Research Supporting Better Access to Dental Care for People with Intellectual and Developmental Disabilities
People with intellectual and developmental disabilities (IDD) continue to face significant barriers to routine dental care. For many, sensory sensitivities, anxiety, communication differences, and difficulty tolerating dental procedures can contribute to delayed treatment and increased reliance on sedation or general anesthesia.
A growing body of research supports the use of preparation, desensitization, behavioral strategies, visual supports, sensory adaptations, and caregiver and provider training to improve dental experiences and expand access to care.
The Sedation Bottleneck
The Sedation Bottleneck explores the challenges people with IDD can face accessing dental care and summarizes research into approaches that may improve cooperation, increase tolerance of dental procedures, and reduce barriers to routine care.
The research highlighted in the video is part of a broader evidence base spanning randomized controlled trials, behavioral interventions, cohort studies, systematic reviews, clinical guidelines, and public health programs.
Evidence & Sources
Randomized & Controlled Studies
Isong 2014 – Video modeling pilot RCT
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Cirio 2022 – Visual pedagogy RCT
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Cermak 2015 – Sensory-adapted environment pilot
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Stein Duker 2023 – SADE crossover RCT, JAMA Network Open
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Altabet 2002 – Desensitization in severe/profound ID
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AlHumaid 2016 – D-TERMINED, GA referrals 14% vs. 45%
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Pastore 2023 – Supported pathway, GA use measured
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Corridore 2026 – ESBA, GA use measured
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Single-Subject / ABA
Conyers 2004 – Desensitization vs. video modeling
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Cuvo 2010 – Oral assessment compliance package
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Carter/Luiselli 2019 – Graduated exposure at school
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McMullen 2017 – Prediction + desensitization case
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Orellana 2014 – TEACCH-based structured teaching
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Nguyen/Lerman 2025 – Telehealth model, adults with sedation history
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Remote BST for Dental Providers 2022
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Cohorts / Case Series
Nelson 2017 – UW, 168 children, 87.5% exam ≤5 visits
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Yost 2019 – UW two-year follow-up, 22% GA
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Star 2023 – UCSF prospective cohort
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Castaño Novoa 2024 – Autistic adults, OT + dentist
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Lefer 2019 – iPad visual schedule
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Structured-Visual Model 2025 – Indonesia
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POV Video Modeling + Desensitization 2026
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Case Report – Treatment without sedation/GA
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Michigan Dental Association Case
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Cai 2022 – Parent perspectives
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Programs / Policy / Medicaid
California Legislative Analyst’s Office 2018 Report
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Calvo/Glassman 2022 – UCSF model + “shorten the line”
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Williams/Glassman 2023 – Shortening-The-Line
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California AB 2510 Analysis
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California AB 316 Bill Text
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The Arc California on AB 341
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Alta California Regional Center Presentation
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Medi-Cal Dental General Anesthesia Report – CY2018
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MACPAC 2025 – Adult I/DD dental access
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ASC vs. Hospital Cost for Dental Surgery in Children with Developmental Disabilities
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National Council on Disability Fiscal Analysis
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Texas Health Institute Cost Analysis
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Systematic Reviews / Meta-Analyses
Lam 2024 – Behavioral therapies meta-analysis
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Lam 2025 – Oral health outcomes meta-analysis
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AlBhaisi 2022 – BMC Oral Health systematic review
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Dental Adaptation Strategies 2024 – Systematic review of RCTs
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Kupzyk & Allen 2019 – IDD medical/dental routines
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Mac Giolla Phadraig 2020 – Behavior change techniques
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Newton 2009 – Restrictive management in ID
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BMC Pediatrics 2023 – Anxiety management systematic review
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SADE for IDD 2023 – Systematic review/meta-analysis
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Scoping Review 2022 – IDD healthcare/hygiene
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Erwin 2022 – Access for autistic children
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Oral Care Interventions 2024 – Systematic review
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JoVE – Non-pharmacological meta-analysis
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Hernandez & Ikkanda 2011 – ABA in dentistry, JADA
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Nelson 2015 – Educational/behavioral approaches
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Goyal 2023 – Special Care in Dentistry
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Clinical Guidelines
American Academy of Pediatric Dentistry – Behavior Guidance
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American Academy of Pediatric Dentistry – Management of Dental Patients with Special Health Care Needs
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American Academy of Pediatric Dentistry – Deep Sedation/General Anesthesia Policy
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This resource library includes independent research, clinical guidance, and policy resources related to dental access and care for people with intellectual and developmental disabilities. Unless specifically noted, the studies and resources listed above did not evaluate the Dental Desensitization Systems program or DDS Kit.