Treating patients with special needs is fulfilling

Dr. Chelsea Fosse points to a medal her friend
Anna won at a Special Olympics event with
which Dr. Fosse volunteered.

New York — Dr. Chelsea Fosse knew she wanted to work with patients with special needs even before she enrolled in dental school.

After she graduated from The University of Texas at Austin, the Michigan-raised dentist worked at the American Academy of Pediatrics, where she gained exposure to the health care hurdles often faced by those with intellectual and developmental disabilities.

In part because of that experience, Dr. Fosse decided she wanted to become a dentist, she told the ADA News, and enrolled at Rutgers School of Dental Medicine, a school that is especially equipped for and trains students to treat patients with special needs. “It can be nerve-wracking when you first start working with this population, even in a controlled environment like dental school,” she said. “But it is so fulfilling to be able to provide care to someone who is truly in need of our services and skills.”

For patients with disabilities, access to dental care can be scant or nonexistent, and the experience of visiting a dentist can be filled with panic and confusion, Dr. Fosse said. After her dental school graduation in 2017, she completed a general practice residency at Helen Hayes Hospital in West Haverstraw, New York, which offers comprehensive care to adults with intellectual, neurological and psychiatric disabilities. Many of these patients once saw pediatric dentists during their youth, but were unable to find general dentists in the community to treat them in adulthood.

Now, as a masters student at the Mailman School of Public Health at Columbia University — due to graduate this year — Dr. Fosse continues to advocate for patients with special needs as a primary care dentistry fellow in the university’s College of Dental Medicine.

To successfully treat patients with disabilities, she said it was important to show openness. “Don’t create barriers in your mind that prevent you from treating this population. You, your staff and your office are likely already equipped and prepared to serve individuals with disabilities in your community. You can make a big difference in the lives of these patients and their families and caregivers and change their outlook on dentistry.”

“We’ve come a long way in the profession, but there is still work to be done,” Dr. Fosse said about dentists stepping up to be inclusive and treating all patients with compassion, skill and understanding.

The Code Maintenance Committee, chaired by the ADA, in March added a code to the CDT Code that applies to patients with special needs. The code applies to “special treatment considerations for patients/individuals with physical, medical, developmental or cognitive conditions resulting in substantial functional limitations, which requires that modifications be made to delivery of treatment to provide comprehensive oral health care services.” It will appear in the case management section of the revised Code on Dental Procedures and Nomenclature, which goes into effect Jan. 1, 2020.

The National Council on Disability, an independent federal agency, is commending the ADA for taking necessary steps in 2018 to improve dental care access for people with disabilities with a revision to the ADA Principles of Ethics and Code of Professional Conduct. The ADA House of Delegates then approved Resolution 50H-2018 that would revise the Code to better reflect the rights of patients with disabilities in providers’ patient selection.

For more information about patients with special needs, visit the ADA’s consumer website MouthHealthy.org.