FISA Foundation

Current Initiatives

Initiatives

Increasing Access to Healthcare for People with Disabilities

Access to Dental Care for People with Disabiliities

Girls Coalition of Southwestern Pennsylvania

Regional Initiative to End Domestic and Sexual Violence

Access to Dental Care for People with Disabilities

What are the links between Health Care and Dental Care?

It is well documented that lack of adequate dental care directly affects overall health and can increase health care costs. For example, a recent study coordinated by the University of Connecticut with help from associates from London, England was published in the New England Journal of Medicine (Tonetti, M. March 1, 2007) demonstrated a direct link between gum disease and risks associated with heart disease. For people with disabilities, these risks are magnified due to complex health histories or congenital anomalies associated with certain disabilities such as Down Syndrome or Cerebral Palsy.

Some disabilities have little impact on a person’s ability to get dental care, but certain limitations (such as cerebral palsy or having a significant intellectual disability) can complicate even basic preventive dental care. Dr. Steven Perlman, Global Clinical Director for the Special Olympics/Special Smiles Program emphasizes that “Dental care now represents the number one health issue among people with neurodevelopmental disorders.”

What prevents people with disabilities from receiving quality dental care?

• People with certain physical disabilities may not be able to sit in a dental chair or hold their mouths open wide enough for exams.
• Those with significant cognitive impairments may experience anxiety or may be unable to tolerate the discomfort of a dental exam. Dentists often are not licensed to provide sedation required by these patients.
• Children with severe disabilities often have so many complex medical needs that basic oral hygiene, such as brushing and flossing, can easily be neglected.
• People with limited verbal communication skills may have difficulty letting caregivers know when they have dental pain. Inability to communicate can result in frustration and agitation. It can take families a long time to understand that these “symptoms” may stem from a toothache rather than a behavioral problem.
• Many barriers to dental care relate to challenges faced by dentists:
  • In recent years, a shortage of dental faculty has resulted in a decrease in the number of students whom dental schools are able to accept. This is causing a national shortage of dentists, especially in rural areas.
  • Few dental schools provide adequate training or incentives for students to treat individuals with severe disabilities or complex medical needs.
  • There is a lack of continuing education courses available for practicing dentists to learn how to serve this population.
  • The majority of people with disabilities have health benefits through Medicaid. However, few dentists in Pennsylvania accept this type of coverage due to its lower reimbursement rates. This is especially true for recent dental school graduates who have student loans and need to make a significant investment to set up their first offices. These factors can make it challenging to locate a willing provider within reasonable driving distance.

What is FISA Foundation doing to increase access to dental care for people with disabilities in southwestern Pennsylvania?

• Through a grant to Achieva, FISA Foundation supported the establishment of a regional Disability Health Policy Forum that is addressing dental care for people with disabilities as its first issue. The project’s goal is to raise awareness and develop recommendations about these issues for policy makers, insurance providers, legislators, and the medical community. The Forum has an advisory committee comprised of experts from across the state. Download a copy of the project’s white paper: Access to Oral Health Care for Pennsylvanians with Disabilities: A Rising Public Health Issue
• FISA also supported curriculum development and expansion of the Center for People with Special Needs at the University of Pittsburgh School of Dental Medicine. The new Center offers diagnostic and preventative services as well as restorative dentistry five days per week. Six multi-specialty treatment rooms are available including two private treatment areas equipped for general anesthesia. A new didactic and clinical curriculum will expand training under the supervision of faculty experts in the fields of general, pediatric and geriatric dentistry combined with additional specialties in periodontics, endodontics oral and maxillofacial surgery, and anesthesia.
• A grant to Children’s Hospital, UCLID Center, supported the design of a web-based curriculum to train (non-dental) health and educational professionals about the early signs of oral health problems in children and adults with disabilities. www.oralhealthtutorial.org
• FISA is helping Western Pennsylvania Donated Dentistry, a chapter of the National Foundation of Dentistry for the Handicapped, to recruit dentists who are willing to accept one patient who is disabled each year at no cost.
• FISA Foundation is willing to provide resources to nonprofit dental clinics in southwestern Pennsylvania who would like to be able to serve people with disabilities.