Page 14 - GP Spring 2018

Enabling Dentists to Care for Individuals with Disabilities
and Fulfilling Their Unmet Needs

By James R. Keenan, DDS, MS, MAGD
Despite fifteen years of consistent pursuit of continuing education, I never had the opportunity
to engage in any program that was both enriching for me and rewarding for others until this past
summer when I attended the Dental Education in the Care of Persons with Disabilities (DECOD)
Fellowship at the University of Washington in Seattle. I am in private practice in Brooklyn and
clinical assistant professor at NYU College of Dentistry, where I work in the Special Patient Care
(SPC) clinic. As such, I am a member of the Special Care Dental Association (SCDA). In March
2017, while I was attending the SCDA Annual Meeting in Charlotte, North Carolina, I met Dr.
Ashland Doomes who introduced me to the DECOD Fellowship. Although I have had a fair
amount of clinical experience with special needs patients through exposure in multiple nursing
facilities and a long term specialized care facility, I have not had any formal training in special
care dentistry other than as a dental student at a time when the program was not structured as it
is today. However, the most influential motivator for me to pursue the fellowship program was
based on the shared vision of Dean Charles Bertolami and Dr. Mark Wolf, Associate Dean for
Pre-doctoral Education, at NYU Dentistry which is to establish a facility that would expand the
scope of services presently provided and to reach out to an even larger population of individuals
with disabilities who have unmet needs.

Therefore, I thought that it would be very rewarding to apply for fellowship to expose me to
and provide me with the knowledge and skills that I could share with colleagues and students at NYU. I applied for the program and
completed it during two 2-week visits to Seattle. DECOD was established in 1974 and prides itself on providing dental treatment to
individuals with special healthcare needs and who are challenged in accessing care in their general communities, while preparing dental
professionals to fulfill those unmet needs. The DECOD program is currently under the direction of Dr. Kimberly Espinoza, DDS, MPH,
FADPD. There are approximately 4,500 dental visits annually at the DECOD clinic. Among those patients who visit the clinic are adults
with developmental and acquired disabilities. The developmental disabilities seen include intellectual disabilities, cerebral palsy, autism,
and Down Syndrome, whereas cerebrovascular accident, multiple sclerosis, muscular dystrophy, amyotrophic lateral sclerosis (Lou
Gehrig’s Disease), and traumatic brain injury are among the acquired disabilities.

By introducing dental professionals (dentists, hygienists, and assistants) to the patients in the clinic and providing supervised hands-on
involvement, the DECOD Fellowship instills the confidence in its participants to appropriately modify their approach to meet the needs
of their patients. Their objective is to expand the number of practitioners across the country that can confidently and comfortably fulfill
the dental needs of individuals with disabilities. The DECOD program provides strategies for communication along with strategies to
modify behavior and present adaptations that will be necessary to render safe and efficient care for this patient population.

The DECOD Fellowship is a four week program. However, there is flexibility in completing the program over multiple single week pe-
riods or double weeks at a time. I elected to complete the program over two 2-week periods that were two weeks apart to allow me time
to return to private practice and the clinic at NYU. The cost of the program is $1000 and requires two letters of recommendation along
with a personal statement discussing the applicant’s interest in the program
and how the experience will be applied. Upon successful completion of the
DECOD Fellowship, 100 CERP-approved participation hours are awarded
along with a certificate. This fulfills the requirements for the MAGD award
in special patient care (subject code 750) since a minimum of 12 participa-
tion hours is required.

More information about the program can be found at:
www.dental.washington.edu/oralmedicine/patient-care/decod-clinic

I would like to take this opportunity to commend Dr. Kimberly
Espinoza, Dr. Ashland Doomes and their team of Dalila, Juana, Ronda,
Mannie, Allan, Masako, and Robin for the patience and dedication they
have with their patients at DECOD. By sharing their knowledge and skills
with dental professionals like myself, we are able to provide an invaluable
service to individuals with special needs. I look forward to the realization of
the NYU Oral Health Center for People with Disabilities and hope to con-
tribute to its development, not only to provide dental care for its patients,
but also to establish a program which will potentially serve as a significant
source of training for dental professionals.

www.nysagd.org l Spring 2018 l GP 14