Beyond the Care Cliff: Advancing Special Care Dentistry Through Pediatric Dentistry

Abstract: The shift from adolescence to adulthood is especially risky for people with special health care needs, who often lose pediatric-based services and struggle to find adult dentists prepared to treat them. Because pediatric dentistry programs hold most of the profession's expertise in caring for these patients, they are well positioned—ethically and clinically—to lead solutions. This review argues that they must help build advanced training pathways in special care dentistry (SCD) to ensure providers can manage adolescents and young adults who need general dental care. Current Commission on Dental Accreditation (CODA) standards for pediatric and advanced general dentistry programs do not require competence in treating transitioning patients, leaving major training gaps and contributing to provider reluctance to treat patients with special health care needs. We outline strategies including new educational models within pediatric programs, dedicated SCD fellowships, and policy changes for CODA, aiming to create a sustainable system in which patients receive continuous, age-appropriate care.