Special care dentistry (SCD) is a branch of dentistry that facilitates care for impaired patients with physical, intellectual, sensory, mental, emotional, medical, or social disabilities.4
Special care dentistry is taught as a postgraduate course that equips dentists to offer dental services to patients with special care needs.
International organizations like the Special Care Dentistry Association (SCDA) are made up of oral dental professionals dedicated to promoting the oral health of persons with special needs.
Those qualified for special-care dentistry are people who need free comprehensive dental treatment. This includes:
In most countries, the elderly make up a significant number of disabled people. They mostly live alone in their homes or are moved to nursing homes for special care.
People with disabilities usually have greater challenges with finding access to affordable dental care. One reason for this is that many disabled people have dental coverage through Medicaid. Some dentists are unwilling to accept dental insurance for the disabled through Medicaid because they would make less money.
Another reason is that most dental offices are unwilling to treat people with disabilities either because of a lack of training or equipment.
Also, people with severe physical disabilities might find it more challenging to care for their oral health as oral hygiene (such as routine visits to the dentist) may be difficult to practice.
For these and other reasons, people with intellectual and developmental disabilities tend to have more dental problems and poorer oral health compared to people without disabilities.7
Disability insurance is insurance coverage for disabled people. It replaces a portion of a person's salary if an injury or illness prevents the person from working. Depending on the type of insurance and the insurance company, some coverage comes with a waiting period, while some do not have a waiting period.
In 2005, the Social Security Administration (SSA) awarded a contract to MDRC, a nonprofit social policy research organization, to carry out a project called Accelerated Benefits (AB) demonstration. This project was designed to figure out the benefits and costs of altering the waiting period for Medicare, particularly for disabled people.6
Disability insurance is primarily meant to protect a portion of your monthly income in case of a disability occurrence. It typically doesn't offer dental coverage. However, some insurance like Basic Social Security Disability Insurance will provide dental coverage.1
According to the United States Government, people with disabilities have three options for health insurance through the government: Medicare, Medicaid, and the Affordable Care Act (ACA). However, they usually do not offer full coverage for adult oral care services.8
Most Medicare and Medicaid enrollees do not have comprehensive health insurance that covers routine dental care or other dental services.3
Medicaid only covers some dental services for children and under-65 adults with disabilities under the Medicaid disability dental coverage. Medicare has some plans that only offer partial dental insurance coverage. ACA also provides dental insurance coverage for children.
Disability living allowance (DLA) is a tax-free benefit, typically in monetary form meant for people with disabilities who need extra care, support in their daily lives, and help with mobility.
A disability living allowance might not give you access to free dental work. However, you might be eligible for other free benefits such as housing, higher child tax, universal credit, and travel support. DLA can also help reduce the cost of prescription fees or doctor’s fees that are not already subsidized.
The U.S. government defines a disabled person as:
Some programs that may provide low-cost dental care for such people include:
Donated Dental Services is a program offered by the Dental Lifeline Network. This is a nonprofit organization that offers education and dental care access to people who cannot afford it as well as people with disabilities.
This nationwide program has a network of over 15,000 volunteer dentists and offers comprehensive free care to people who cannot afford standard treatment fees.
Healthy Mouth Movement, provided by Aspen Dental, is a program that helps people that find it difficult to access dental care around the country (whether because of a disability, lack of funding, or both).
They also focus on dental care for disabled veterans. Aspen Dental has a dentist office on wheels, called MouthMobile, which travels the country to provide free dental services to veterans living in remote communities.
Schools like UW School of Dentistry train dentists and providers to offer specialized dental care to patients with special needs. UW School of Dentistry’s DECOD clinic is partly supported by private donations and provides care to patients with acquired or developmental disabilities such as cerebral palsy and multiple sclerosis.5
Another school that offers this program is the NYU College of Dentistry. This school dedicated its oral health center to providing support and sensitive essential care to people with disabilities. The school’s dental clinic is fully equipped to accommodate the needs of caregivers, patients, and families.
The Illinois Foundation of Dentistry for the Handicapped through the Donated Dental Services programs offers free or very low-cost dental services to the elderly and other people living with disabilities. Qualified applicants must be elderly, chronically ill, or permanently disabled.
Some community dental clinics offer dental services at a low cost. Your local hospital may be able to refer you to one, or you can search on the internet for “community dental clinics.”
Many dentists can treat people with special dental needs. However, some patients with certain disabilities may require specialized services from dental clinics.
Dentists or dental specialists (orthodontists and periodontists) are trained to provide comprehensive care to people that need dental treatment regardless of who the patient is.
But recently, different continuing education programs have been developed to assist dentists in learning better techniques for providing dentistry care to patients with special needs (e.g., MSc in Special Care Dentistry).
There are also dental clinics that prioritize oral health care for disabled adults. These clinics work with volunteer dentists and might offer affordable dental care for disabled adults.
If you are looking for a special-care dentist, the first step is to ask around. For example, ask your local dentist, family members, friends, or even disability services. They might know a clinic with a dental team that provides special care to people with disabilities.
Aside from getting referrals and recommendations, here are more tips to help you find a special-care dentist:
Asmussen, Natalie. “Dental Help for Adults with Disabilities: Care and Considerations.” Dentaly.org, 12 March 2021.
"Benefits and Insurance for People with Disabilities." USA.gov, 23 April 2021.
Katch, Hannah, and Van De Water, Paul. “Medicaid and Medicare Enrollees Need Dental, Vision, and Hearing Benefits.” Center on Budget and Policy Priorities, 8 December 2020.
Nunn, June, and Gorman, Tina. “Special Care Dentistry and the Dental Team.” Vital, Vol 7, (2010): 22-25.
“Special Care for Healthy Smiles.” University of Washington, January 2017.
Weathers, Robert, et al. “Expanding Access to Health Care for Social Security Disability Insurance Beneficiaries: Early Findings from the Accelerated Benefits Demonstration.” Social Security Bulletin, Vol. 70, 4. (2010).
Wilson, Nathan et al. “Countering the Poor Oral Health of People with Intellectual and Developmental Disability: A Scoping LIterature Review.” BMC PUblic Health, Vol 19, 1530 (2019). Doi: 10.1186/s12889-019-7863-1.
Vujicic Marko. “Obamacare, Trumpcare and Your Mouth.” Health Affairs. 13 January 2017.