Disparities in dental care faced by people with intellectual and developmental disabilities | Touro College of Dentistry


Raquel Rozdolski, DMD, Director of Anesthesia and Pain Control, and Susan DiSenso-Brown, DDS, Director of Special Needs

There is a gap in access to appropriate dental care for people with intellectual and developmental disabilities (IDD). Many general dentists are not trained to properly handle situations that may arise when treating the population, while caregivers of people with IDD are constantly on the lookout for providers equipped to address disparities.

Drs. Raquel Rozdolski, DMD, Director of Anesthesia and Pain Control at Touro College of Dental Medicine (TCDM), and Susan DiSenso-Browne, DDS, Director of Special Needs at TCDM, are working to educate professionals of oral health to fill these gaps and the subject. Both Program Directors for the New NYSADC Fellowship’s TCDM Program to Address Oral Health Disparities, the two also led a 2020 project called, United smiles; an innovative support model to provide people with intellectual and developmental disabilities with access to quality dental care by connecting them virtually with oral care providers.

Here they share their perspective on the gaps in care in the IDD community and why it is so important that dental professionals receive training to treat this population.

Q: What qualifies someone with special needs?​

A: Dr. Raquel Rozdolski: The term “special needs” is broad, including physical, cognitive, developmental, and/or medical conditions that require unique individualized care considerations. This includes people with intellectual and developmental disabilities (IDD), who make up approximately 17% of the US population. According to the American Dental Association, this can include people with autism, Alzheimer’s disease, Down syndrome, spinal cord injuries and countless other conditions or injuries that can make procedures more difficult. standard dental.

Q: What are some of the challenges people with special needs face when seeking dental care?

A: Dr. Susan DiSenso-Browne: The challenges are unique for each person, but more specifically, people with IDD face a huge challenge in accessing care. Whether it is a lack of provider training, inadequate facilities and services, transportation barriers, or a lack of oral health education from caregivers, Many people with DID go months or even years without proper dental care.

Q: Are people with special needs more susceptible to oral health problems?

A: Dr. Susan DiSenso-Browne: In general, people with compromising medical conditions and related disabilities are often more susceptible to oral disease. This increased susceptibility may be related to a systemic disease or genetic condition, as a result of dexterity issues affecting home care, lack of caregiver education on the importance of oral health; or related to the aforementioned access to care issues, to name a few.

Q: Why Proper Training in Specialty Dentistry is Important, From a Provider Perspective?

A: Dr. Susan DiSenso-Browne: Training in special care dentistry provides a provider’s experience, skill, and confidence in assessing and managing appropriate care for an individual’s needs, thereby improving the dentist’s communication and clinical skills, while helping to close the gap in access to care. The provider expands their scope of practice and also better understands when and how to refer. Improved training also expands an individual’s referral base and, by extension, care options.

Q: Are there oral health educational resources for caregivers?

A: Dr. Raquel Rozdolski: Yes! The COVID-19 pandemic has had a significant impact on people with IDD, unfortunately worsening the already existing gap in their access to appropriate medical and dental care. Seeing this disparity and determined to close the gap, Touro College of Dental Medicine (TCDM) received a grant from the New York State Developmental Disabilities Planning Council to develop Smiles United project, as mentioned above.

There are many other avenues in which dental providers can engage directly with caregivers, especially with regards to caregivers who work in group homes. More resources are needed to bridge the gap between a patient’s daily oral care regimen and their annual or semi-annual visits to dental providers.


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