11 July 2023

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Delta Dental of Tennessee introduces enhanced special needs benefit

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To help expand access to dental care for individuals with special health care needs, Delta Dental of Tennessee announced on June 28 that it is introducing enhanced benefits and a new training program for providers. Beginning Jan. 1, 2024, children and adults with special health care needs will have access to expanded benefits through the Delta Dental network.

Dental care is often cited as the greatest unmet health care need facing individuals with intellectual disabilities. At Niswonger Children’s Hospital in Johnson City, Tennessee, dental care is frequently the reason that children with intellectual disabilities are admitted into the hospital, a fact that concerned Chris Jett, Niswonger’s CEO.

“Dental care is critically important to overall health, but rarely is a hospital the best place to receive that care,” he said in the news release. “Unfortunately, however, there are instances where we see children with intellectual disabilities that need to utilize the hospital to receive anesthesia or other care not accessible to them in a dental office,” said Jett. 

The enhanced special health care needs benefit will cover additional consultations to help patients learn what to expect prior to treatment. The benefit will also cover up to four dental cleanings in a benefit year and treatment delivery modifications necessary to care for patients with sensory sensitivities, behavioral challenges, severe anxiety or other barriers to treatment.

There is no age limit for the coverage, which aligns with the American Academy of Pediatric Dentistry’s definition of special health care needs. These benefits will be available with Delta Dental of Tennessee’s Individual & Family Plans and with all fully insured clients effective next January. Self-insured clients will have the opportunity to opt-in for these benefits for contracts already in service.

Delta Dental first announced its plans on June 17 at First Horizon Park in advance of the “Smile Power” Nashville Sounds game. The press conference featured remarks from Adam Germek, president and CEO of Special Olympics of Tennessee, who highlighted the work of the organization’s Special Smiles program, the dental health division of Special Olympics Healthy Athletes.

Special Smiles provides comprehensive oral health information and instructions, free dental screenings, and preventative supplies including toothbrushes, toothpaste and fluoride varnish. Delta Dental is a longtime supporter of Special Smiles in Tennessee. Since its inception, Special Smiles has conducted more than 5,000 dental screenings across the state, including 500 in the last year alone, to help athletes feel and compete at their best level.

“Access to dental care is a real and critical need,” said Germek in the news release. “For every 10 athletes on a Special Olympics team, we know from our screenings that four have untreated tooth decay, and one or two need urgent dental care. “We are grateful for the leadership and longstanding support of our friends at Delta Dental and their commitment to reducing barriers to care for all Tennesseans.”

In September 2022, Special Smiles partnered with Meharry Medical College’s mobile dental unit to provide dental screenings and on-site interventions when needed for athletes competing at the state golf tournament for the first time. AJ Lawhorn, a 34-year-old golfer from Pigeon Forge who represented Team Tennessee at the 2022 USA Games, was among the athletes who received dental care through the mobile clinic.

Lawhorn’s mother, Shirley, said that the family has at times struggled to find providers who have the proper training to care for individuals with special health care needs. The family sees the one dentist near their home who will treat AJ and another family member, Mike Sweet, who also has special health care needs and is active with Special Olympics.

“The mobile dental clinic was a great experience – I wish they were everywhere,” she said. “We need more dentists and doctors who are willing to work with special needs patients and are not afraid of them.”

To help dentists better understand and care for patients with special health care needs, Delta Dental has made a series of professional development programs hosted by the University of Pennsylvania’s Dental Medicine program available at no charge to any dentist or support staff member. Providers completing 18 or more courses within three years will receive a Disabilities Dentistry Clinician Expert designation.

There is emerging evidence that with greater provider training and awareness, a different and safer way of caring for individuals with special health care needs is possible.

The dental program at Ohio State University’s Nisonger Center, an interdisciplinary care, education and research center that aims to improve the lives of individuals with intellectual and neurodevelopmental disabilities, provides one example. While all their patients are referred in for treatment under sedation, they are ultimately able to provide care for 80% of their patients without any type of modification, says Dr. Stephen Beetstra, the Center’s dental program director.

“Using a psychological approach to manage this population is not something we learn in dental schools,” said Beetstra. “Providing quality care to patients with intellectual disabilities takes time, training and resources that very few dentists have today. We need to understand and develop the skills to enjoy their humanity and idiosyncrasies which often makes working with this population so rewarding.”

About Delta Dental of Tennessee

Delta Dental of Tennessee is the state’s largest independent dental benefits carrier with 1.4 million lives covered. As part of the Delta Dental Plans Association, Delta Dental of Tennessee members have access to the largest dental network in the nation with more than 154,000 providers serving more than 443,000 locations.

With the simple mission of ensuring healthy smiles, Delta Dental of Tennessee works hard to help members of the communities it serves. Along with its corporate foundation, Smile180, Delta Dental of Tennessee donated more than $5.4 million in funding and in-kind services to over 110 organizations in 2022.