Dental Schools to Train Clinicians in Treating Patients with Disabilities

Dentistry Today
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The Health Resources and Services Administration (HRSA) has awarded grants to the New York University (NYU) College of Dentistry and the University of Washington (UW) School of Dentistry to fund programs that will teach dental students and others how to care for patients with special needs, improving their access to care.

NYU College of Dentistry

The New York University College of Dentistry Department of Pediatric Dentistry received a nearly $2 million grant to fund its Bridging the Gap program, which trains dentists and other health professionals in providing oral healthcare to people with disabilities and complex medical conditions. This is the fourth HRSA grant awarded to the Department of Pediatric Dentistry since 2015.

Bridging the Gap will integrate this training into NYU’s existing Advanced Education Program in Pediatric Dentistry. It will create new training programs and curricula for educating general dentists and dental hygienists in caring for patients with disabilities. It will be led by Courtney H. Chinn, DDS, MPH, clinical associate professor and associate chair of pediatric dentistry at NYU Dentistry.

“People with disabilities and complex medical conditions face too many barriers in accessing oral health services, including finding a dentist with the skills and capabilities to manage their care. We are working to build a competent and compassionate dental workforce to care for people with these unique needs, ensuring that dentists have the skills for, and commitment to, caring for vulnerable populations,” said Chinn.

While some dental programs may focus on people with disabilities, NYU Dentistry said, special needs dentistry isn’t formally recognized as an accredited specialty. Many general dentists lack the skills, experience, or capacity to care for people with disabilities, the school said.

Given their training, pediatric dentists historically have been the primary dental professionals to serve people with disabilities, NYU Dentistry said, but there aren’t enough pediatric dentists, and they often are unable to continue caring for these patients after they reach adulthood.

Also, some people with disabilities and medical conditions have poor oral health due to difficulties in brushing their teeth or the medications they take, NYU Dentistry said. Patients often must forego preventive care in a dental office and are only seen in hospital operating rooms or under sedation, the school added, and only when a dental emergency occurs.

NYU Dentistry, then, opened its Oral Health Center for People with Disabilities in 2019 to provide much needed care for people whose disabilities or medical conditions prevent them from receiving care in a conventional dental setting. It features specialized equipment, sedation suites, a multisensory room, and unique training opportunities, the school said.

Bridging the Gap will train pediatric dental postgraduate students to care for people with disabilities including developing and implementing a new curriculum and enhancing their clinical experiences through rotations at the NYU Dentistry Oral Health Center for People with Disabilities and NYU’s school-based dental care program in New York City schools.

The program also will train other health professionals. NYU Dentistry will create a one-year program for dentists and dental hygienists caring for children, adolescents, and adults with disabilities. It will partner with the NYU Rory Meyers College of Nursing to pilot a teledentistry program where nurse practitioner students doing clinical rotations in New York City schools and other community settings will connect people with disabilities to NYU Dentistry for virtual treatment planning and referrals.

Throughout the program, Chinn and his team will evaluate its success through pre-surveys and post-surveys of trainees to measure their confidence in treating people with disabilities and intent to treat vulnerable populations.

The five-year grant begins July 1, 2020, with the training programs launching in September 2011. Each year, 16 pediatric dental postdoctoral students and up to three general dentists and/or dental hygienists are expected to participate in the program, along with many additional interprofessional students.

UW School of Dentistry

The UW Department of Pediatric Dentistry received a $2.25 million HRSA grant for a training program designed to significantly broaden access to dental care for Washington children with special healthcare needs.

Dr. Travis Nelson, acting chair of the department, will lead the five-year grant, which will fund the creation of an Interdisciplinary Special Needs Access Network (I-SPAN). The program will provide enhanced training for pediatric dental residents in caring for children with special healthcare needs and other underserved populations.

Also, the program will develop a postgraduate interdisciplinary training center drawing on the expertise of dental and medical providers at Seattle Children’s Hospital and the UW’s Leadership Education in Neurodevelopmental and Related Disabilities (LEND) clinic.

Other partners include the School of Dentistry’s DECOD special-needs dental clinic and training program, residents in the state’s Advanced Education General Dentistry program, and other UW dental specialty programs

Plus, the program will use telehealth technology to allow remote dental screenings and wider access to specialized care for children in rural and underserved areas.

Faculty and residents involved in I-SPAN also will provide training in the care of targeted children to dentists in the state’s Access to Baby and Child Dentistry (ABCD) network. ABCD was launched in the 1990s to improve low-income children’s access to dental care. In the past 20 years, it has produced dramatic oral health improvements for Washington children, UW said.

“The prevalence of children with developmental and/or intellectual disability, ADHD, and autism has increased significantly over the last decade,” Nelson wrote in his grant proposal.

“Today, roughly one in six children has special healthcare needs. Dental care for children in poverty, especially in rural areas, is routinely reported as the greatest unmet healthcare need in this population, with an estimated 10% to 20% of children with special needs unable to obtain this care,” Nelson wrote.

Nelson indicated that the problem is aggravated by the lower numbers of dentists, especially specialists, in rural areas and the fact that rural residents are less likely to have dental insurance. He noted that children with special healthcare needs are also more likely to have problems such as teeth grinding, overgrown gum tissue, developmental tooth defects, and jaw disorders.

“We are absolutely thrilled to have received this funding. It will support training to better equip dental providers to care for these incredibly deserving patients. We will see immediate local effects in enhanced training for UW residents,” Nelson said.

“As the network develops, access to care will improve throughout our state as existing providers receive training, through teledentistry, and when residents graduate and take the skills into practice,” Nelson said.

Planning and organization is expected to take up the first year of the grant, with implementation to follow in years two through five.

Through its Center for Pediatric Dentistry clinic in Seattle’s Sand Point neighborhood, the Department of Pediatric Dentistry already has won recognition for its extensive care for children with special needs. This includes a clinic for children with autism, which Nelson established in 2012 and has since had exceptional success in providing dental care, UW said.

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