People with developmental disabilities may find it easier to get dental care after a national board changed its ethics policy to be more inclusive.

The American Dental Association recently revised its code of conduct to prohibit denial of care to patients with physical, developmental or intellectual disabilities. In cases where a dentist does not have the equipment or expertise to meet a particular person’s special needs, the code now requires them to refer the patient to an appropriate dentist rather than simply turning them away.

Dr. James Smith, who leads the ethics council of the dental association, called the change which took effect late last year “the right thing to do.”

“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,” Smith said.

Members of the dental association are required to abide by the code of conduct, which also serves as the standard for state laws, Smith added.

Because of a lack of access to dental care, advocates say adults with developmental disabilities are at higher risk for poor oral health. In Wisconsin alone, nearly one-third of adults with disabilities had a tooth removed in the last year and one in four had not visited a dentist in at least 12 months, according to Disability Rights Wisconsin.

The change should improve access to care and “represents a step towards full participation, independent living and economic self-sufficiency,” said Neil Romano, chairman of the National Council on Disability, in a statement. The council had recommended the change to the dental association.

Dental providers have expressed concern about the additional time it may require to treat people with intellectual and developmental disabilities, experts said.

“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 for the Pew Charitable Trusts.

Patients with special needs are then more likely to receive general anesthesia for routine dental care, Koppelman said.

“Is it a sober reality that we need to anesthetize some people with disabilities or are there better ways to deal with communicating with them? There are some strides happening on that front,” she said.

One option to bring up with dental providers is silver diamine fluoride, a varnish for the teeth that can prevent cavities, Koppelman said.

The American Academy of Pediatrics has reported that silver diamine fluoride is useful as a preventive tool for patients whose cooperation may be limited because of intellectual or developmental disabilities.

While few dental practices specialize in treating people with developmental disabilities, most dental offices can make accommodations for patients with special needs, advocates said.

The lights, sounds, textures and smells of a dental office can pose sensory challenges. A patient with autism, for example, may be helped by seeing pictures of the dental office and going over the schedule for the appointment to know what to expect, said Donna Murray, vice president of clinical programs at Autism Speaks.

“It’s important to work with health care professionals experienced with children on the spectrum to make the process as comfortable as possible,” Murray said.

The autism advocacy group supports the dental association’s move toward equal access for people with disabilities, Murray said. The group also offers a dental toolkit.

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