The Compromised Care and Hospital Dentistry Fellowship at Texas A&M College of Dentistry is expanding treatment options for a unique population as the first special-needs-focused postdoctoral program in the state.
The fellowship serves patients with intellectual disabilities, developmental issues or medical conditions who require specialized dental treatment. Its champion is Dr. Dan Burch, clinical associate professor in pediatric dentistry, who was instrumental in creating the program two years ago from a five-year, $3.3 million Health Resources and Services grant.
“HRSA has recently made a considerable effort to fund complex care and intellectual/developmental disability health care training projects,” he explains. “There are very few educational training centers for special-needs dentistry in the U.S.”
In the first 18 months of operations, the fellowship program saw 6,100 patients. Burch estimates that by June 2022, that number will reach 8,000 to 9,000 patients.
“The amazing thing is this is just across two fellows per year,” he says. “This has been a really good program to implement for the community.”
Current fellows Dr. Lianna Pulliam and Dr. Krizia Acosta, both class of 2021, are working to meet demand. Pulliam says the fellowship has exposed her to treatment methods and unique patients she didn’t experience as a dental student.
“Working with this patient population has been amazing,” Pulliam says. “Once you get used to seeing these beautiful souls that communicate in their own special ways every single day, I don’t see myself practicing dentistry without caring for this population.”
Special care fellows currently rotate through Children’s Medical Center Dallas, Scottish Rite for Children, HHM Health and North Dallas Shared Ministries. Future growth will involve seeking out grants and other sources of funding, increasing the size of the fellowship from two to four, adding rotation sites, and increasing collaboration with private practices in the area.
Creating a campus clinic devoted to special needs dentistry is another priority. The space on the 8th floor of the Clinic and Education Building will contain multiple dental chairs, including one for bariatric patients and one with a wheelchair ramp, and accommodate sedation services ranging from oral sedation to general anesthesia.
“Although the College of Dentistry currently provides care for patients with special needs at local pediatric hospitals, over the years the need has intensified,” Burch says, explaining that resulting delays in treatment times can compound issues these children are facing. The special needs fellowship and future clinic stand to impact not only the patients served but the number of dentists available to care for them.
“We’re also expanding the abilities of our dental trainees and, by exposing them to this special patient population, giving them the chance to learn and understand how to manage these patients once they actually go into private practice settings,” Burch says.