Across the healthcare industry, acceptance of the “mouth–body connection” is growing. Research reinforces that what happens in the mouth directly affects the overall health of the body.
As awareness about this dynamic grows, and as people increasingly acknowledge and prioritize their oral health, individuals with special needs or those who face barriers to seeing a dentist are often overlooked. Patients on the autism spectrum or who have sensory sensitivities often struggle with regular dental visits, especially if their local dentist is unaccustomed to treating patients with these needs. As a result, people with autism are significantly more likely to experience periodontal disease. Recent literature has shown that more than 86% of individuals with severe autism have gum disease1 and a 57% higher risk of developing diabetes.2
Inflammation in the mouth, if untreated, can lead to inflammation in the body as bacteria travels from the mouth to the bloodstream. Specifically, Porphyromonas gingivalis has been found in tissue samples and spinal fluid of individuals with Alzheimer’s disease.3 Growing research finds that heart disease and diabetes are also linked to poor oral health. Patients with Down syndrome are four times more likely to have diabetes4 and often develop gum disease starting in their teens, putting them at greater risk of serious conditions like heart disease and early-onset Alzheimer’s.
These factors make the gaps in access to care for this population all the more troubling. There are, however, some simple ideas that the dental industry and dental offices can easily implement to help address this gap and reduce the threat of these conditions for the special needs population.
Leverage Medical History
In recognizing the mouth–body connection it is important to take a holistic approach that integrates dental and medical health to gain a better understanding of the patient. Dental–medical integration is expanding, but for underserved populations like the special needs community the dental industry is still behind.
Many families of patients with special needs often face difficulties managing simple dental visits, making it even tougher to compile a comprehensive snapshot of the patient’s overall health. At the Dentists for Special Needs office in Phoenix, Arizona, there is a clinical focus on engaging with patients and their families to obtain a thorough medical history.
Research shows that patient engagement influences the experience and delivery of care. Patients with special needs and minority patients may be more likely to have lower rates of preventative services and suffer delays in diagnosis due to lack of communication and awareness.5 To provide equitable care, clinicians are responsible for communicating effectively across a broad range of patients with varying degrees of health literacy. Practices should consider services for translation and sign language interpretation so that each patient and their family understands the patient’s health condition in a clear and concise manner.
Similarly, a thorough medical history needs to be completed for dental appointments. Doctors at the Dentists for Special Needs office work with families and caregivers to collect details about a patient’s past diagnoses and treatments, their current medications, allergies, and surgical history, as well as family medical history. Knowing if a patient is predisposed to conditions like diabetes can help tailor the appointment or treatment needs with a preventative approach. Dentists can intervene regarding potentially serious conditions before they become chronic, especially considering the increased susceptibility to periodontal disease among the special needs population.
Spending time educating parents and caregivers on proper oral hygiene techniques by introducing adaptive toothbrushes and demonstrating effective brushing methods can significantly improve oral home care. Some patients may benefit from prescription toothpastes and mouthrinses that can also enhance their overall health outcomes.
Incorporate Education and Training in Dental Schools
A frequent comment heard from families is that dentists and clinicians are not comfortable treating patients with special needs. It’s not that they don’t want to, but they may lack confidence in their ability to provide adequate care.
When clinicians are exposed to the idea of treating patients with different needs early in their education, it may make them more comfortable and open to treating these patients should they walk through the door of their private practice. Dental schools must make a greater effort to outline general strategies for treating patients with special intellectual and developmental needs who might struggle in a traditional medical office environment. This can help ensure that patients and their families are not turned away.
The Dentists for Special Needs office provides basic education and training, partnering with schools and organizations to help host service events and offer educational training with the goal of increasing clinicians’ awareness of and comfort and confidence in providing more accessible treatment.
The University of the Pacific’s Arthur A. Dugoni School of Dentistry, which is one of Pacific Dental Service Foundation’s partners, has been teaching students strategies for effectively treating patients with intellectual and developmental disabilities. The school’s curriculum includes behavioral management techniques, instruction on spending time building rapport and gaining a patient’s trust, and introducing ideas to make the appointment more comfortable for the patient, such as dimming the operatory lights or adding a weighted blanket. These are simple concepts to help dentists set the stage for a successful visit.
Conclusion
While tremendous progress has been made for patients with special healthcare needs, much work is still needed to bridge the gap in access to care and to expand education and treatment rooted in the mouth–body connection. Often, all it takes is offering a few additional options and allowing a little more time and patience. People with different needs should not experience a heightened health risk because of lack of access. As the importance of the mouth–body connection becomes clearer across the dental and medical industry, taking small steps to accommodate the special needs community can make the difference in identifying a potentially serious condition before it becomes chronic.
About the Authors
Michael M. Le, MBA, JD
Executive Director, Pacific Dental Services Foundation, Irvine, California
Beatriz Adame
Operations Manager, Dentists for Special Needs, Phoenix, Arizona
Kayla Erps, DDS
Dentist, Dentists for Special Needs, Phoenix, Arizona
References
1. Berbé L, Machouart M, Luc A, et al. High prevalence of periodontal disease and periodontopathogen colonization in adults with autism spectrum disorder: a pilot study. Front Microbiol. 2025;16:1552656.
2. Dhanasekara CS, Ancona D, Cortes L, et al. Association between autism spectrum disorders and cardiometabolic diseases: a systematic review and meta-analysis. JAMA Pediatr. 2023;177(3):248-257.
3. American Academy of Periodontology. Periodontal disease bacteria linked to Alzheimer’s disease. AAP website. January 28, 2019. https://www.perio.org/press-release/periodontal-disease-bacteria-linked-to-alzheimers-disease/. Accessed June 19, 2025.
4. King’s College London. Children and young adults with Down Syndrome four times more likely to have diabetes. King’s College London website. October 5, 2022. https://www.kcl.ac.uk/news/children-and-young-adults-with-down-syndrome-four-times-more-likely-to-have-diabetes. Accessed June 19, 2025.
5. Krist AH, Tong ST, Aycock RA, Longo DR. Engaging patients in decision-making and behavior change to promote prevention. Stud Health Technol Inform. 2017:240:284-302.
