SAN ANTONIO – Dental school students will soon be required to learn how to care for patients with disabilities under new guidelines.
Beginning in 2020, all U.S. dental schools must change their programs to be inclusive of patients with intellectual and developmental disabilities.
The Commission on Dental Accreditation approved the following new standards, which affect predoctoral dental, orthodontics, dental hygiene and dental assistant programs:
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For predoctoral programs and orthodontics programs, dental students must be trained to assess and manage the treatment of patients with “special needs.”
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For dental hygiene programs, students must be competent in providing care to “special needs” patient populations.
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For dental assistant programs, students must familiarize themselves with patients with “special needs,” including patients whose medical, physical, psychological, or social conditions make it necessary to modify regular dental routines.
UT Health San Antonio’s School of Dentistry has already been addressing the needs of patients with special needs.
“We have to wheelchair the patient back into the dental chair, and then the unit will place the patient in a more suppliant position to allow the clinician to then manage the work on the patient in easy fashion with minimal discomfort to the patient,” said Peter Loomer, dean and professor at the UT Health San Antonio School of Dentistry, while demonstrating a device created for patients who use a wheelchair.
Members of the Special Care Dentistry Association Student Network are dedicated to promoting oral health and well-being for people with special needs.
“Our main focus is on community service events. We like to put together booths where we hand out toothbrushes, toothpaste, special types of toothbrushes, like three-sided ones that make it easier for the parents and caregivers to brush their child's teeth,” said Kelli Jimerson, dental school student and co-president of the Special Care Dentistry Association Student Network.
Jimerson said her interest in this topic started in college.
“I spent a lot of time in college volunteering with an organization that served individuals with special needs, and that piqued my interest a lot. So I sought out a personal caregiver part-time job in college. And so, between both of those areas, I just fell in love with working with those individuals and their families,” Jimerson said.
“We've already been teaching students how to work with patients with special needs, however, they still have limited access to treat them based on our capacities at our facility,” Loomer said.
The School of Dentistry has invested in a new clinic, specifically addressing the requirement for patients with special needs, which will open in winter 2021.
Currently, not every student has experience treating patients with special needs, from young to old, Loomer said.
Loomer said students would rotate through the new clinic, making sure they know how to cater to these individuals. The school will create an integrated course, too. For example, students will learn how to help patients with mobility issues get in and out of the dental chair.
“We want to make sure that they understand that, no matter what your physical ability is, what your mental capacity is, everybody deserves access to health care, including dental care,” Loomer said.
The National Council on Disability first made recommendations following its 2017 report, "Neglected for Too Long: Dental Care for Patients with Intellectual and Developmental Disabilities.” NCD’s findings included the following:
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Adults with developmental disabilities are at risk for multiple health problems, including poor oral health.
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People with I/DD (intellectual and developmental disabilities) regularly face an uphill battle in finding clinicians properly trained to treat them because most dentists lack the proper training and exposure with respect to the health and psychosocial needs of this population.
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According to one study, more than 50% of dental and medical school deans have stated that their graduates are not competent to treat patients with I/DD; as a result, people with I/DD are more likely to have poor oral hygiene, periodontal disease, and untreated dental caries than are members of the general population.
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People with I/DD have been more likely to not have had their teeth cleaned in the past five years, or never to have had their teeth cleaned, than those who are not disabled.
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Due to the lack of proper skills among dentists, dental care is often more difficult to find than any other type of service for people with I/DD.
Changes for the predoctoral dental, dental hygiene and dental assistant programs are required to take effect by July 1, 2020, with modifications to the orthodontics programs to be required by Jan. 1.
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