Dr. Ray Lyons has dedicated his dental career of more than 40 years to treating people with disabilities. His Albuquerque-based Special Needs Dental Clinic, part of the New Mexico Department of Health, treats individuals with intellectual and developmental disabilities who can’t or won’t be seen in other clinics due to movement disorders or complex medical burdens. The clinic’s other dentist, Dr. Alicia Grady, says she joined Lyons’ team six years ago because of his clinic’s impact on the community. While state Medicaid programs are required to provide preventive care for children, it’s optional when it comes to adults, including those with disabilities. One of the states that includes preventive care in its benefits is New Mexico — and its Special Needs Dental Clinic demonstrates that benefit in action. 

How is Special Needs Dental Clinic different in its approach to dentistry?

Dr. Lyons: Going to the dentist for our patients is a lesson in coping. They have intellectual and functional disabilities, and they have challenges with change and communication. Our approach is to try and build relationships with them: accept them for who they are, laugh with them when we can, treat them as a whole person. That’s our underlying principal — to help them get to know us. It’s a whole-team approach. 

Dr. Grady: When we see a new patient, the whole team comes together and we only make it about that person. So it’s not so overwhelming for them or for us. There aren’t five other patients in the waiting room, there’s not a lot of noise, there’s not a lot going on. We take the time to get to know them as a person and really celebrate them as individuals. The next time they come in, it’s just a little less scary — because they really know us. 

The stronger the relationship, the easier it is to provide care and achieve or maintain good oral health. Dental care can’t be performed the same for everyone — and this population in particular requires putting the person and their caregivers at the center of any restorative or preventive care plan.

Is there a patient you’ve helped whose story has stuck with you over the years?

Dr. Lyons: A school bus wheelchair lift failed one morning, and the entire blow of the fall put the arm of a wheelchair into our patient’s face and mouth. It took several hours to stabilize her, and Neva lost a couple of teeth in the process. We saw her every month after that. She had cerebral palsy and didn’t have a voice, but she could point — and she would point to the missing teeth. We always thought she was reliving the trauma of that event. But she really cared how she looked — she liked going to the beautician! 

A lot of times when our patients lose teeth, there’s no reasonable replacement we can provide — the ER may appear to be their only option. In this case, the ER was not a place Neva could go for massive bridge work, for example. So we said, “Let’s see if we can replace those teeth with a simple Maryland bridge.” When she looked at herself in the mirror after getting her teeth back, it meant the world to her. 

Dr. Grady: We have had many parents say, “Your office treated my son or daughter like a real person. There is no judgement and they actually enjoy coming to your office.” That should be the goal: Everyone should have a dental home where they feel heard, valued and respected, and we hope that our office is that for the community of individuals with special needs.

It’s clear that building relationships with patients is a huge part of your approach to preventive medicine. How else does prevention play into the care you deliver?

Dr. Grady: We try to stay up on the latest preventive trends. We are using more silver nitrate, silver diamine fluoride, sealants when appropriate — things to be protective in nature so that we’re not constantly fighting decay. And so our patients, when they come back — now every six months — have an enjoyable experience.

Read more stories about Preventists changing their communities and learn more about the future of oral health at Preventistry.org.