Serving Patients With IDDs

Individuals with disabilities face challenges in many aspects of their daily lives, and accessing care to maintain their overall health and oral health is no exception. For individuals with intellectual and developmental disabilities (IDDs), which include Down syndrome, autism spectrum disorder, and other conditions, these challenges can be particularly significant.

In dentistry, the obligation to treat patients with IDDs has been codified in the American Dental Association's Principles of Ethics and Code of Professional Conduct and in requirements established by the Commission on Dental Accreditation. However, as these patients transition from pediatric to adult dentistry, in some locations, many of their caregivers are still experiencing difficulty finding dental practices that are equipped to treat them. Our February cover story reveals that this is a highly complex issue and explores some of the main driving factors, including a lack of appropriate training among dentists and their teams, insufficient reimbursement, and more. It also discusses treatment modifications and highlights some of the work being done by universities and organizations to improve education and raise awareness.

Certainly, eliminating any social stigma or fear associated with caring for individuals with IDDs is essential to increasing access to dentistry for this underserved population, but I believe that most dentists are compassionate caregivers who are willing to treat these patients-the issues are training and reimbursement. Dental school programs need to continue to improve their educational offerings at all levels regarding treating patients with IDDs. At the University of Iowa College of Dentistry, we offer a 1-year postgraduate program for a certificate in Geriatric and Special Needs Dentistry. Regarding reimbursement, although organizations are advocating for increased insurance and Medicaid payments for treating patients with IDDs, progress is slow. However, as the article notes, for dentists who seek out the training, treating patients with IDDs can not only provide an opportunity to improve oral healthcare for an underserved population but also provide an opportunity to boost profits by acquiring their family members as patients.

Robert C. Margeas, DDS
Editor-in-Chief, Inside Dentistry
Private Practice, Des Moines, Iowa
Adjunct Professor
Department of Operative Dentistry
University of Iowa, Iowa City, Iowa
rmargeas_eic@aegiscomm.com