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Special Care for Special Athletes

Dental school puts teeth in a much-neglected problem


In the slide show above, School of Dental Medicine students, faculty, and alums screen Special Olympics athletes for dental problems.

Research has shown that people with intellectual disabilities are more likely than others to have untreated health issues like tooth decay, poor vision, or hearing problems. One reason for that may be that a large majority — 81 percent — of medical school students report that they aren’t properly trained to work with patients who have intellectual disabilities.

Last Saturday, students from BU’s Goldman School of Dental Medicine took part in an event that is likely to remedy both sides of the problem: they offered free dental screenings to athletes at the Massachusetts Special Olympics Summer Games, held at BU’s Track and Tennis Center and at Harvard University.

School of Medicine ophthalmology students also volunteered, performing vision screenings with Jean Ramsey and David Moverman, both MED faculty members. The group worked collaboratively on the screenings with a team from the New England School of Optometry and made recommendations for follow-up eye care. They even consulted on an athlete with minor ocular trauma from sunblock inadvertently getting in his eyes. Other students from Boston-area medical schools examined the athletes’ hearing and general fitness — all part of Special Olympics Healthy Athletes program.

The dental component, Special Smiles, gave the athletes a dental screening, oral health information, instructions on proper brushing and flossing, and supplies like electric toothbrushes and mouth guards. SDM had 35 dental students volunteer for the program; they collected dental health data from 285 athletes, which will be used to study patterns of Special Olympics athletes’ health around the world.

The Special Smiles program was founded in 1993 by Steven Perlman (SDM’76), an adjunct clinical professor of pediatric dentistry at SDM, who now serves as the program’s global clinical advisor.

It all started, Perlman recalls, with a call from the late Eunice Kennedy Shriver, the founder of Special Olympics. Shriver’s intellectually disabled sister, Rosemary Kennedy, who had had a failed lobotomy in 1941, was suffering from dental problems.

“Rosemary was in her 60s at the time, and she was afforded the best medical care that money could buy,” Perlman says. But her doctors recommended removing all of her teeth because she had tooth decay. “Her guardians were Ted Kennedy and Eunice, and when they searched for a second opinion, they found me. I restored everything in her mouth, and for the rest of her life she had no other dental problems.”

“I remember Eunice saying that if her sister was having problems, what about poor people?” says Perlman. “She flew me to meet with her, her husband, Sargent Shriver, and Dr. Bob Cooke, and we talked about the lack of good health care for people with intellectual disabilities.”

Shriver and Perlman decided to use Special Olympics, established in 1968, as a vehicle to deliver the much-needed care. Special Smiles was established in 1995 by Perlman and his fellow dentists at BU, the first of seven Healthy Athletes initiatives.

Today, more than 150 Special Smiles events take place each year all over the world. For his work, Perlman has received the Let Me Be Brave lifetime achievement award and the Special Spirit in China Award of Excellence.

“We want to change attitudes,” says Perlman. “At most medical schools, students are not exposed to these patients. The attitude is the most important thing. We hope that by these students volunteering, they’ll learn a little more.”

“A lot of people take brushing teeth for granted,” says Amit Patel (SDM’12), who volunteered for the first time Saturday. “It takes a lot of manual dexterity. Sometimes you see people with intellectual disabilities who brush too hard and as a result wear down their teeth. Their gums begin to recede or their teeth become really sensitive.”

“This population has a huge need for access to care,” says Paul Farsai (SDM’94,’95, SPH’97), an SDM associate professor of dentistry. “Working with people who have intellectual disabilities needs to be integrated more into the curriculum. This event is great because it opens our students’ eyes.”

Amy Laskowski can be reached at amlaskow@bu.edu; follow her on Twitter at @amlaskow.


2 Comments on Special Care for Special Athletes

  • Anonymous on 06.24.2010 at 3:00 pm

    What a Wonderful Idea and Legacy

    This is such a wonderful idea! When I first got out of college, I worked with intellectually disabled adults for a few years and helped with their participation in the Special Olympics. I saw first-hand how important oral hygiene was, and the limitations of the athletes, and also the staff who worked with them. One of my colleagues would brush Glenn’s teeth until his gums bled, because she thought that was a sign of a thorough cleaning. He ended up having a tooth pulled, and I always wondered if we could have done something to save the tooth, instead.

    Clinics like this help the athletes and those who care for them.

  • Anonymous on 07.06.2010 at 12:21 pm

    I'm not a Dental Hygenist ...

    My wife is a Dental Hygenist who has worked with many special needs patients. It takes training not only to treat someone effectively, but to say “this patient cannot be treated today.”

    Some of these patients will get it into their heads they are an animal and attempt to bite. The risk of sroke and heart failure is often larger than the general population. The risk of slicing a tongue ot gums of a patient who can’t, or doesn’t know how to hold still is very real. Even the texture and resiliency of their soft tissues may be unusual.

    I applaud encouraging Dental professionals to work with the Special Olympics patients. I also can’t fault any dental practice for not wanting them as regular patients – because they aren’t regular patients – they are patients with special dental care needs.

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