Approximately 57 million Americans’ lives are complicated by a disability. Oral health care is a particular and sometimes overlooked challenge for people with special health care needs.

Two-thirds of residential facilities that care for people with disabilities report that inadequate access to dental care is a significant issue. This means people with a disability are more likely to have untreated tooth decay, and have higher instances of trauma to the mouth and face. People with intellectual disabilities also have a higher prevalence of gum disease than the average American, and children with special needs are more likely to develop orthodontic problems.

Oral health care can be generally divided into three levels, which are:

  1. Emergent care, for treating emergency conditions

  2. Preventative care, which works to prevent future oral diseases and keep current ones from worsening

  3. Restorative care, for rehabilitating oral functions.

While patients with special needs may require more time and effort in their care, it is still essential they have access to all three levels of oral care.

Dentists and dental hygienists caring for people with special needs must have extensive knowledge of medical, mental and behavioral health, while also understanding patients’ fears and feelings, and their other impairments, such as limited hearing or sight. Providers must also be able to provide mild to moderate levels of sedation when needed, or even to provide oral care in an operating room using general anesthesia. 

Oral health providers must work diligently with other health care providers, like physicians and psychiatrists, to understand and manage patients’ medical conditions, and make properly informed decisions about care plans and in the need for sedation and general anesthesia.

Dental schools and residency programs — for pediatric dentistry, geriatrics, general practice and advanced education in general dentistry — train students on how to best provide oral care for people with special needs. However, evidence suggests there is a shortage of dental providers for this segment of the population.

To give more oral health providers the training they need to properly care for people with disabilities, dental schools and residency programs must receive state and federal funding to expand their programs. While training more oral health providers in this fashion should be a main concern, a provider database, such as the one in South Carolina (www.sandsc.org), can be helpful in finding trained providers willing and able to care for patients with special needs.