Dental school students will soon be required to learn how to care for patients with disabilities under new guidelines from an accrediting body.

The Commission on Dental Accreditation approved new standards this summer requiring all U.S. dental schools to train students in the assessment and management of patients with intellectual and developmental disabilities, among other special needs populations.

The change means that by mid-2020, schools that offer degrees in dentistry, orthodontics, dental hygiene and dental assistant programs must include clinical training with a “special needs” population of patients in their graduation requirements or risk losing their accreditation.

The National Council on Disability helped push for the change in standards after publishing a report in 2017 showing that adults with developmental disabilities are at higher risk for poor oral health and face multiple barriers to accessing care, including a shortage of appropriately trained professionals.

The change in dental education standards is a “huge breakthrough” after 20 years of work from dental professionals and disability advocates, said Amged Soliman, attorney advisor with the council.

“People with disabilities, specifically intellectual and developmental disabilities, can’t get dental care because dentists aren’t trained to treat them,” Soliman said. “It’s not fair they simply can’t get dental care because nobody knows how to do it.”

The practice of dentistry is no different for patients with autism, Down syndrome or other developmental disabilities, but the interactions might be, said Dr. Rita Marie Bilello, dental director of Metro Community Health Centers in New York City and a professor of dentistry at New York University.

The lights, sounds, textures and smells of a dental office can pose sensory challenges. Dental providers have to be willing to break protocol and allow a patient with autism to wear headphones, or decline the use of water picks, for example, she said.

Because there may be trust or anxiety issues, “you have to take the time to develop a relationship,” Bilello said.

Historically, only students who completed residency programs in hospitals or who specialized in pediatric dentistry received any clinical training with patients with developmental disabilities, Bilello said.

That means people with disabilities are regularly turned away or sent to hospitals for dental care, where they may be treated under unnecessary sedation.

The move from the accrediting body follows the American Dental Association’s revision of its code of conduct in 2018 to prohibit denial of care to patients with physical, developmental or intellectual disabilities and to refer patients to another dentist with appropriate equipment or expertise if necessary.

With the changes to dental training standards and the code of conduct, dental professionals will be better prepared to serve all of their patients, Bilello indicated.

“If even a percentage of the graduating providers realize ‘I’m capable of doing this,’ it’s going to do wonders at chopping down the disparity,” Bilello said. “If you give somebody the opportunity to really learn and to be exposed, it makes you a better dentist. You have increased confidence not only in yourself, you have the ability to empathize in a way that translates to any patient you’re ever going to treat.”

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