Practice without Pressure: Using the entire dental team

to Incorporate Patients with Developmental

Disabilities into the dental practice to improve

outcomes without frustration

Patients with Developmental disabilities present a wide variation of behavioral and medical complexity.  Many dentists find that serving patients with intellectual disabilities (formerly called mental retardation) disrupts practice schedules, results in failed appointments and is not adequately reimbursed.  Unprecedented numbers of people with functional limitations and complex medical conditions live in community settings and need oral health care.  The aging of disabled populations needing complex oral health care management presents challenges for dental offices. However, these patients also bring opportunities to grow our practices and develop preventive strategies that equip the dental team to face these challenges.

The United States Surgeon General’s office has identified oral health as a priority disparity to improve for patients with special needs.  A former United States Surgeon General has stated:

 â€œIndividuals with mental retardation are more likely to receive inappropriate and inadequate treatment, or be denied health care altogether.  Americans with mental retardation, and their families, face enormous obstacles in seeking the kind of basic health care that many of us take for granted. Unfortunately, societal misunderstanding of mental retardation, even by many health care providers, contributes to the terrible burden. Too few providers receive adequate training in treating persons with mental retardation. Even providers with appropriate training find our current service system offers few incentives to ensure appropriate health care for children and adults with special needs…  We are a treatment-oriented society. We wait for people to get sick and then we spend top dollar to make them healthy again. We need to bridge the cultural divide … from a treatment society to a prevention society. “

This presentation will equip the dental team to understand behavior as communication and develop prevention strategies to allow improved oral health outcomes.   Using the concept of incremental desensitization with prevention the dental outreach team creates a bridge to community caregivers and reduces the fear reaction of special needs patients before they are in the operatory.

Participants will learn:

1. The different types of developmental disabilities and their implications to oral health
2. How to assess behavior and medical complexity for referral for hospital based care. 
3. How to improve oral health outcomes for patients with special needs through treatment planning.
4. To schedule complex patients with behavior for productive appointments.
5. To utilize the  existing community based care system to support dental objectives for oral health
6. How the entire dental team can be utilized and make everyone more comfortable in treating patients with developmental disabilities.

Intended audience:  General Dentists, Hygienists, Dental Assistants, Front Office staff

David Fray DDS, MBA is Chief of the Hawaii Department of Health Developmental Disabilities and Community Dentistry Division. He was in private dental practice for 17 years and is active as an educator, public health administrator and serves as a dentist in federally qualified health centers.   He is a graduate of the University of Texas’ Health Science Center School of Dentistry at Houston.