What’s Trending in the News: Special Needs Dental Care Gains Momentum

March is Developmental Disabilities Awareness Month — time to shine a spotlight on emerging trends in dental care for individuals with intellectual and developmental disabilities (I/DD). Research indicates that I/DD patients are more vulnerable to poor oral health, and have more complex oral health care needs. Treatment for I/DD patients can be complex due to additional medical conditions they are managing, use of medications that can adversely affect oral health, and anxiety about dental care that can prevent treatment. These factors have made it common to treat I/DD patients in the operating room, under sedation, for procedures that typically would be handled in the dental office. In addition, I/DD patients have often had fewer choices in dental providers, which in some cases has led to delays in preventive care and treatment.

However, this trend is changing as schools like Penn Dental Medicine at Penn State, and New York University College of Dentistry have pioneered dental care tailored for I/DD patients, and are training dental students in these best practices. At the NYU Dentistry Oral Health Center for People with Disabilities, every aspect of the patient experience is designed for people with disabilities, with care delivered by dental providers trained to care for this population. Penn Dental Medicine’s Care Center for Persons with Disabilities Personalized Care Suite is the community service component of the school’s extensive research and education centered on I/DD patients. The school also offers comprehensive dental care training for persons with disabilities workshops for providers. 

In Recent News

In recent years, top dental schools across the U.S. have opened special needs care clinics and started or enhanced student education in treating this population. 2024 is off to a good start, with these announcements:

• In February, the University of Texas Health San Antonio School of Dentistry opened a special-care dental clinic. The first university-led special needs clinic for dental care in South Texas, it serves individuals of all ages with intellectual, developmental, cognitive, or physical disabilities. It also provides specific training for dental school students on providing care to people with disabilities.
• Also in February, the University of Minnesota School of Dentistry Special Healthcare Needs Clinic received a $100,000 Clinical Dental Education and Innovations Grant from the Minnesota Department of Health. The Special Healthcare Needs Clinic provides comprehensive dental care for patients with complex medical conditions, developmental disabilities, physical disabilities, and older adults. The grant will be used to improve efficiency in diagnosis and treatment planning, and to increase accessibility for patients.

How SKYGEN Can Help

As it becomes more widely recognized that I/DD patients need more time and a different patient experience for dental care to be successful, insurers need ways to more effectively serve these plan members. SKYGEN works with many insurers to implement strategies such as: 

• Revising business rules: Insurers can adjust diagnosis codes to enhance benefits, such as increasing the frequency of preventive visits. They can also adjust individual procedure rates for this population.
• Supporting desensitization initiatives: Investing in efforts to gradually acclimate I/DD patients to the dental office environment can increase treatment success within the office setting. Insurers can allocate more time for these appointments as well as multiple appointments.  
• Including dual eligibility coverage: Recognizing that many I/DD patients have dual eligibility, insurers can ensure that members have a seamless experience. Providers are able to submit a single bill and are paid quickly. 

 
SKYGEN’s flexible benefits management platform helps insurers automate administration of special rules or exceptions. In addition, with the platform’s high configurability, adjustments to business rules can be made quickly and easily by insurers using the SaaS platform, and by the SKYGEN team for third-party administration clients. If you are an insurer interested in enhancing dental care for special needs members/patients, contact SKYGEN. Our specialty benefits experts can work with you on strategies that facilitate the transition from operating rooms to the dental office.