Research Spotlight: New Pediatric Disability Educational Program Starts this Academic Year
Note: This article, originally published on April 12th, 2023, was updated on December 5th, 2023 to reflect the latest status of the program.
GSDM was awarded a $1.5 million, five-year grant to develop a program to give predoctoral dental students more experiences caring for pediatric patients with disabilities as well as develop a new complementary training program for general dentists working in community health centers. As of this academic year, several components of the program will be fully implemented into the predoctoral curriculum, while the rest is still in development.
Dr. Breno Reboucas, the school’s director of predoctoral pediatric dentistry and a clinical associate professor of general and pediatric dentistry, is the principal investigator on the grant, which was awarded by the Health Resources and Services Administration (HRSA.) He said he is excited to have elements of this much needed initiative be introduced to GSDM students.
“The goal is [improving] care and increasing access to care for patients [with disabilities], and at the same time making our students competent and comfortable in treating patients [with disabilities] once they graduate,” Reboucas said of the program known as “Innovations in Pediatric Dentistry Special Needs Training.”
The term “special needs” captures a broad spectrum of mental, physical, and behavioral disabilities.
Dr. Keri Discepolo, GSDM clinical associate professor of pediatric dentistry and chair of pediatric dentistry, said the Council of Dental Accreditation (CODA) has identified disabilities and special healthcare needs as an area of need across all U.S. dental schools. According to Discepolo, CODA believes that predoctoral students lack familiarity, resources and confidence when it comes to caring for different medical conditions.
“The goal of the grant is to demystify some of the care and [give predoctoral students] the experience so they can feel confident caring for these patients out in the world,” Discepolo said.
Dr. Reboucas and his colleagues will use the grant to develop three complementary components related to treating pediatric patients with disabilities that will then be incorporated into an updated predoctoral curriculum. Additionally, they will work with the University of Massachusetts Medical School and Codman Square Health Center to create and implement a training program for community health center dentists.
The vision of the program is two-fold: improving the curriculum for predoctoral students to help raise awareness in the next generation of dentists and to train current dentists on specific skills and knowledge to improve care now.
For predoctoral students, Reboucas and his team are developing two modules: an interdisciplinary didactic module on disabilities, designed with support from the Autism Friendly Initiative at Boston Medical Center, that will be added to the current pediatric dentistry courses for third-year students and a video module that will assess students’ behavior-management and treatment-planning skills for treating patients with disabilities.
The interdisciplinary didactic module on disabilities was piloted in the spring 2023 semester with great reviews from students, Reboucas said. This didactic module will be fully integrated into the DMD3 and AS2 curriculum for the 2023-2024 academic year.
“[I am] excited that they liked it and they were able to see the perspective from [parents and other professionals from the Autism Friendly Initiative,]” Reboucas said.
The video cases for the modules were recorded in spring 2023 and are currently being edited. Reboucas said the goal is to add the video module as part of the DMD 4 and AS 2 rotations in the fall 2023 semester and use them as an additional tool to improve students’ behavior-management and treatment-planning skills for treating patients with disabilities. He noted that additional funds were secured from the HRSA in 2023 to adapt the case scenarios to be delivered remotely.
Outside of the classroom, there will be a new rotation for all predoctoral students that will take them to three clinical setting which includes two dental operatories within Codman Square Health Center’s pediatric medical clinic and a school-based oral health program within Franciscan Children’s Kennedy Day School for pediatric patients with disabilities. Reboucas said the enhancements of the current special needs and pediatric rotations are underway, and students will start participating in the new rotations during the fall 2023 semester.
Reboucas said the new rotation will increase both the amount of time and the number of patients with disabilities with whom students work, boosting students’ confidence once they leave the educational setting. He said the enhancements of the current special needs and pediatric rotations are underway, and the goal is to have students participating in the new rotations starting in the fall 2023 semester.
“[It’s about becoming] more comfortable in treating patients with disabilities, or even sometimes just trying to figure out what the need is and where to send those patients [if they needed to be referred],” Reboucas said. “Sometimes those patients don’t even enter the system because there is no one willing to assess them.”
The second part of “Innovations in Pediatric Dentistry Special Needs Training” focuses on practicing dentists in community health centers. Reboucas said his team is working with the University of Massachusetts Medical School and Codman Square Health Center to develop a training program that will provide tailored skills and knowledge to current dentists to later implement in their workplaces.
Retraining current practicing dentists can alleviate barriers to accessing care for patients with disabilities, Discepolo said, as a licensed dentist with the right skillset can accept a new patient and provide treatment right away.
“Getting those practitioners prepared or feel as if they’re capable of caring for these patients would obviously help to alleviate some of the access to care faster than training students,” said Discepolo, noting that predoctoral students, depending on where they are in the program, may not be able to take on their own patients for three years or more.
Eventually, Reboucas said he wants to expand the training program for community health center dentists into a standardized referral system for healthcare centers across the state for patients, both pediatric and adult, with disabilities.
“Part of the goal is not only to educate the next generation of dentists, but also the people who are practicing but didn’t have the experience of treating those patients before,” Reboucas said. “And now hopefully, we’re going to give them the tools that will make them a little bit more comfortable treating those patients, or that, or if they’re not comfortable, they would at least know where to refer and when to refer, so the patients would get the care that they need.”
Not only does Reboucas want to enhance disability treatment education, but he also hopes to work towards reducing disparities in oral health and increasing access to care for those with disabilities. He said there are numerous studies showing that patients with disabilities have increased susceptibility for poor oral and general health outcomes.
“People are looking for places to send their patients with disabilities, looking for professionals that are comfortable treating them and seeing them,” Reboucas said. “The barriers to care for that patient population is so high. Their dental health is only a tip of the iceberg…”
By the end of the five-year grant, Discepolo said she hopes the program will be successful in giving GSDM students sufficient special healthcare needs training to feel confident utilizing their skills in their future professional settings.
“[The hope is to] have these predoctoral students come out of their training feeling like they can take on a few patients with disabilities in their practice,” Discepolo said. “Maybe their whole practice is not about special care, but they see it as any of the other types of procedures do. You take care of someone who needs a root canal, take care of someone who needs dentures, you know, also have in your toolbox the ability to take care of someone who maybe needs alternative care.”