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Patients with disabilities to receive improved access to dental care

The ADA’s revised code of professional conduct will now grant equal access to oral health services to patients with special needs. (Photograph: r.classen/Shutterstock)

Wed. 6. March 2019


Chicago, U.S.: The American Dental Association (ADA) has recently revised its Principles of Ethics and Code of Professional Conduct to improve access to dental care services for patients with physical, developmental or intellectual disabilities. A second change is that other medically compromised patients, including those infected with bloodborne pathogens, should also be treated or referred to specialists or consulting dentists.

People with developmental disabilities will now gain access to dental care more easily after the ADA, the nation’s largest dental association, revised its Principles of Ethics policy to be more inclusive. In effect since late last year, the updated code of ethics now requires dentists to attend to medically compromised patients. In the event that a dentist is not appropriately equipped or lacks the expertise to meet the patient’s needs, the patient has to be directed to the appropriate dentist to receive proper care.

“We recognized that addressing this and including this in the code of conduct helps to ensure that we are providing justice and equity for individuals with disabilities,” said Dr. James Smith, the Chairman of the ADA Council on Ethics, Bylaws and Judicial Affairs.

Owing to the lack of access to dental care, advocates say adults with developmental disabilities are at greater risk of poor oral health. The change, recommended by the National Council on Disability, “represents a step towards full participation, independent living and economic self-sufficiency,” said council chairman Neil Romano.

“Sometimes it’s difficult to have a patient in the chair if they are very, very anxious about being treated, if they have difficulty sitting still or if they feel a lot of fear, and sometimes those circumstances are more prevalent in people with varying disabilities,” said Jane Koppelman, senior manager of the dental access campaign at the Pew Charitable Trusts. Since patients with special needs may also require additional treatment time, they are more likely to receive general anesthesia for routine dental care, Koppelman added. As an alternative, Koppelman recommended using silver diamine fluoride, which has been reported useful as a preventive tool for patients with intellectual or developmental disabilities by the American Academy of Pediatrics.

To better accommodate patients with special needs such as autism, Donna Murray, Vice President of Clinical Programs at Autism Speaks, suggests showing the patient pictures of the dental office and discussing the schedule for the appointment to prepare the patient for what is going to happen. “It’s important to work with health care professionals experienced with children on the spectrum to make the process as comfortable as possible,” she said.

The ADA’s revised Principles of Ethics and Code of Professional Conduct can be found at:

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