Patients with disabilities languish on waiting lists for years for the few places that can see them — usually dental schools. Appointments frequently require time off work for caregivers, long drives from remote areas, hotel stays and out-of-pocket fees.
A typical dental office cannot perform general anesthesia nor can it accommodate other disabilities requiring wheelchair lifts or other specialized equipment.
“The state is responsible for ensuring access to dental care for patients with special health care needs,” Terlet said. “If California is serious about its commitment to health equity, people with special health care needs must be provided timely access to dental care.” Without a centralized database, the number of patients that need special dental care is hard to quantify. Approximately, or 15% of all children, in the state have chronic physical, developmental or behavioral conditions — although of course not all of those require special dentistry. The Department of Developmental Services also serves an estimated 330,000 individuals with disabilities. And California’s growing aging population includes 690,000 seniors with Alzheimer’s disease.
One of the primary reasons it’s so difficult to find a dentist is that most don’t accept Medi-Cal, the state health plan for its poorest residents, which a majority of people with disabilities rely on. In 2021, about 36% of active licensed dentists in the state accepted Medi-Cal. That number has grown by about 10% since 2017, when the state
“The phone rings all day long, but we’re excluding a lot of patients right now because we have to charge them,” Barnes said.from the Legislative Analyst’s Office on improving dental access for patients with disabilities, only a third of Medi-Cal enrollees received any dental care between 2014 and 2016 while even fewer regional center clients — 20% — saw a dentist in the same time period., said Eric Sung, chair of special patient care at UCLA’s dental school and Jones’ dentist.
“It’s really frustrating that there’s not somewhere in local areas or in each region that can take care of your kids with special needs,” Creede said. It’s even harder for adults with special and complex health needs to find a dentist. Medi-Cal is more likely to reimburse sedation for children than for adults, and while many pediatric dentists have some experience working with special needs patients, most adult dentists do not.has doubled in the past seven years, it still remains far below childhood visits.
It’s a common story, said Sung, the dentist at UCLA, where the waiting list is more than a year long. “A lot of families, literally when I see them on screening day, meaning one year after they called, say it’s been a decade or more since they’ve seen a dentist,” Sung said. Richard Kunihira, a dentist in the Inland Empire, has operating room privileges at Kaiser Fontana but tries to reduce patients’ need for sedation to once every two years or so. He takes the time to get patients used to the dental office and the sensations in their mouth and teaches parents and caregivers how to gently brush their teeth at home.
“There might not be a procedure ,” Sung said. “You need to desensitize them, have them come in, visit you and perhaps not perform work at all. The second time, come a little bit closer. Look in your mouth and maybe touch therapy just so that they get used to the whole experience, the new environment.”
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