Dental care for disabilities inadequate, say advocates, family members

The head of one of B.C.'s largest autism support networks says the province's dental care system is not meeting the needs of people with severe disabilities.

Autism Training Community executive director Deborah Pugh says not enough dentists are trained to deal with the specific challenges of severely disabled adults.

"It's a clearly disproportionate and discriminatory approach to health care," she said.

'People with autism just do this'

Severe autism means patients like Graeme Rush need general anaesthetic for even the most routine procedures, like taking an X-ray, filling cavities or cleaning teeth.

But the 27-year-old's parents say they've struggled to find him care.

At one point, Joan and Dennis Rush say their son was hitting his face and his ears in pain.

But when they took him to a specialty dental clinic at Vancouver General Hospital, they say the dentist dismissed the need for an X-ray.

"The dentist there said don't come back. It's not his teeth," said Joan Rush. "She said people with autism just do this. They hit themselves."

The Rushes say they went back to the dental clinic after Graeme woke up screaming in pain. The dentist found two abscessed teeth and another 15 in need of repair.

Difficulty communicating pain

Pugh says the Rushes' plight isn't unusual.

"Having the option of a general anaesthetic is an important option, but one that's denied for many children and adults with autism in terms of getting prompt care," said Pugh.

She says people with severe cognitive disabilities often can't communicate pain or discomfort.

"What you'd need almost invariably for an adult with significant developmental disabilities is a very skilled level of dental service," Pugh said. "I think what happens often is you don't get it."

Dentist Anita Gartner says she was motivated to treat patients with special needs because she has family members with disabilities.

She thinks dentists should have more training in school to work with people who have cognitive or physical disabilities.

"I think a lot of it is exposure and maybe fear of the unknown," Gartner said.

She says the problem is compounded by wait lists for the operating time necessary to carry out procedures using general anaesthetic.

"My hands are often tied because I face long waiting lists," she said.

Wait times up to six months

Vancouver Coastal Health says operating room time has quadrupled over the past two years, but Gartner says patients still have to wait up to six months.

Gartner says cost is also an issue for families of severely disabled patients. She does pro-bono work, otherwise government-funded programs only cover about 50 per cent of her fees.

"As a dentist you're a business person but you're also a caregiver," she said.

In a written response to CBC, the Ministry of Social Development and Social Innovation said adults receiving disability assistance are provided $1,000 every two years for basic dental care.

An additional $1,000 annual coverage is provided when dental services are required to be performed under a general anaesthetic. 

To listen to the full interview with the Rushes, click on the audio labelled: Joan and Dennis Rush describe their son's dental nightmare