Transforming Lives: In-Hospital Dental Care for Adults with Disabilities

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A Collaborative Effort to Bring Dental Care to the Special Needs Community in St. Louis

Photo by Matt Miller, Video by Huy Mach

Sallye Holland beams with pride as her daughter, Cassandra, enjoys a pain-free smile after receiving life-changing oral surgery through the Special Needs Dental Surgery Program, a groundbreaking collaboration in St. Louis.

For many individuals with severe physical, mental, or developmental disabilities, dental care can seem like a distant dream. Undergoing necessary procedures often requires general anesthesia, a service that is not only hard to come by but also incredibly costly. The consequence? Routine dental care slips further out of reach, leaving many with decaying teeth, painful gums, and a struggle to eat, speak, and live their lives to the fullest.

But hope is on the horizon! A transformative program has been launched in the St. Louis area, thanks to the dedicated efforts of a coalition that includes a leading dental school, a community health organization, and prestigious hospitals. This initiative focuses on providing specialized dental care under general anesthesia for patients with severe disabilities, ensuring that they receive the treatment they truly deserve.

“In the St. Louis area alone, over half a million individuals are living with disabilities, but finding a dentist that can cater to their needs is a Herculean task,” explains Dr. Robert J. Schmidt, a key player in this initiative. “This program opens doors for those who have been unable to get the dental care they need, offering them a chance at a healthier, brighter smile.”

Since its pilot launch in the fall of 2021, this program has quickly evolved into a vital resource for the community. With the help of Affinia Healthcare, a nonprofit committed to serving underserved populations, the initiative connects those in need with essential services at Barnes-Jewish Hospital.

Twice a month, one operating room is set aside to provide care for special-needs patients, staffed by a skilled team from ATSU-MOSDOH, Washington University, and Barnes-Jewish Hospital. The hospital has invested in state-of-the-art specialized equipment, ensuring that each patient receives the highest standard of care. And here’s the exciting part: these services are often covered by Medicaid, making them accessible to those who need them most.

“This pioneering partnership is a game changer for individuals with special needs,” says Dr. Dwight McLeod, dean of ATSU-MOSDOH. “We offer not just dental care, but a compassionate approach that prioritizes the dignity and respect of our patients.”

This collaboration is part of a larger mission to ensure that every resident of St. Louis, regardless of their circumstances, has access to quality dental care. The St. Louis Dental Center was established in 2015 to address the dire shortage of dental services for vulnerable populations, and since then, it has expanded its capabilities to meet the unique needs of special-needs patients.

“Patients often face long wait times in emergency rooms due to the nature of their conditions,” explains Dr. Jackie Martin Jr. from Barnes-Jewish Hospital. “Before this program, many were left without adequate care, often forced to travel long distances for specialized services. We knew we had to act.”

Dr. Alan Freeman, CEO of Affinia Healthcare, emphasizes the significance of this program: “This is more than just a service; it’s a monumental leap forward in advocating for our most vulnerable populations.”

Patients needing dental care under general anesthesia encompass a wide spectrum of challenges—from communication barriers due to developmental disabilities to physical restrictions caused by medical conditions. The complexity of their needs requires a highly coordinated, multidisciplinary approach that only a fully equipped hospital can provide.

“These are patients with significant hurdles to accessing treatment,” says Dr. Ivan Kangrga, an anesthesiology professor. “Being part of a team that provides top-notch care for this often-overlooked population fills me with pride.”

Due to the intricacies of treatment, this program can only accommodate a limited number of patients each day, and the waiting list continues to grow as word spreads. “We’re adding one or two new patients weekly, many of whom are in severe pain,” says Dr. Schmidt. “It’s disheartening to have to turn families away, but we are committed to expanding our reach and providing care for those who need it most.”