For Special Needs Population, Dental Care is a Struggle

Navigating the challenges of finding a dentist for special needs patients in New Jersey.

Meet Prince, a dragon with dentures the KinderSmile Foundation uses to teach special needs children oral hygiene.
Meet Prince, a dragon with dentures the KinderSmile Foundation uses to teach special needs children oral hygiene.
Photo by Andy Foster

People with special needs face unique obstacles in finding dentists who will work with their physical, developmental and financial limitations. “That’s the quiet sadness of it, the special needs,” says Dr. Elisa Velazquez, a pediatric dentist in Ocean County.

Special-needs patients—people with a wide range of conditions, including autism, Down syndrome, cerebral palsy, epilepsy, schizophrenia, Alzheimer’s and even severe dental phobias—tend to be overlooked when it comes to oral health policy, education and care. Many dentists refuse or are not prepared to handle patients who cannot sit still, communicate or cooperate for basic procedures. Nonverbal patients can’t describe their symptoms. Patients in wheelchairs may not be able to sit in a dental chair. Some may have assisted breathing devices or tracheal tubes, which complicate treatment.

READ MORE: Left Behind: New Jersey’s Dental-Care Gap

“There are really limited facilities throughout the state, so people tend to travel great distances,” says Dr. Mary L. Voytus, director of Medical Education and the Dental Residency program at Hackensack UMC Mountainside Hospital in Montclair. The hospital is one of several in the state that lets non-local special-needs patients receive general anesthesia in its operating rooms for basic dental procedures.

The Delta Dental School of New Jersey Special Care Center, a clinic at the Rutgers School of Dental Medicine in Newark (formerly UMDNJ), treats more than 4,000 patients per year—mostly Medicaid special-needs patients who travel from all over, including patients from Delaware, New York and Pennsylvania.

“I think it often is an innate desire or natural disposition to feel comfortable with the special population,” says Velazquez, who feels the earlier special-needs children experience dental care, the better. She recommends starting all kids by age 1. To help them acclimate to a stranger putting sharp tools into their mouths, Velazquez invites special-needs kids into her office once a month for a simulated cleaning. “So when it’s time for their cleaning at the six-month mark,” she says, “I’ve already seen them six times, and then [ideally], they hop in the chair.”

The KinderSmile Foundation in Essex County visits special-needs schools, like the Arc Kohler School in Mountainside, to give children pro bono cleanings with parental consent. On one visit in May, roughly half of the students had consent. After the participating dentists brushed and cleaned their teeth, the children sat with dental students who showed them how to brush using a giant toothbrush on a smiling, purple stuffed dragon named Prince.

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