Integrating Oral Health for People with Disabilities

The American Public Health Association adopted 11 new policy statements at their annual meeting last week.

The policy statements covered topics ranging from increasing the minimum wage, to reducing exposure to harmful chemicals, to promoting transgender and gender diverse health—and promoting oral health prevention and treatment for people living with intellectual and developmental disabilities. The full policy statement will be available online in early 2017—a brief description of the statement is below:

20161 Oral health and developmental disabilities — Noting the people living with intellectual and developmental disabilities typically experience poorer oral health outcomes than people without such disabilities, calls for the integration of oral health promotion, prevention and treatment within medical care for such populations.

  • Encourages the U.S. Department of Health and Human Services to develop an integrated public health plan to address social barriers to care and promote oral health among people with intellectual and developmental disabilities.

  • Urges HHS to designate people with such disabilities living in community settings as medically and orally underserved populations.

  • Calls on the Centers for Medicare and Medicaid Services to require state Medicaid funding to cover dental services for adults living with such disabilities, and on the U.S. Health Resources and Services Administration to increase access to federally qualified health clinics and other interdisciplinary health services for people with intellectual and developmental disabilities.

This, of course, is great news, and reading about it reminded me of the Special Olympics Healthy Athletes Program and their Special Smiles screenings.

Officially launched in 1997, Healthy Athletes organizes screenings for Special Olympics athletes, educates the participants about healthy lifestyle choices and identifies problems that may need additional follow-up. Dr. Matthew Holder and Dr. Allen Wong,  among other things (read their bio’s below), have championed this program. Below is an interview that I conducted with them last year before the UCSF Developmental Disabilities Conference:

Dr. Holder, how did you first get involved with Special Olympics?

My first experience with Special Olympics was when I met the current Chairman of the Board, Tim Shriver in Washington, DC about 12 years ago.  At the time, I was not in the field of Developmental Medicine, but I was looking to make an impact on the health of people with intellectual and developmental disabilities. 

A small group of us had just formed the American Academy of Developmental Medicine and Dentistry, a professional organization of physicians and dentists that focus on improving the quality of healthcare for people with intellectual and developmental disabilities (IDD).  When we met with Tim and some of the leadership at Special Olympics, we instantly bonded over the possibilities of what could be done to improve the lives of people with IDD through better attention to their health.  At that time, I was undecided about my career path. 

I was just testing the waters in this field, but the enthusiasm that the people at Special Olympics had really made me feel like I could make a difference.  For the next two years, I worked on a couple of health-related projects with Special Olympics and in 2005, right before their World Winter Games in Nagano, Japan, they asked me to be their Global Medical Advisor.  That event was my first World Games experience, and it was amazing.  The Summer Games in Los Angeles will be my 6th World Games and I can’t wait.

Dr. Wong, many people (including me!) are afraid of going to the dentist. During screenings, how do you deal with people like me?

Dental fear is very common.  If you ever had a bad experience as a child, it will tend to follow you through adulthood.  I don’t think anyone likes the idea of having sharp things in their mouths and picking at teeth or poking at gums. At screenings or  appointments, it’s important  to convey your thoughts of fear so that the dentist is aware.

During Special Smiles screenings, we give the patient a “tour” or “show and tell” of the dental chair/ equipment. We show  teeth models and offer giving the patient a mirror to watch.  Most of all, we give the control to the patient when they need to rest.

We also desensitize the patient with more visual inspection rather  than with sharp instruments and focus on developing trust and understanding of what is present in the oral area. We help the patient overcome fear through a team approach where the patient is the focus.  For some patients, having someone else brush their teeth can be painful if not careful or done gently.

Dr. Holder, how receptive are athletes to health screenings?

The athletes love the screenings!  It’s not like going to the typical doctor’s office.  There are no lab coats, no needles, and no boring waiting rooms.  All of the medical volunteers are happy and excited to be there and the programs were designed for people with intellectual disabilities.  They athletes are the star of the show and I think they feel it when they come to Healthy Athletes.

Dr. Wong, are clinicians prepared to treat athletes during the screenings?

We identify, we give oral hygiene and nutritional information and at some venues, we offer fluoride varnish to those at high cavity risk and athletic mouth guards for those who desire and involved with contact sports. At the healthy athlete special smiles screenings we do not “treat” active disease. But there are many stories of patients having dental abscesses and infection that have been suffering in silence.  At one screening, a dentist and coach were concerned about a growth in Dustin Plunkit’s jaw. Dustin, one of our Special Olympic Global Scholars, was referred to a caring orals surgeon for follow up, who removed the growth that ended up being cancerous.

Dustin is now cancer free.

mattholderMatthew Holder, MD, MBA, in addition to his work as Global Medical Advisor for the Special Olympics, is CEO of Lee Specialty Clinic, which was  featured in the New York Times. Dr. Holder is past President of the American Academy of Developmental Medicine and Dentistry,Vice-President, Council on Developmental Disabilities and immediate Past President, Special Olympics Kentucky.

allenddsAllen Wong, DDS, FAAHD, DABSCD, in addition to his work with the Special Olympics, is a Professor at the University of the Pacific-Arthur A. Dugoni School of Dentistry. He’s the Director of Hospital Dentistry Program for General Dentistry, the Director of Hospital Dentistry Program and Director of AEGD Program Pacific Dugoni School of Dentistry in San Francisco.

The Special Hope Foundation is a proud supporter of the AADMD. 

2017-06-20T16:47:44+00:00 November 7th, 2016|Blog|

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