What if we stopped expecting people with disabilities to adapt to dental care, and instead designed dental care to meet their needs?
Securing a dental appointment for people with disabilities does not guarantee inclusive care.
A recent community oral health survey revealed this unfair reality: Even when patients with disabilities
manage to get into a dental clinic, the environment is rarely customized to their needs.
I am a dentist who has dedicated my career to serving people with disabilities. Not surprisingly, my patients’ needs are diverse. Some need a weighted blanket to feel less anxious in the dental chair. Others need to remain in a wheelchair during their visits. Others only feel comfortable when we dim the overhead lights, muffle the sound of our instruments, or allow their caregiver to sit nearby. We’re happy to provide these accommodations, but in the past, our patients have not been afforded this level of care.
I’ve been hearing these stories for decades, and it’s beyond time for a change. I want dentists to stop asking patients to adapt to their offices. Instead, I want them to ask, How can we adapt our offices to meet patients’ diverse needs?
This question has guided my career, and it was the driving force behind the creation of NYU Dentistry’s Oral Health Center for People with Disabilities (OHCPD), the center I direct. At the NYU Dentistry OHCPD, accessibility rules. The environment is designed to put patients at ease, with oversized exam rooms that provide plenty of space for caregivers. There are reclining platforms that allow people to receive dental care without leaving their wheelchairs. A multisensory room with soothing music, adjustable lighting, and calming images on the walls helps reduce patient anxiety prior to treatment. A bariatric dental chair is available for those who need it. Most importantly, the entire center team — staff as well as providers — is trained to ensure that people with disabilities and complex medical conditions know we don’t just care about their dental health; we also care about them as people.
What We’ve Learned
We recently participated in a survey of The Viscardi Center’s community to learn about their dental care experiences. Patients, families, and caregivers identified common barriers to accessing care: physical and sensory challenges, long waits for appointments, and poorly trained staff. But the survey also revealed some less predictable findings:
- The Viscardi Center community values dental care.
Even though half of the survey participants said it was somewhat or very difficult to get care, two-thirds of them receive regular dental check-ups, and they are willing to travel for care that meets their needs.
- Healthcare providers remain the primary source of dental information and support for the community.
Health professionals — not Google, social media, or AI — were the most trusted source by far. Three quarters of patients and their caregivers turn to dentists, doctors, and therapists for advice, with friends and family a distant second.
- The desire for special care dentistry is even greater than we realized.
The NYU Dentistry OHCPD has served thousands of patients since opening our doors in 2019, yet most survey respondents had never heard of us. Perhaps we shouldn’t be surprised. Despite dissatisfaction with their current care, many patients are so conditioned to adapting to conventional dentistry that they don’t even know to look for dentists who are willing to accommodate their needs.
Dr. Rita Bilello, Clinical Director, NYU Dentistry Oral Health Center for People with Disabilities (OHCPD). Photo credit: NYU Dentistry.
A Roadmap for Change
The survey findings prompted us to reconsider what we mean by access. Accessible spaces, providers who understand patients’ diverse needs, an environment that allows people with disabilities to receive care with dignity — these are essential to the access equation, but they are not enough. If patients cannot find us or other dental care that works for them, access remains out of reach.
The findings also give us a roadmap for increasing access to special care dentistry. The people we serve have told us what they want and what stands in their way. Now the profession has to decide whether those barriers are problems patients must overcome, or problems we are willing to address by redesigning care.
We’re proud of the environment we’ve created at the NYU Dentistry OHCPD, but one dental office won’t change the care paradigm for people with disabilities. That requires another critical facet of our center’s mission: preparing the next generation of dentists to provide care that accommodates all the needs of people with disabilities. Then we can finally stop asking patients to adapt to dentistry’s limitations, and instead, provide truly accessible care.
This October, during National Dental Hygiene Month, guest contributor Dr. Rita Bilello, Clinical Director of the NYU Dentistry Oral Health Center for People with Disabilities, breaks down the frustrating disconnect between dental care and accessibility. Drawing on her years of clinical experience, she explains what patients and families want—and how clinics like hers are actively training the next generation of dentists to provide it.
Opinions expressed are solely those of the writer(s) and do not necessarily reflect the opinions of Able News at The Viscardi Center and/or The Viscardi Center.