At the Dentist Office, Practitioners are More Prepared to Care for All Patients

At the Dentist Office, Practitioners are More Prepared to Care for All Patients

SLU Pediatric Dentistry Residency Program Leads in Disability-Focused Oral Health Care

The dentist's office is becoming a more inclusive place, thanks to better training for those who will care for children with disabilities.

The Pediatric Dentistry Residency Program at Saint Louis University's Center for Advanced Dental Education (CADE) leads in educating future pediatric dentists to treat patients with disabilities and complex medical needs.

According to the National Council on Disability, these patients are at higher risk for poor oral health and face multiple barriers to accessing care, including a shortage of appropriately trained professionals. While at the dentist's office, children with autism, for example, may struggle with sensory overload during the unfamiliar sensations experienced at a teeth cleaning. A patient who uses a wheelchair may have difficulty accessing a dentist's chair. Someone with a blood disorder may worry that a dentist isn't trained to provide care in a way that is safe for their condition.

The Commission on Dental Accreditation (CODA) approved standards in 2019, requiring all U.S. dental schools to train students in assessing and managing patients with disabilities and complex medical needs in their graduation requirements.

Providing residents with the required clinicial training has been a strength of SLU's program since it started in 2017, said Dan Stoeckel, DDS, pediatric dentistry graduate program director at SLU's CADE.

"The variety of patients we see at SLU prepares our residents to be confident and skilled at working with all patients," said Stoeckel, who also directs pediatric dentistry at SSM Health Cardinal Glennon Children's Hospital and works in private practice at St. Louis Children's Hospital.

CODA fully accredits SLU's program, and it is the only pediatric dentistry residency program in eastern Missouri or southern Illinois. Residents admitted to the program serve children and adolescent patients with disabilities and complex medical needs in a clinical setting at CADE and in the operating rooms and emergency room at SSM Health Cardinal Glennon Children's Hospital.

"Upon completing the program, our residents are equipped with the clinical experience to tackle the oral health and psychosocial needs of vulnerable populations, ranging from those with blood disorders and cancer patients to those who have autism and Down syndrome," said Avanija Reddy, DMD, the associate program director at SLU's Cade. "Dental students and dentists specializing in pediatric dentistry seek this experience."

Residents at SLU learn to use non-pharmacological behavior management techniques, like modeling, as well as nitrous oxide and conscious sedation at the SLU clinic. When necessary, the residents perform dental care under general anesthesia at SSM Health Cardinal Glennon Children's Hospital. They also learn advanced diagnostic and surgical procedures, oral pathology, child-related pharmacology, radiology, child development, and oral or facial trauma management.

Physicians at the Danis Pediatric Center at SSM Health Cardinal Glennon Children's Hospital directly refer low-income patients from birth to age 12 years old to the pediatric dental clinic for regular cleanings and checkups. The clinic will accept patients with disabilities and complex medical needs referred by Cardinal Glennon up to age 21. The dental clinic is one of the few in the St. Louis Metropolitan area that accept Medicaid.