Oral Health for People with Disabilities

Oral health has been, and continues to be, is an important health issue for the approximately 6.5 million people in the US with intellectual and developmental disabilities (I/DD) who are not able to access the dental care they need.  

Despite some progress over the years, a significant disparity still exists in oral healthcare between I/DD and the general population. Barriers generated by finances, a lack of appropriately trained dental providers (less than 10% of all dentists treat patients with disabilities), limited accessibility of dental clinics, lack of Medicare and Medicaid funding and the patients themselves combine to create significant challenges to providing dental care. (This last part of the statement is not intended to blame the individual, but rather stress the inaccessibility of the system as a whole).  However, there are programs and strategies that can help to decrease the magnitude of these obstacles and help minimize this health disparity. Read this article by Michael Milano, DMD for more information.

The Oregon Office on Disability and Health and the University Center for Excellence in Developmental Disabilities along with our many partners are committed to increasing the awareness of, and efforts around, addressing and minimizing these oral health disparities. 

In 2020 and into 2021 we are working together with our partners on the following oral health activities.  We welcome additional partners!  If you are interested in collaborating, please contact Angela Weaver at weaverro@ohsu.edu.  

Mouth Matters: Disability and Oral Health Webinar Series 

In June 2020, we offered a 2-Part Webinar Series - Mouth Matters: Disability and Oral Health

For more information on the two webinars and to access the archived webinars, click on the links below. 

Mouth Matters Session 1: Intended audience: people with I/DD and other disabilities, their families and disability service providers support staff, and dental professionals and students. View the recorded webinar here. View transcript here.

Mouth Matters Session 2: Intended audience: dental hygienists, other dental professionals and dental students. (Might also be of interest to people with I/DD and other disabilities, their families and disability service providers support staff.) CEUs are available for dental hygienists, dentists, and other health professionals. View the recorded webinar hereTo access the webinar please click the top bar dated June 10th, labeled “SoD-Mouth Matters Webinars." If you would like to receive CDEs, please visit  www.ohsu.edu/cde and register for the course.

Feeling Good about Your Smile Program

Starting in the Fall / Winter of 2020 we are hosting several Feeling Good about Your Smile program trainings in Oregon.  Four years ago, Oral Health Kansas worked with the Kansas Disability and Health Program at the University of Kansas to create a program designed for adults with intellectual and developmental disabilities (I/DD) to help them feel confident about how they can keep their mouth and teeth healthy.  The program offers a 90-minute interactive workshop that is fun, engaging, and gives participants with I/DD and their support staff the opportunity to practice concepts that improve oral health.  The workshop stresses the importance of good oral health in order to reduce the risk of oral disease, as well as its importance on overall health and wellbeing, especially for people with chronic conditions such as diabetes, obesity, and heart disease.  

The Feeling Good about Your Smile program also engages dental hygienists, who are trained to facilitate the workshops.  This fall, OODH and UCEDD staff will recruit and train 15 to 20 dental hygienists in order to build capacity and sustain the program in Oregon.  The training events for the hygienists will take place while conducting Feeling Good about Your Smile workshops for people with I/DD and their care providers.    If you are interested in being part of this new program in Oregon, please contact Angela Weaver at weaverro@ohsu.edu.

Relevant Data:

Special Smiles is the dental health program of Special Olympics Healthy Athletes® that provides athletes with intellectual disabilities the opportunity to participate in dental screening and take charge of their oral health. 

Special Olympics Oral Health Conditions

According to Special Olympics’ Healthy Athletes’ Special Smiles 2019 US Report, during the Special Smiles’ oral examinations of approximately 138,500 Special Olympics’ athletes, from 2007-2019, about half of the athletes were unaware that they had underlining oral health issues. Their data showed that almost 50% of the athletes had signs of gingivitis, 25% had untreated tooth decay, 9% received an urgent dental referral, 12% experienced mouth pain, and lastly, 30% of the Special Olympics athletes were missing one or more teeth.  (For more information on the Special Olympics Special Smiles resource page.)

Percent of Oregon Adults who have had a dental visit in past year
Percent of Oregon Adults who have had a dental visit in past year

In Oregon, 2018 Behavioral Risk Factor Surveillance System survey (BRFSS) data shows that fewer adults with disabilities, or just 59%, visited a dentist within a one-year period, compared to 71% of adults without disabilities. This means that people with disabilities are not accessing and benefiting from, the same yearly dental care as people without disabilities.

Percent of Oregon Adults Who have had permanent teeth removal
Percent of Oregon adults who have had permanent teeth removal

In this chart, the orange bars represent adults with disabilities and the blue bars represent people without disabilities.  The BRFSS data in this chart demonstrates how Oregonians with disabilities (60%) reported having had at least one permanent tooth removed, compared to 33% of adults without disabilities. (When you add the two orange 30% bars together.)  In other words, the number of people with disabilities who have had one or more of their teeth removed is twice that of people without disabilities.  Moreover, three times more people with disabilities (30%) reported having had six or more teeth removed than people without disabilities (9%).  Having teeth removed is an indication of poor oral health. The more teeth a person has removed, often correlates with poor oral health and/or limited access to appropriate oral health care.