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Authors: John Morgan, Bonnie F. Zimble

Introduction to Special Care in Dentistry:

Barriers to Dental Care


Special Care in Dentistry
John Morgan, DDS
Tufts University School of Dental Medicine, 2008


Study Questions:

  1. What barriers exist in the world of disability from the dentist’s perspective?
  2. From the patient’s perspective?

From the dentists’ perspective …

  • There exists a void in dental and dental hygiene school curricula, which has translated to a lack of exposure to and experience with disability among dental students.
  • This has understandably led to reluctance to treat patients with disabilities.
  • There may be a loss of revenue when treating this population. For example, consider the lower fee schedule for MassHealth, which pays for dental treatment for most persons with disabilities.
  • Dentists may lack access to or be unfamiliar with special equipment that may be required.
  • And they may fear that these factors will lead to ineffective treatment…whereas the truth is that most patients with disabilities can be successfully treated in a general dental office if time is taken to explain procedures and allay anxieties.                                 

From the disabled patients’ perspective …

  • There is a scarcity of dentists who accept patients with disabilities.
  • There is a lack of available and appropriate transportation, such as wheelchair cars.
  • Financial constraints might stand in the way of treatment.
  • Many parents are fearful and overprotective. They may also have concern that dental treatment may compromise their child’s medical condition.
  • Adults with disabilities may have experienced very negative dental experiences in the past.