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How an Arizona Dentist is Making Care More Inclusive for Patients with Special Needs

David Jourabchi, DDS, of Pacific Dental Services (PDS) Foundation Dentists For Special Needs, is a 2021 Health Equity Hero.

Twenty years ago, Dr. David Jourabchi witnessed his cousin get rejected from the local dentist’s office. She was a young girl with intellectual and developmental disability (IDD) in need of dental care but with nowhere to turn.

“Even though she was healthy, nobody was willing to see her,” says Jourabchi. “There is a stigma about treating individuals with special needs, which impacts the level of care they receive.”

After witnessing how this stigma and lack of trained professionals affected his cousin firsthand, Jourabchi was inspired to make a difference. Now, decades later, he is making sure patients like his cousin have a dental home at Pacific Dental Services Foundation, where he is the practicing clinician at Pacific Dental Services® Foundation Dentists for Special Needs in Phoenix, Arizona.

His work helps fill a critical gap. While there are an adequate number of licensed dentists in Arizona and across the nation to meet the demand for dental services, there are not enough practitioners adequately trained to provide care for people with special needs, IDD or willing to accept Medicaid—leaving this set of patients twice as likely to have unmet oral health care needs.

“Currently, a lot of patients with special needs receive care from their pediatric dentist. The issue is, once they age out of that practitioner’s scope of practice, they have nowhere to go to receive treatment.”

At PDS Foundation, Jourabchi provides the appropriate accommodations needed to treat patients with IDD, including desensitization to combat challenges with physical disabilities as well as sensory stimuli like speech, sound and light. The accommodations go beyond just the dental chair. Starting in the reception area, patients are introduced to a sensory room with sensory tiles, fish tanks with bubbles, and galaxy lights that match sensory stimuli preferences. These special considerations extend through the entire visit to ensure patients feel comfortable and safe.

The office has seen immense success—patients who were once unable to complete a dental appointment without sedation are now capable of achieving each step of an appointment without incident.

“These desensitization techniques are critical to helping our patients have a positive experience at the dentist. Repeated exposure to our office and treatment help to desensitize over time. We even send kits home with our patients so they can continue to learn desensitization at home in preparation for their next visit.”

Creating an accommodating environment for patients with special needs is important, but according to Jourabchi and PDS Foundation, it’s not enough. The number one health care problem faced by people with intellectual and physical disabilities is the inability to access competent oral healthcare.

That lack of access manifests itself every day at PDS Foundation, where people travel from all over the state and country to see Jourabchi, one of the only dentists in Arizona who specializes in treating patients with IDD. Since 2019, he has treated more than 1,200 patients and was one of the only dentists to continue care for patients with IDD during the pandemic.

Fortunately, recognition that this is a serious gap that needs to be addressed is growing within the dental industry. In 2020, the Commission on Dental Accreditation (CODA) began to require all U.S. predoctoral dental education programs to educate students on managing patients with IDDs. This requirement update will support the 56.7 million Americans diagnosed with special needs, with more than half of this population aged 18 to 64.

To Jourabchi, training dental students and equipping them with the proper skills and solutions to treat patients with special needs is a no brainer.

“Every dentist has to know and understand the care involved in treating everybody so that no patient is turned away when they are in pain and in need of care.”

David Jourabchi is a 2021 Health Equity Hero. He is supporting Special Olympics of Arizona and PDS Foundation with his award donation.