Evidence from National Surveys and Claims Data
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Individuals with cognitive, intellectual, and developmental disabilities (CD/IDD) face disproportionate oral health challenges, due to both clinical and social factors. Some individuals, for example, may struggle with oral hygiene practices due to limited fine motor skills or reliance on caregiver support. Factors such as cost of care, lack of transportation access, dental anxiety, and a shortage of dentists trained to care for individuals with CD/IDD also influence dental care utilization.
This report provides a comprehensive, multi-dataset assessment of oral health outcomes among individuals with CD/IDD in the US. Key findings include:
- Individuals with CD/IDD have significantly worse oral health outcomes than the general population, including higher prevalence of self-reported fair or poor oral health and tooth loss.
- Despite higher rates of public insurance (Medicaid) coverage, individuals with CD/IDD have approximately three times higher odds of cost-related barriers to care than those without disabilities.
- Claims-based findings show higher frequency of extractions, anesthesia, and emergency care for individuals with CD/IDD, suggesting a pattern of episodic, invasive care rather than routine prevention and early intervention.
The authors write: Insurance coverage alone is insufficient to ensure timely, preventive, and appropriate dental care for individuals with CD/IDD. Potential approaches include strengthening provider training in special care dentistry, increasing reimbursement for longer or more complex visits, and enhancing coordination between dental, medical, and disability support systems.
You may also be interested in:
- Medicaid Adult Dental Coverage Checker, an interactive tool showing each state’s Medicaid adult dental benefits, including coverage for individuals with intellectual and developmental disabilities.
- Special Patient Care, a collection of free self-paced courses that help dental teams tailor care to individuals with complex care needs — such as physical, developmental and cognitive disabilities. Each course is eligible for one free CE credit.
- Teaching Dental Students to Confidently Care for Patients with Disabilities, a blog post about a pilot program at the University of Florida College of Dentistry that trains the next generation of dentists to confidently care for patients with special needs.