teams and consult with other service professionals.
• Dentists should use people-first language and avoid treating someone with I/DD disrespectfully or as dumb.
• Dentists should remember who the patient is and direct conversation towards them.
• Dentists should use behavior guidance techniques such as Tell-Show-Do, slow approach, distraction, positive reinforcement, and voice modulation.
• Dentists may need to desensitize a patient to all the bells and whistles of dental treatment, such as the saliva ejector, prophy brush, air/water syringe, anesthesia, caries, etch, bond, composite process, and tooth extraction.
• Dentists should gather identifying data, self-consent/guardian consent, chief concern, history of present illness, medical history, dental history, social history, clinical, radiographic, laboratory examinations, diagnosis, and plan (phases, ethical considerations, further diagnostic steps).
• Dentists can apply for a fellowship to address oral health disparities, which is a one-year training program focused on patients with I/DD following completion of GPR or AEGD.
• Institutions that offer the fellowship include Columbia University College of Dental Medicine, New York University College of Dentistry, Stony Brook University School of Dental Medicine, Touro College of Dental Medicine, University at Buffalo School of Dental Medicine, and University of Rochester School of Medicine & Dentistry.
• Dentists can email [email protected] if they have any questions about the fellowship, patients with special needs, or dental school.