The Center for Dental Anesthesia in Alexandria is one of just a handful of practices in the United States that specializes in dental care for people with disabilities. With 12.8% of the American population identified as disabled, the need for special needs dentistry is very high.
Special Needs Dentistry
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Until recently, dentists were under no obligation to treat disabled patients. Dental care providers would decline them for various reasons: because of the extra time required to treat a single patient; a lack of specialized equipment; or an unfamiliarity with issues related to a particular special need.
But in early 2019 the American Dental Association revised its code of conduct to specifically prohibit dentists from denying care to special needs patients.
“We recognized,” said Dr. James Smith, who heads the ADA’s ethics council, “that addressing this and including this in the code of conduct helps to ensure that we are providing justice and equity for individuals with disabilities.” Now, at very least, a dentist must provide a referral to an appropriate dentist.
“All areas of special needs require special experience, training and facilities,” says Dr. Zeyad Mady, of the Center for Dental Anesthesia. Treating special needs patients has been the focus of the CDA since he and several colleagues assumed operation of the practice in 2015.
Major Health Disparities
Special needs dentistry is defined as “a method of oral health management that is specially designed for patients with special needs who have a variety of medical conditions or disabilities that require more time or altered delivery methods than the routine delivery of dental care for the general population.”
Dr. Mady takes this a step further. “To me,” he adds, “special needs means the inability to cope with a traditional dental office setting, whether it is voluntary or involuntary. Dental phobia, in my opinion, is also considered a special need.”
“We all strive to make the experience
as calm and comforting to patients as
– Dr. Zeyad Mady
People with developmental disabilities are more likely to have poor oral health than those who are not affected. Historically, special needs patients have also had a harder time finding, getting to, and paying for adequate health care, according to a 2002 U.S. Surgeon General report. Each of these factors, Dr. Mady says, “can contribute to a major health disparity between people with special needs and the general population.”
The CDA was established to handle all special needs dentistry patients. The practice features:
- Dental chairs and equipment adapted for physically disabled patients
- Private, non-threatening consultation rooms
- Wheelchair accessibility (entire facility)
- Personalized treatment plans
- Accurate medical and dental assessment
- Monitored “spa” recovery rooms
Most CDA patients find these accommodations comforting and effective, but sometimes it is not enough. “All dental offices can be comforting,” Dr. Mady explains. “Patients with dental phobias and/or special care needs, typically still find these settings threatening.”
Many special needs patients require some form of sedation in order to complete their dental care. Dr. Mady and his CDA colleagues have all had advanced sedation training and are certified to the highest level of dental anesthesia assistance.
The CDA staff wants all of their patients to have a positive experience, and makes this a top priority. “It all starts with a consultation and assessment of the patient’s wants and needs,” Dr. Mady explained. “We always hope to ‘graduate’ patients from the complete sedation experiences at all visits and work very hard to accomplish [this].”
The objective is pain-free treatment, and not everyone, of course, needs sedation. “The experience is personalized to have minimal impact on the patient at all times,” Dr. Mady said.
The Right Direction
ADA officials say revising their code of ethics was the right thing to do. The National Council on Disability commended the decision, calling it “a leap in the right direction toward equal access.”
Even so, special needs dental patients remain one of the underserved groups in the United States. With the amended ADA code of ethics, and through the efforts of dental care professionals like Dr. Zeyad Mady and the CDA, this may begin to change.
In the meantime, the Center for Dental Anesthesia in Alexandria remains committed to treating patients with many different special needs, as well as the general public. No one should be without quality dental care. Please call our office to schedule an appointment.
 12.8% of population: 2017 Disability Statistics Annual Report, p. 2.
 “Neglected for Too Long: Dental Care for People with Intellectual and Developmental Disabilities,” issued by the National Council on Disability, Fall 2017. Referred to hereafter as “Neglected.”
 “Dentists No Longer Permitted to Turn Away Patients Due to Disabilities,” by Blythe Bernhard, Disability Scoop, Feb. 28, 2019.
https://www.disabilityscoop.com/2019/02/28/dentists-turn-away-disabilities/26093/, referred to hereafter as “Scoop.”
See also, Principles of Ethics and Code of Professional Conduct, American Dental Association (p. 8):
 Interview, March 2019.
 “Preparedness and willingness of dental care providers to treat patients with special needs,” p. 1.
 Interview, March 2019.
 Neglected, p. 1. Quote: Interview, March 2019.
 Interview, July 2019.
 Interview, July 2019.
 Some patients will always need anesthesia: “Getting Dental Care Can Be A Challenge for People with Disabilities,” National Public Radio, October 24, 2016.
Dr. Mady quote: Interview, July 2019.
 “Federal agency thanks Association for revising Code of Conduct,” January 28, 2019.
 “General Dentists and Special Needs Patients: Does Dental Education Matter?”