Serving Those With No Voice: Special Needs Dentistry

We hear the term “special needs” a lot. It’s often in reference to children whose physical or psychological condition requires a particular adaptation so they can access a facility or service. The term dates back to the Adoption and Safe Families Act of 1997, if not earlier, and the need to legally define children who needed more attention in foster care due to a disability.[1]

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Not everyone cares for the term. “I was confused with all the ‘special needs’ this and that,” said the mother of a special needs child, who has an impairment herself. “‘Disability,’ I was and am completely used to, both as a person with disabilities and as a professional working in the field … but ‘special needs’?”[2]

While some people do not care for it, “special needs” has long since entered everyday vocabulary. It is used in this article without any assumptions about those to whom it may refer. And there is no denying that physically and mentally challenged people are not always able to use facilities and services that most people take for granted.

This is as true for dentistry as anything else – and maybe more so. “There are very few dentists nationwide who deal with special needs patients,” said Dr. Zeyad Mady, who has made special needs dentistry a centerpiece of the Center for Dental Anesthesia, his practice in Alexandria VA. “In fact, the lack of willingness and the competence of dental care providers to treat patients with special health care needs, as well as the hurdles these providers face themselves, remain barriers to provide special needs access to dental care.”[3]

The need is there; the balance of this article examines the reasons why.

More Vulnerable

Everyone is susceptible to dental problems, of course. But people with disabilities, some of whom cannot communicate easily, may be more vulnerable than most. “Studies have shown that individuals with special health care needs have more risk of developing dental problems and untreated dental diseases compared with their healthier counterparts,” Dr. Mady notes.[4]

Broadly speaking, dental patients falling into the special needs category include people with:

  • Down syndrome
  • ADHD
  • Dental phobia
  • Muscular dystrophy
  • Alzheimer’s disease
  • Medically complex conditions
  • Blindness
  • Epilepsy

A handful of dental professionals have advocated for special needs dentistry as far back as 1981. “In the United States, Special Care Dentistry has been described as ‘an approach to oral health management tailored to the individual needs of people with a variety of medical conditions or limitations that require more than routine delivery of care,” wrote Ronald L. Ettinger and several colleagues in 2004. Special care or special needs dentistry, he added, “‘encompasses preventive, diagnostic, and treatment services.’”[5]

Dr. Mady further refines the term: “To me, ‘special needs’ means the inability to cope with a traditional dental office setting, whether it is voluntary or involuntary.”[6]

This segment of dental patients, Dr. Mady says, remains underserved by the profession. He noticed this early in his career. “Every time a patient with special needs was on our schedule, we would all accept compromised oral health and dentistry, and say, ‘we can only do the best we can,’” he recalls. “That wasn’t good enough for me. I sought out the partnership with some amazing mentors in our area that dealt with a lot of special needs patients, and together we were able to prove that excellent dentistry can be provided to all special needs patients with no compromise.”[7]

The Center for Dental Anesthesia

After the mentor retired in 2015, Dr. Mady partnered with other dentists and health care professionals to assume operation of The Center for Dental Anesthesia. Together they renovated the CDA with state-of-the-art technology to provide a more comprehensive approach to dentistry, including patients with special health care needs.[8]

The Center for Dental Anesthesia is equipped to handle all special needs dentistry patients:

  • The entire facility is wheelchair accessible
  • Dental chairs and equipment adapted for physically disabled patients
  • Private, non-threatening consultation rooms
  • Accurate medical and dental assessment
  • Personalized treatment plans
  • Monitored “spa” recovery rooms

All areas of special needs dentistry, Dr. Mady explains, require experience, training and facilities, since any single condition may bring with it increased medical concerns. “That is why a team approach is always a necessity,” he said. “This team should include both dental and medical professionals to thoroughly assess cases and make sure they all receive the best care possible. All patients with special needs must have equal access and high-quality treatment that focuses on patient safety, patient-centered care, and treatment of all dental needs.”[9]

Those With No Voice

With some twelve million children in the United States classified as “special needs,” the necessity for a practice like the Center for Dental Anesthesia is clear.[10]

The CDA provides a full range of dental services to the general public, and its team values all their patients. But they are proud to be one of the few practices in the country that serves disabled patients. “There is a sense of completion when you know that you have helped a patient who has no voice, and is unable to express their total satisfaction,” Dr. Mady says. “When we look in the eyes of our patients after treatment, we know they appreciate us as do the families that come to see us from all over the country.”[11]

The Center for Dental Anesthesia in Alexandria is committed to treating patients with many different special needs, and believes that no one should be without professional dental care. Each member of the CDA team has years of experience in providing dental healthcare to special needs patients. Please call our office to schedule an appointment.




[1]      Adoption and Safe Families Act of 1997: “What Does ‘Special Needs’ Mean?”, referred to hereafter as “What Does…?”

[2]      Quote: “The Difference Between Special Needs and Disability”

See also, “3 Reasons to Say ‘Disability’ Instead of ‘Special Needs’”

and “’Special needs’ is an ineffective euphemism”

[3]      Interview with Dr. Zayed Mady, DDS, FAGD, FICOI, March 2019, referred to hereafter as Interview.

[4]      Interview, and “Oral Health for Families with Special  Health Care Needs”

See also “Special Care Dentistry: A professional challenge”

[5]      Quote: “Dentistry for Persons with Special Needs: How Should It Be Recognized?” by Ronald L. Ettinger, B.D.S., M.D.S., D.D.Sc., and Jane Chalmers, B.D.Sc., M.S., Ph.D., and Heather Frenkel, B.D.S., Ph.D., in the Journal of Dental Education. August 2004.

The authors cite “National Oral Health Information Clearinghouse. Glossary of terms. In: Oral health care for people with developmental disabilities: information for patients and professionals. Rockville, MD: National Institute of Dental and Craniofacial Research, National Institutes of Health, U.S. Department of Health and Human Services, July 2003.”

[6]      Interview.

[7]      Interview.

[8]      Dr. Mady, April 5, 2019.

[9]      Interview.

[10]     Number of children: Interview, and “What Does…?”

[11]     Interview.


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5284 Dawes Ave
Alexandria, Virginia