Persons with intellectual disabilities have an increased prevalence of caries, periodontal disease and poor oral hygiene compared to the general population. They are also one of the most underserved groups of dental patients in both Canada and the United States.

Pediatric dentists receive extensive training in the area of special care dentistry. However, because of their limited number, it is crucial that general dentists and their staff be well versed in treating persons with special needs. Yet previous research has shown that practising dentists cite level of training as their greatest area of concern in treating patients with special needs.

The purpose of our study was to develop and implement a survey for Canadian dental schools in order to assess the didactic and clinical education that students enrolled in these programs receive in the area of special needs education, and to evaluate the role of the Commission on Dental Accreditation (CDAC) guidelines and requirements in curriculum related to persons with special needs.

Pediatric dentists receive extensive training in the area of special care dentistry. However, because of their limited number, it is crucial that general dentists and their staff be well versed in treating persons with special needs. Yet previous research has shown that practising dentists cite level of training as their greatest area of concern in treating patients with special needs. The purpose of our study was to develop and implement a survey for Canadian dental schools in order to assess the didactic and clinical education that students enrolled in these programs receive in the area of special needs education, and to evaluate the role of the Commission on Dental Accreditation (CDAC) guidelines and requirements in curriculum related to persons with special needs.

The Survey
A survey was mailed to all schools of dental assisting (27), dental hygiene (50), dental undergraduate (10) and graduate (23) programs in Canada. The survey included questions related to didactic instruction, clinical training, department(s) involved in teaching topics related to patients with special needs, aspects of special needs care, mandatory versus elective education, observation versus treatment, evaluation of students’ skills, perceived competency of students and CDAC curriculum guidelines.

Key Survey Results by the Numbers
All 10 dental undergraduate programs responded to the survey and these results are reported here. The number of didactic hours devoted to special needs dentistry within the undergraduate curriculum ranged from 0 to 18. The number of hours students spent observing patients on mandatory rotation was, on average, 13.6, and ranged from 0 to 75 hours. The number of hours spent treating patients on mandatory rotation also ranged from 0 to 75, with an average of 13.3 hours. Ninety percent of respondents agreed with the CDAC statement that students’ experiences with persons with special needs are highly desirable, but should not be mandatory.

A Snapshot of Dental Undergraduate Programs
The results of our study are similar to previous research and suggest that undergraduate students’ experiences in the care of persons with special needs are still varied and limited. Some respondents cited curriculum overload, the importance of learning basic dental skills, and an inability to guarantee the patient population as reasons why the amount of educational experience they can provide students in the area of special needs care is limited. However, educators from each undergraduate institution were willing to affirm that most of their students would be competent to treat some patients with special needs. For some schools, the apparent lack of direct exposure to special needs patients is offset by the vertical and horizontal integration of topics related to special needs care in the curriculum. Several respondents mentioned the ability to transfer skills learned in one area to a similar field as a reason for their confidence in their students’ ability to treat patients with special needs.

Conclusion
Some critics feel that providing educational programs increases awareness, but does not ultimately increase the number of graduating students that will treat intellectually disabled patients. Results of surveys indicate otherwise, as dentists are asking for additional training because they feel they are lacking in special care dentistry skills. Ultimately more research in this area is required.