Jeffrey Hicks, D.D.S.
Member, Special Care Dentistry Association
“State and federal funding for higher education is essential to dental schools and residency programs in expanding or increasing training for oral providers…”
Approximately 57 million Americans have a disability complicating their lives. One challenge in particular for people with special needs and their caregivers is accessing and receiving adequate oral healthcare.
Compared to the general population, people with a disability:
- Have more untreated tooth decay
- Have a higher prevalence of gum disease, if intellectual disabilities are present
- Are more prone to develop orthodontic problems as children
- Have more problems related to trauma of the mouth and face
Consequently, two-thirds of residential facilities for people with disabilities report that inadequate access to dental care is a significant issue demanding immediate and focused attention.
The three levels of care
Oral healthcare, for both the disabled and general populations, can be generally divided into three levels:
- Emergent care, or treating an emergency condition
- Preventative care against future disease or the worsening of current oral disease
- Restorative care to rehabilitate oral function
Even though patients with special needs may require more time and effort in their care, access to all three of these levels is as essential for patients with special needs as it is for those without.
Dentists and dental hygienists caring for people with special needs require extensive knowledge of medical, mental and behavioral health, patients’ fears and feelings, and their other impairments, such as limited hearing or sight. Providers must possess the knowledge and skills to provide mild to moderate levels of sedation, when needed, or even oral care delivered in an operating room under general anesthesia. Dental providers must also work effectively with healthcare providers, like physicians and psychiatrists, in dealing with patients’ medical conditions and in the need for sedation and general anesthesia.
A call for training
Training in the oral care of persons with special needs is taught in dental schools and residency programs of pediatric dentistry, geriatrics, general practice, and advanced education in general dentistry. However, evidence suggests that there is a significant shortage of dental providers for this particular population.
State and federal funding for higher education is essential to dental schools and residency programs in expanding or increasing training for oral providers to care for patients with special needs. While access to care can be a main concern, a provider database, such as the one in South Carolina, has proven helpful in identifying trained providers willing to provide care to patients with special needs.
Jeffrey Hicks, D.D.S., Member, Special Care Dentistry Association, [email protected]