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Care for members with intellectual, developmental disabilities
November 7, 2023

This article is for dentists, oral surgeons, mental health providers, and primary care providers caring for our members

What are intellectual and developmental disabilities?
Intellectual disabilities may manifest any time before a child turns 18. They may affect intellectual functioning, such as learning, problem solving, judgement; and adaptive functioning, like the ability to perform activities of daily life.1 Developmental disabilities are a broader group of physical, intellectual, and/or behavioral conditions that begin during the developmental period and include conditions ranging from autism, Down syndrome, epilepsy, and cerebral palsy.2

Each patient with an intellectual and/or developmental disability has unique dental challenges due to their specific capabilities and abilities. Because dental health has been shown to impact overall health, dental and health care professionals can help their patients by encouraging them to get regular oral health care. Blue Cross is supporting your efforts by offering additional dental care benefits for members of Dental Blue with these conditions.

Dental care for patients with intellectual disabilities

Intellectual disabilities can vary in severity, but research shows that people with intellectual disability have more untreated caries (cavities) and a higher prevalence of gingivitis and other periodontal diseases than the general population, according to the National Institute of Dental and Craniofacial Research (NIDCR).3 Because people with intellectual disabilities may also have other conditions such as cerebral palsy, seizure or psychiatric disorders, attention deficit/hyperactivity disorder, or problems with vision, communication, and eating, NIDCR recommends taking a patient’s medical history before the dental visit. NIDCR’s fact sheet suggests many strategies for oral health care problems commonly found in patients with intellectual disabilities.

Dental care for patients with developmental disabilities

NIDCR also notes that people with developmental disabilities may each have distinct challenges in routine dental care, due to:

  • Varied mental capabilities which may impact how well they can remember and execute daily care activities
  • Behavior problems, including anxiety around receiving care in the dental office
  • Mobility problems, which may affect their ability to manipulate a toothbrush or to access your dental office
  • Neuromusculatural issues or uncontrolled body movements. 4

They note that patients with developmental disabilities may be more likely to have latex allergies, may be taking medications that dry their mouths, and may have damaging oral health habits such as teeth grinding and clenching. The Special Care Dentistry Association offers education and training for providers to learn more about the specific needs of patients with different developmental disabilities. 5

How Blue Cross is supporting our members

Because patients with intellectual and/or developmental disabilities can benefit from more frequent visits to a dental professional, we’ve expanded our Enhanced Dental Benefits. “At Blue Cross, we’re proud to be offering members with intellectual and developmental disabilities the opportunity for additional preventive dental care that will improve their oral health and their overall quality of life,” notes Robert Lewando, DDS, Executive Director of Dental Professional Services.

Members who have dental coverage with Blue Cross may receive additional cleaning, periodontal maintenance, oral cancer screening, and fluoride treatment benefits after their doctor or health care provider has signed an enrollment form to indicate their eligibility. These new benefits are available for members in new or renewing health plans on or after October 1, 2023.

What can providers do?

Both dentists and medical professionals have a role to play in helping their patients.

  • Dental professionals can listen to their patients and their caregivers about the challenges they face in maintaining their dental care at home. Educate them about the additional benefits available to them by providing them with the member fact sheet and recommending that they work with the patient’s physician or clinician to enroll.
  • Medical and mental health professionals can ask their patients whether they have dental health insurance with Blue Cross Blue Shield of Massachusetts and complete an Enhanced Dental Benefits enrollment form for those who are eligible.

1. psychiatry.org/patients-families/intellectual-disability/what-is-intellectual-disability
2. cdc.gov/ncbddd/developmentaldisabilities/facts.html
3. nidcr.nih.gov/sites/default/files/2017-09/practical-oral-care-intellectual-care.pdf
4. nidcr.nih.gov/health-info/developmental-disabilities
5. scdaonline.org