Innovation in Special Needs Dentistry

There is a crisis in special needs dental care, with patients in some cases waiting years and often having to travel long distances to see a dentist who can accommodate them. For patients and caregivers, this can lead to increasing stress with declining oral health and other complications. For dentists who are prepared to accommodate these patients, it is a tremendous opportunity to both build a practice and have an impact on the community.

• Only 69% of dentists treat patients with disabilities, and some studies have found that between 50% and 75% of people with disabilities have had some level of difficulty receiving dental care.
• Some of these patients are also more prone to poor oral health due to habits such as teeth grinding and clenching, food pouching, and tongue thrusting.  
• When dental care is not easily accessible, patients and caregivers often need to take time off of work to travel for care.

Since 2021, I have built a practice focused on serving patients with special needs, disabilities, and children. While I offer a range of sedation options, one of my most valuable tools has been the Solea^® All-Tissue Laser, a 9.3-micron CO₂ laser that allows me to perform most procedures with little or no local anesthetic. That means minimal use of needles and generally no sound of the drill for cavity preps. I have also been able to perform more soft tissue procedures with virtually no bleeding and fast healing times. 

Solea has been a game-changer when it comes to putting patients and their caregivers at ease, and it has allowed me to treat patients who had refused treatment at other clinics. I can also perform multi-quadrant, same-day dentistry, allowing me to get more done in a single appointment. Since adopting laser dentistry, my practice added an average of 100 new patients each month until we ultimately had to stop accepting new patients. 

By focusing our practice on treating patients with special needs, we have been able to build trust and grow our practice. Working with the Solea laser has contributed to this growth in several important ways:

Reduced need for sedation:

I offer all types of sedation in my office, but one of the biggest benefits of using the Solea is that sedation is less necessary. For example, with Solea, a patient who previously might have required deep sedation may only need oral sedation. A patient who would have previously needed oral sedation may only need nitrous when using the laser. And some patients may not need any sedation at all. Pediatric patients absolutely love the idea that they can receive their treatment without a “pinch.”

One patient in particular worked himself into a near panic before his appointment by looking up anesthesia online. When he learned I had a piece of equipment that would allow me to treat him without numbing, I won him over. Now, he is not afraid of the dentist anymore.

Increased safety:

There is a risk in using a traditional dental drill with some special needs patients who have high anxiety, sensory processing or movement disorders. When a dentist takes their foot off the rheostat, the burr does not stop right away, but continues spinning. That can lead to injuries for the patient or for dentists and their staff. With Solea, as soon as I take my foot off the pedal, the laser stops. Even if I do accidentally hit soft tissue with the laser, it will not cause damage like a drill would.

Enhanced efficiency:

Prior to adopting the Solea, we would often have patients come in for an appointment only to refuse anesthesia, and as a result, we would have to send them home. This created delays in treatment and made scheduling more complicated. Now, because we anesthetize patients less often, we do not run into that challenge.

Expanded capabilities:

When patients have special needs or disabilities, it can be particularly difficult for them to see unfamiliar practitioners to address their different oral health needs. Given the shortage of providers prepared to offer care to these individuals, identifying options for multiple procedures can be difficult or impossible. 

With Solea, I am now able to perform a variety of soft tissue surgeries, including frenectomies. I do more gingivectomies and operculectomies and have been removing fibromas and papillomas with the laser. This has allowed me to expand my practice while also improving the treatment experience for my patients. 

There is a tremendous need for special needs dental care. And while treating special-needs patients can be intimidating, the right preparation, attitude, and technology can open the door to business growth and the reward of knowing your practice is making a difference.

About the author
Dr. Laura Holena owns Special Care Smiles in Wilkes-Barre, PA and spent 12 years in a group practice for special-needs patients before opening her clinic. A graduate of Penn State University and the University of Buffalo Dental School, Dr. Holena is currently President-Elect of the Special Care Dentistry Association (SCDA) and a board member of the Academy of Dentistry for Persons with Disabilities.