Examining Dental Care Transition for Individuals with Intellectual and Developmental Disabilities in North Carolina: A Qualitative Study

BACKGROUND The aim of this qualitative study was to examine the barriers to care for individuals with intellectual and developmental disabilities (IDD) in North Carolina when transitioning from a pediatric to general dentist. METHODS Semi-structured interviews were conducted with invested parties: IDD individuals’ families (n = 19), pediatric and general dentists (n = 9), and access to care experts (n = 3). Families were identified with email and social media postings via partnerships with IDD advocacy and research groups. A traditional content analysis was used to identify prominent themes among each group. Interviews were conducted until conceptual depth was obtained. RESULTS All parties agreed that many critical barriers exist regarding dental care transition for IDD populations. Families reported barriers including low provider comfort, low Medicaid acceptance among providers, and traveling far distances to see willing providers. Providers suggested that financial constraints and ill-equipped offices contribute to an inconducive environment for transition. Access-to-care experts reported limited special-needs education within dental school curricula, poor workforce distribution, and offices’ discriminatory practices for accepting patients as system-level barriers to transition. LIMITATIONS While the goal was to include all, not every IDD condition is represented in this study. Themes and barriers represented in this study are very likely transferable to other IDD populations. Additionally, inclusion criteria included those who attempted transition many years ago; however, the barriers they experienced are identical to those who transitioned more recently. CONCLUSIONS Individuals with IDD currently face significant barriers when attempting dental care transition. This study highlights several areas that can be addressed for improved transition, most notably improved dental school education and reimbursement rates. This study also finds that many adults with IDD currently lack proper access to dental care. The transition between a pediatric and a general dentist is a pivotal moment where many lose coverage. Addressing barriers to care can improve oral health care access for this vulnerable population.