Dental Education Moving Forward
By Allen Wong, DDS, EdD, Helen Journal Publisher
Access to dental care for those with special healthcare needs has many challenges. One of those challenges is dental graduate’s comfort level in assessing and treating patients with special healthcare needs. Recently, through the advocacy efforts from AADMD and National Council on Disability (NCD), the American Dental Association (ADA) Code of Ethics was updated to include those with disabilities cannot be discriminated. As a result, the ADA Commission on Dental Accreditation (CODA) updated their accreditation standard (Standard 2-25) that all dental graduates MUST be competent in assessing and managing patients with disabilities. Dental schools are accredited on by CODA every seven years and accreditation is critical for existence. Not all dental schools have developed resources, rotations or experiences to meet the needs yet but all are trying.
In an attempt to help remedy the situation, AADMD has offered to produce a National Inclusive Curriculum for Health Education (NICHE) Oral Health for those with intellectual/developmental disabilities. A grant from Delta Dental Foundation was obtained for the project. The NICHE Oral Health project is a collaborative care curriculum project with over 18 dental schools and over 80 authors that is meant to be shared with all dental education. The NICHE curriculum can be used in parts or the whole and will be online. The three dental schools who are championing the project is University of Texas Health Science Houston, Penn Dental, and Pacific Dugoni. The first phase of gathering information from our many authors is mostly done and edited. We are in the process of the chapters being designed for easy use as handouts and powerpoints as needed.
We hope to roll out the first part of the project this fall.
Recently in New Orleans, the American Dental Education Association (ADEA) had their annual meeting. ADEA is known as the “The Voice of Dental Education”.
ADEA is the sole national organization representing academic dentistry. Membership includes all 80 U.S. and Canadian dental schools, more than 800 allied and advanced dental education programs, more than 55 corporations and approximately 15,000 individuals.
We commend the ADEA leadership and the adoption of ADEA Resolution SH-2023.
Resolution SH-2023
ADEA Policy on Oral Health Providers' Education and Care for People with Intellectual and Developmental Disorders and Special Health Care Needs
Background: There are 61 million Americans who live with a disability. Two in five adults aged 65 and older and one in four women are living with a disability.1 Seven million of these disabilities are people with intellectual and developmental disabilities (IDD). People with IDD face multiple oral health and systemic conditions. Although oral health care is essential to maintaining overall health and well-being, maintaining access to oral health care is one of the more significant problems faced by this underserved population. Early diagnosis is crucial to prevent disease progression and manage the conditions and behavior. Access to care is a problem for many Americans, where one in three adults with disabilities (aged 18 to 44 years) does not have a regular health care provider.(Ref 2) The lack of access is more pronounced with People with IDD, such as Down syndrome, Fragile X syndrome, autism spectrum disorder, fetal alcohol syndrome, and other conditions. People with IDD experience a lack of care due to a shortage of adequately trained dental care providers who are willing to provide that care.(Ref 2) While many people with IDD can access developmental pediatricians when they are children, it can be challenging to find trained providers when they transition to adulthood. The ADA Principles of Ethics and Code of Professional Conduct indicate that " ... dentists shall not refuse to accept patients into their practice or deny service to patients because of the patient's ...disability".(Ref 3) This statement elevates the provision of treatment for individuals with IDD to being a professional obligation for dentists. In a survey of training of health care professionals, more than 50% of medical and dental school deans report that graduates of their programs are "not competent" to treat people with IDD.(Ref 4,5)
The purpose of this resolution is to acknowledge and support the importance of education and care for persons with IDD. This policy will demonstrate that ADEA recognizes the importance of enhancing the quality and capacity of oral health professionals to provide access to care for persons with IDD through education, practice, and reimbursement training programs for more significant oral health equity.
References
1. National Disability Navigator Resource Collaborative. Population-specific fact sheet-intellectual disability, 2014. At https://nationaldisabilitynavigator.org/ndnrc-materials/fact-sheets/population-specific-fact-sheet-intellectual-disability/. Accessed: Dec. 17, 2021.
2. Centers for Disease Control and Prevention. Disability impacts all of us, 2019. At: https://www.cdc.gov/ncbddd/disabilityandhealth/documents/disabilities impacts all_of_us. pg£. Accessed: Dec. 17, 2021.
3. American Dental Association. ADA Principles of Ethics and Code of Professional Conduct. At: https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/about/ada code of_ethics.pdf?rev=86aeaa6fb0d0467f8a380a3de35e8301&hash=89BAA88FB9305B8F134414E337CAE55A. Accessed: Nov. 15, 2022.
4. National Council on Disability, 2017. At: https://ncd.gov/publications/2017/dental-issue-brief. Accessed: Oct. 15, 2022.
5. Corbin S, Holder M, Engstrom K. Changing Attitudes, Changing the World: The Health and Health Care of People with Intellectual Disabilities. Washington, DC: Special Olympics International, 2005.
The ADEA Board of Directors asks the House to approve the following resolution establishing an ADEA Policy on Oral Health Providers' Education and Care for People With Intellectual and Developmental Disabilities and Special Health Care Needs.