As recommended by the National Council on Disability (NCD), all dental schools in the United States now must revamp their curricula and training programs to include patients with intellectual and developmental disabilities (ID/DD).
The Council on Dental Accreditation (CODA) recently voted to require dental schools to now train their students in managing treatment of patients with ID/DD. Previously, patients with ID/DD were largely unable to obtain dental care because dental students were simply not required to learn to manage their treatment.
“Every dental patient in America deserves the same care, whether or not they have a disability,” said NCD chairman Neil Romano. “NCD applauds this decision that we view as necessary for people with ID/DD to obtain critical access to dental treatment, which is critical to the total health of all people.”
CODA held and passed four related votes regarding the predoctoral dental, orthodontics, dental hygiene, and dental assistant programs.
For predoctoral programs and orthodontics programs, dental students must be trained to assess and manage the treatment of patients with special needs. For dental hygiene programs, students must be competent in providing care to special needs patient populations.
For dental assistant programs, students must be familiarized with patients with special needs, including patients whose medical, physical, psychological, or social conditions make it necessary to modify normal dental routines.
CODA generally defines people with special needs as people with developmental disabilities, cognitive impairment, complex medical problems, significant physical limitations, and the vulnerable elderly.
Changes for the predoctoral dental, dental hygiene, and dental assistant programs are required to take effect by July 1, 2020, with changes to the orthodontics programs required by January 1, 2020.
NCD first made recommendations to CODA following its 2017 issue brief, “Neglected for Too Long: Dental Care for Patients with Intellectual and Developmental Disabilities,” which found that adults with developmental disabilities are at risk for multiple health problems including poor oral health.
The report also found that people with ID/DD 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.
NCD reports that more than 50% of dental medical school deans have stated that their graduates are not competent to treat patients with ID/DD. As a result, people with ID/DD are more likely to have poor oral hygiene, periodontal disease, and untreated dental caries than members of the general population.
Also, people with ID/DD are more likely not to have had their teeth cleaned in the past five years or never to have had their teeth cleaned than those who aren’t disabled. And, due to the lack of proper skills among dentists, dental care often is more difficult to find than any other type of service for people with ID/DD.
Last year, NCD worked with the ADA to revise its Code of Professional Conduct to state that “dentists shall not refuse to accept patients into their practice or deny dental service to patients because of the patient’s… disability.” Many states adopted this code revision as state law of professional conduct.