Delta Dental of Tennessee Introduces Enhanced Special Health Care Needs Benefit

To help expand access to dental care for individuals with special health care needs, Delta Dental of Tennessee (Delta Dental) is introducing enhanced benefits and a new training program for providers. Beginning January 1, 2024, children and adults with special health care needs will have access to expanded benefits through the Delta Dental network.

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From Left to Right: Adam Germek, Special Olympics of Tennessee; Adam English, Nashville Sounds; Booster; Mike Sweet, Special Olympics of Tennessee Athlete; AJ Lawhorn, Special Olympics of Tennessee Athlete; Marshall Molar; Jaxon Lawhorn, Special Olympics family member; Natalee Kamau, Special Olympics of Tennessee; Phil Wenk, DDS, Delta Dental of Tennessee; Jeff Ballard, Delta Dental of Tennessee; Shirley Lawhorn, Special Olympics family member; and Santiago Allaria, Special Olympics of Tennessee. (Photo: Business Wire)

Dental care is often cited as the greatest unmet health care need facing individuals with intellectual disabilities (ID). At Niswonger Children’s Hospital in Johnson City, Tennessee, dental care is frequently the reason that children with ID are admitted into the hospital, a fact that concerned Chris Jett, Niswonger’s CEO.

“Dental care is critically important to overall health, but rarely is a hospital the best place to receive that care. Unfortunately however, there are instances where we see children with intellectual disabilities that need to utilize the hospital in order to receive anesthesia or other care not accessible to them in a dental office,” said Chris Jett, CEO of Niswonger Children’s Hospital in Johnson City, Tenn. “We applaud Delta Dental of Tennessee for expanding its benefits and helping dentists learn how to care for these young patients in their offices.”

The enhanced special health care needs benefit will cover additional consultations to help patients learn what to expect prior to their first treatment, up to four dental cleanings in a benefit year, and treatment delivery modifications necessary to care for patients with sensory sensitivities, behavioral challenges, severe anxiety, or other barriers to treatment. There is no age limit for the coverage, which aligns with the American Academy of Pediatric Dentistry’s definition of special health care needs. These benefits will be available with Delta Dental of Tennessee’s Individual & Family Plans and with all fully-insured clients effective January 1, 2024. Self-insured clients will have the opportunity to opt-in for these benefits for contracts already in service.

Delta Dental first announced its plans on June 17 at First Horizon Park in advance of the “Smile Power” Nashville Sounds game. The press conference featured remarks from Adam Germek, President and CEO of Special Olympics of Tennessee, who highlighted the work of the organization’s Special Smiles program, the dental health division of Special Olympics Healthy Athletes®.

Special Smiles provides comprehensive oral health information and instructions, free dental screenings, and preventative supplies including toothbrushes, toothpaste, and fluoride varnish. Delta Dental is a longtime supporter of Special Smiles in Tennessee; since its inception, Special Smiles has conducted more than 5,000 dental screenings across the state, including 500 in the last year alone, to help athletes feel and compete at their best level.

“Access to dental care is a real and critical need. For every 10 athletes on a Special Olympics team, we know from our screenings that four have untreated tooth decay, and one or two need urgent dental care,” said Germek. “We are grateful for the leadership and longstanding support of our friends at Delta Dental and their commitment to reducing barriers to care for all Tennesseans.”

In September 2022, Special Smiles partnered with Meharry Medical College’s mobile dental unit to provide dental screenings and on-site interventions when needed to athletes competing at the state golf tournament for the first time. AJ Lawhorn, a 34-year-old golfer from Pigeon Forge who represented Team Tennessee at the 2022 USA Games, was among the athletes who received dental care through the mobile clinic.

Lawhorn’s mother, Shirley, noted that the family has at times struggled to find providers who have the proper training to care for individuals with special health care needs. The family sees the one dentist near their home who will treat AJ and another family member, Mike Sweet, who also has special health care needs and is active with Special Olympics.

“The mobile dental clinic was a great experience - I wish they were everywhere! We need more dentists and doctors who are willing to work with special needs patients and are not afraid of them,” Shirley said.

To help dentists better understand and care for patients with special health care needs, Delta Dental has made a series of professional development programs hosted by the University of Pennsylvania’s Dental Medicine program available at no charge to any dentist or support staff member. Providers completing 18 or more courses within three years will receive a Disabilities Dentistry Clinician Expert designation.

There is emerging evidence that with greater provider training and awareness, a different and safer way of caring for individuals with special health care needs is possible.

The dental program at Ohio State University’s Nisonger Center, an interdisciplinary care, education, and research center that aims to improve the lives of individuals with intellectual and neurodevelopmental disabilities, provides one example. While all their patients are referred in for treatment under sedation, they are ultimately able to provide care for 80% of their patients without any type of modification, says Dr. Stephen Beetstra, the Center’s dental program director.

“Using a psychological approach to manage this population is not something we learn in dental schools,” said Dr. Beetstra. “Providing quality care to patients with intellectual disabilities takes time, training, and resources that very few dentists have today. We need to understand and develop the skills to enjoy their humanity and idiosyncrasies which often makes working with this population so rewarding.”

“It is our core belief at Delta Dental that quality oral health care should be accessible and inclusive to all, and dentists should be fairly compensated,” said Dr. Phil Wenk, CEO of Delta Dental of Tennessee. “This is the right thing to do, and we look forward to working with both our providers and members as we roll out this benefit in the coming months.”

To learn more about Delta Dental of Tennessee’s special health care needs benefit, visit DeltaDentalTN.com/SpecialNeeds.

Delta Dental of Tennessee

Delta Dental of Tennessee is the state’s largest independent dental benefits carrier with 1.4 million lives covered. As part of the Delta Dental Plans Association, Delta Dental of Tennessee members have access to the largest dental network in the nation with more than 154,000 providers serving more than 443,000 locations. With the simple mission of ensuring healthy smiles, Delta Dental of Tennessee works hard to help members of the communities it serves. Along with its corporate foundation, Smile180, Delta Dental of Tennessee donated more than $5.4 million in funding and in-kind services to over 110 organizations in 2022.

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