Dr. James Scapillato, of Family Dental Care Oak Park, has treated over 3,000 special needs patients in his almost 50 years as a practicing dentist. Now, he is leading a campaign to see March 3 recognized nationally as the “Special Needs Day of Dentistry.”
The campaign is meant in part to bring awareness to the lack of service being provided to patients with special needs. Finding a dentist equipped to not only work on teeth, but one also able to provide services in a way that accommodates particular needs, can be incredibly difficult.
“I’m still getting families who are finally finding me,” said Scapillato. “They’ve many times called multiple offices and had no luck because the dentists are not trained or comfortable working on their special needs relative.”
And once a capable dentist is found, the special needs patient may not be able to immediately see the doctor. Some have to wait as long as a year or even two for an appointment. This makes the situation particularly difficult considering people are advised to have their teeth cleaned by a dentist twice a year.
Professional dental cleanings may be needed more often than once every six months for those people who cannot hold a toothbrush, according to Scapillato.
“Or sometimes it’s just an intrusion on their space, which is common with people with autism,” he said. “Some of them are not very comfortable with you even touching them, let alone you trying to work in their mouth.”
Oak Park Village Trustee Susan Buchanan and her son are patients of Scapillato’s. Her son started to see Scapillato when he was around five years old. At the time, his sensory sensitivities and anxiety was such that neither she nor her husband had tried to take him to see a dentist before.
Over a period of visits, Scapillato was able to build trust with his young patient, teaching him how to care properly for his teeth. Now 17, he and Scapillato go together like toothpaste and a toothbrush.
“They’re best buddies,” Buchanan said. “My son loves Dr. Jim.”
Maintaining personal hygiene can be a problem for people with autism due to extra sensory perception, according to the National Autistic Society, but oral hygiene can impact a person’s overall health. Poor dental care can lead to certain forms of cancer, heart disease, diabetes and dementia, making it critical for all people to take care of their mouths and teeth.
In promoting “Special Needs Day of Dentistry,” Scapillato hopes one day to have an internet database that will connect patients with special needs throughout the U.S. to dentists that have the capability to provide them care. Having that resource, he hopes, will eliminate lengthy wait times and reduce the stress associated with finding the right dentist.
The lack of services for special needs patients is caused by a combination of factors, Scapillato believes. Dental schools have only recently begun to incorporate special needs treatment into their training programs. Treating patients with special needs often necessitates a lot more time and staff than a visit to the dentist might otherwise require. Scapillato estimated that dental visits take about twice as long for those patients.
“You’re still only going to bill for the service you perform, but it’s taking you longer,” he said.
Scapillato doesn’t specialize in special needs dentistry in the technical sense, but he was exposed to it during his preceptorship at Advocate Illinois Masonic Medical Center in the 1970s. It was there he realized that most people who went to the hospital for dental care had special needs.
Now, he sees about 75 to 80 patients with special needs on a yearly basis. Those patients account for roughly 15% of his practice, but he makes adjustments to acclimate them to the dental examination setting. Much time is spent discussing oral health care with the patient’s family or caregiver.
The first visit is something of a meet and greet to identify what the patient likes and dislikes, as well as how the patient might react to certain things. The dentist also tries to at least look at the teeth during that initial visit, but there’s not necessarily always time to do a cleaning then.
“If we’re capable of taking x-rays, we will do so, but it’s usually limited because you’re putting this sensor in the mouth and you need them to hold still,” said Scapillato.
Oftentimes, they are unable to get x-rays done, but just getting the patient in for a cleaning can do a world of good in preventing cavities and tooth extractions.
There can be as many as four people in the examination room during one appointment.
Scapillato does the cleaning, while one dental assistant helps the doctor clean, and another holds the mouth props. A family member or guardian is often there to keep the patient calm and, if necessary, restrict their movements. That offers a more caring touch than physical restraints.
“I do not like to use restraints,” Scapillato said.
There is no special equipment. If a patient with sensory sensitivities wants to use headphones, Scapillato welcomes them to do so. He will also play music should the patient wish to listen. Once in a while, an anesthesiologist will be brought in to administer general anesthesia to a patient if a lot of work is needed to be done in one setting, but Scapillato prefers not to have to go that route if it can be avoided.
Scapillato approaches his work on a patient-to-patient basis, understanding that no two individuals are exactly alike, regardless of whether they have Asperger’s Syndrome or Down Syndrome.
“They have the same feelings that you and I have, so I try to give them the best care and maintain their teeth as long as possible,” he said.