Optimizing Dental Care for Adults With Intellectual and Developmental Disabilities: Challenges, Strategies, and Preventative Approaches

Individuals with intellectual and developmental disabilities (IDD) often face numerous barriers to dental care, leading to higher rates of untreated caries and periodontal disease. This editorial explores the challenges associated with dental care for individuals with intellectual disabilities and suggests methods to enhance their dental care. Preventive dental care is crucial for maintaining health. Recommendations, mirroring those for the general population, include brushing and flossing teeth twice daily, biannual dental cleanings, and adopting a diet low in acids and added sugars. Specialized toothbrushes with larger handles have been designed to improve daily cleanings and water flossers may be preferred over traditional flossing. Regular observation of independent tooth brushing habits and daily reminders by caretakers contribute to effective plaque removal. Sealants should be placed routinely for additional cavity protection. Patients with IDD may face challenges in practicing ideal preventive care due to oral sensitivity or motor limitations. Caretakers should discuss these challenges to explore feasible adjustments in dental hygiene routines or utensils. When adjustments are not possible, strict dietary control may improve dental outcomes. Sensitivities related to foods may align with dental care sensitivities, necessitating collaboration with occupational therapists and nutritionists to balance nutritional needs while limiting sugary foods. Dental visits often cause anxiety for individuals with IDD. Studies suggest that conscious sedation, commonly using nitrous oxide, is sufficient for cleanings and minor procedures. Seeking a dentist familiar with caring for patients with IDD can provide additional guidance and care. For those who become edentulous, malnutrition is a common outcome. Dentures are a viable solution, but individuals with IDD may require extra counseling to understand the benefits and risks. Dentures, while effective, pose a choking hazard, which can be mitigated by anchoring with implants or other fixation methods. For those who prefer no reconstructive intervention, dietary adjustments are necessary to meet daily energy and nutritional needs. Many US insurance companies/systems including Medicaid and Medicare do not sufficiently cover dental cleaning or care, adding an additional barrier to care for patients with IDD. Some dental-specific plans support dental care for patients with IDD, but remain an additional financial burden patients face in protecting their dental hygiene.