This summer, we recognize several disability awareness days, including the anniversary of the Americans with Disabilities Act (July 26). While major strides have been made to promote awareness, accessibility, and equal opportunity for people with disabilities, there is still more work to be done, especially in the dental field. 

As part of its 2023 strategic plan roadmap, AIDPH plans a renewed focus in this area. We know that oral health is directly linked to overall health, and many people with disabilities suffer physical conditions that exacerbate dental problems.

As dental public health professionals and disability advocates, we must increase awareness about the challenges disabled people often face when trying to access care. One way to do this is to educate dental and healthcare providers about how they can help make care more physically accessible and encourage them to act.

Disabilities can affect dental visits in a variety of ways. 

According to the National Institute for Health (NIH), physical limitations such as the need to use a wheelchair or walker can make visiting the dentist difficult. People with developmental disabilities may require a renewed approach to dental care, as they often struggle with accomplishing daily activities like brushing their teeth. 

Those with disabilities that involve neuromuscular problems may drool, gag, or have trouble swallowing, which can complicate dental procedures where patients must keep their mouth open for extended periods of time. Patients with cerebral palsy may need equipment, like a headrest, to cushion their neck and head during treatment. Those with hearing or vision limitations may struggle to communicate, leading to misunderstandings and misdiagnoses. Other conditions like seizures or cardiac disease (which has a direct link to poor oral health outcomes) must be recognized to provide optimal dental treatment for everyone.

Additionally, disabled patients may have limited financial resources and face other barriers, including these:

1. Medicaid does not cover dental procedures for disabled adults, despite being the largest minority population with unmet oral healthcare needs;
2. Dental insurance plans do not cover specialized equipment or procedures for disabled patients; and 
3. Many disabled patients need caregivers at dental visits, which can make traveling to appointments, and scheduling and receiving care difficult and expensive. 

Sadly, many do not seek routine dental care as a result of these barriers and challenges, and when they do seek dental care, it’s often because of expensive emergencies that could have easily been prevented.

What Healthcare Providers Can Do

According to the National Institute of Health, dentists and healthcare staff should:

1. Communicate with patients and caregivers about how the patient’s abilities can affect treatment. Ask your team, “how can we ensure the experience is successful for everyone involved?”
2. Involve the entire treatment team, from receptionists to the dental assistant, when disabled patients come in for treatment. By keeping everyone informed and engaged about a patient’s needs, their experience at a dental clinic can be much more positive, from the time they enter the clinic to the time they leave.
3. Observe the patient for physical limitations or challenges, such as uncontrolled body movements or conditions that make it difficult to sit in a dental chair. Talk as a team about how to accommodate these conditions.
4. Ask patients about allergies, especially latex, which can be life-threatening.
5. Encourage patients to follow a regular dental care routine, including flossing and brushing twice a day. Some people with disabilities are more prone to oral health issues, so prevention is key.

Finally, ensuring that a dental clinic is wheelchair accessible and easy to navigate for those who are visually or hearing impaired can make a huge difference in patients’ experiences. Offering payment plans or educating those who struggle to pay for care about their options can help ease financial burdens so that cost is not a barrier for necessary treatment. 

We all must work together to ensure that dental clinics are accessible for everyone—physically and financially. When disabled people get the oral healthcare treatment they need, they move closer toward achieving optimal wellbeing, and we all move closer to a system of care that is equitable and just.

Resources:

National Foundation of Dentistry for the Handicapped
Special Care Dentistry Association