Preliminary Results of an Interdisciplinary Behavioral Program to Improve Access to Preventative Dental Care for Adults With Intellectual and Developmental Disabilities

Abstract

Adults with intellectual and developmental disabilities (AIDD) experience significant oral health disparities, partially due to perceived behavioral issues. This article describes the preliminary outcomes of a developing interdisciplinary (dental, medical, behavioral) program involving a behavioral intervention for AIDD previously receiving preventative dental care with sedation, general anesthesia, or protective stabilization (SAS). After a baseline assessment, a board-certified behavior analyst implemented increasingly complex behavioral interventions during simulated dental visits. Prior to COVID-19 pandemic-related restrictions, there were 32 active participants; 15 (46.9%) successfully completed a focused, real dental exam with simple behavioral interventions and 17 (53.1%) remain in treatment. These preliminary results suggest that many AIDD previously receiving SAS may participate in a preventative dental exam with minimal behavioral supports, if given the opportunity.

Putting the power of behavior analysis in the hands of nonbehavioral professionals: Toward a blueprint for dissemination†

“…All of the participants in her study previously received sedation, general anesthesia, or restraint during preventive dental exams. In light of this history, the project team was surprised when more than 60% of the 32 participants responded successfully to the "best practices" package, with several additional participants requiring only the addition of NCR (Berens et al, 2022). Results of this study informed the final training content for dentists, which included tell-show-do, NCR, frequent breaks, and praise for cooperation.…”

Retrospective Evaluation of 20 Years of Outpatient Dental Services to Adults with Disabilities at the Dental Hospitals of the Medical University of Innsbruck, Austria

“…Generally, a well-trained and geared staff constitute the basis for appropriate communication and confidence building, which are essential in the attainment of collaboration (within patients’ personal limits) [ 13 ]. Additionally, alternative approaches, e.g., behavior management, hypnodontia, or conscious sedation might increase treatment success [ 14 , 15 ]. Aside from these general professional framework conditions, patience, dedication, and the arrangement of enough time seem to be crucial factors in the achievement of amenability and compliance in patients with disablement [ 13 , 16 ].…”