From providing education about oral health to calming fears about procedures, dental assistants share a special bond with their patients. Dental assistants are adept at reading body language, getting to know their patients, and communicating effectively — skills that are critical for providing the best experience to everyone who enters the office.
These traits are especially important when treating patients who have physical, psychological, developmental, or intellectual disabilities.
Every patient has unique oral health needs, and dental teams — including assistants — make a point to learn about the challenges patients are facing and accommodate them accordingly. It starts with simply getting to know the patient.
Laura Ruscio, CDA, CPFDA, CRFDA, EMT, has worked at a practice serving patients with disabilities in Reading, Massachusetts, for over a decade. She says preparation is imperative to provide the best experience for patients with disabilities.
“For patients who are new to our office, the steps we take to accommodate them begin before they even visit our office,” she explains. “When a parent or caregiver calls to schedule an appointment for a patient who will be new to our office, we spend a lot of time discussing the patient’s diagnosis so we can obtain enough information to tailor the visit to the individual.”
Maria Cristina Rodriguez, CDA, M.S., says collaborating with her team is another key to smooth appointments for patients with disabilities.
“Usually in the morning huddle, we discuss the different patients and procedures of the day,” explains Rodriguez. “During those meetings, we plan how to handle different situations with patients based on previous appointments.”
According to Ruscio, it’s particularly important for the dental team to learn about the patient’s home-care routines, prior dental visits, and any sensory issues — such as sensitivity to light, loud noises, smells, tastes, and other stimuli. By gathering this information from parents or caregivers, the dental staff can make appropriate accommodations to make for a successful visit.
“It’s important to get to know the family and the patient environment, to try to re-create that sense of security they have at home at the dentist,” says Rodriguez. “It’s important to make the patient feel they’re in a safe space.”
Ultimately, this preparation is about building trust with patients who have disabilities. It doesn’t always happen instantly, and in many cases, takes multiple appointments.
“Although this can be a slow process, with time and patience, each successful visit will help pave the way for more successful ones in the future,” says Ruscio.
Rodriguez agrees that patience is critical.
“The main thing when working with patients with disabilities is to be patient, take your time, and adapt to their needs,” she says.
Overcoming obstacles to better dental health
Historically, people with disabilities have been underserved when it comes to dental care. CareQuest’s State of Oral Health Equity in America 2022 report found that these individuals are less likely to receive preventive or restorative dental care, leaving them at an increased risk of tooth decay, gum disease, and other oral health conditions.
Barriers to dental care for people with disabilities are wide-ranging, according to a 2020 analysis published in the International Journal of Dentistry. The primary barriers include patient anxiety, high cost, lack of accommodations in dental facilities, and a shortage of dentists who are trained to treat individuals with disabilities.
“Special needs practices are few and far between,” says Ruscio. “We have patients who travel long distances to come see us — sometimes from out of state — due to the lack of dental offices that work with patients who have disabilities, especially ones with hospital credentials, such as the one I work at currently.”
Rodriguez believes there are potential solutions the dental industry could consider to better serve patients with disabilities, such as increasing community dental care, opening offices that accept all types of insurance, and creating mobile clinics for patients who can’t go to a dental office.
For parents or caregivers seeking dental treatment for a person with disabilities, the lack of available care can be discouraging. Ruscio and Rodriguez have some advice for finding the right dental office.
“Usually, pediatric dentists are trained to treat patients with all kinds of disabilities,” explains Rodriguez. “Sometimes, dental offices that are affiliated with a hospital are a good option, in case there is a procedure that can’t be done in a dental chair and the patient needs to be in a hospital setting. Or, a general dentist can take care of the patient and give a referral if need be.”
Ruscio says it’s helpful to find a dental team with the proper training and understanding of various patient needs. This allows them to modify the visit accordingly and help ensure patients with disabilities are comfortable.
“For example, our patients and caregivers have found comfort in knowing that they will be the only people in our office when they visit, and that our environment is calm and without extraneous stimulation,” says Ruscio.
Because of the disparity in dental care for individuals with disabilities, Ruscio says serving these patients is particularly rewarding.
“In a population where home care and professional dental care can be challenging, it is a great feeling to know that our efforts are contributing to our patients’ overall health,” she explains.
Rodriguez remembers a time she helped a child with autism overcome his fear of the dentist.
“I remember after the second appointment, he gave me a hug and he said, ‘Are you going to be in the room next time? I am not scared anymore,’” she recalls. “Since that day, we have put a request on his file that I have to be his dental assistant for all appointments.”
This interaction didn’t just have a lasting effect on the patient — but also on Rodriguez.
“The little boy made me realize the great impact a dental assistant has in a procedure and that a simple appointment can change people for life,” she shares.
Ruscio says it’s also important for dental teams to avoid focusing solely on the patient’s disability. Instead, she strives to get to know her patients on a more personal level and learn what makes them unique.
“While we focus on accommodations we make for a patient’s disability, we also take the time to understand and utilize the patient’s abilities,” says Ruscio. “Our patients are amazing!”