Informing Best Practice for the Comprehensive Community Dental Care of Adults with Developmental Disabilities: a Grounded Theory Study

Abstract

Background: Dental care for the persons with Intellectual Disabilities/Developmental Disabilities (ID/DD) is an underdeveloped specialty within the field of Dental Healthcare. There are no consistent and agreed upon training or licensing guidelines. Patients with ID/DD are 13% less likely to receive a routine dental appointment one time per year compared to young adults without a disability. Further, patients’ negative experiences with dental care can affect the overall success of dental appointments and likelihood that the patient will engage in continuing care. To address this gap in the literature, this study sought to, take the first steps toward establishing a set of core competencies for a patient centered dental care provision among patients with DDs utilizing a grounded theory approachMethods and procedures: In 2020, semi-structured qualitative interviews were conducted with 13 dental care professionals including 8 Dentists and 5 Dental Hygienists. There were 6 female participants and 7 male participants. NVivo software was used to conduct thematic data analyses. A grounded theory research approach was utilized to integrate the findings into some preliminary theories. Outcomes and Results: Three main themes emerged from the analyses: Perceptions of dental care providers regarding best practices for inclusive practice: Techniques and provider characteristics; Barriers to inclusive practice and Facilitators to inclusive practice. Many of the participants had personal relationships with at least one person with developmental disabilities which influenced their decision to specialize in that type of dentistry. Providers mentioned empathy and patience as key qualities among those conducting comprehensive dental care in the community setting. Some of the significant barriers to comprehensive community care were the lack of formal education in patient centered ID/DD dental care provision, lack of practice preparation of dental providers, and a lack of dental funding. Conclusions and implications: Most providers had no formal knowledge of PCC and the majority of the clinicians interviewed had no formal training on the dental care of persons with DDs. Dental programs should increase the availability of training that facilitates PC community care for this population (e.g. sedation methods). More structured educational programs are needed in order for both medical and dental providers to feel better prepared for comprehensive care of persons with DDs in the community setting. Further, future research should examine the perspectives of ID/DD patients and their caregivers with regard to dental care to better address their specific needs.