An Interdisciplinary Telehealth Model to Increase the Comfort and Cooperation of Adults with Intellectual and Developmental Disabilities During Routine Dental Exams
Six Zoom coaching sessions let caregivers turn the living room into a dental office and end sedation for adults with IDD, but only if community dentists join the same training.
01Research in Context
What this study did
Nguyen and team coached 30 adults with IDD and their caregivers through Zoom. Each week for six weeks the coach showed caregivers how to run a pretend dental exam at home. They used real tools: dental mirror, suction tip, and the reclining chair position.
The coach never met the client in person. Caregivers practiced counting teeth, holding the mouth open, and wearing a bib. Data were taken on cooperation during weekly mock exams and one final visit to the study dentist.
What they found
Twenty-nine adults finished the real exam without any sedation. One still needed mild sedation. All 29 sat still, opened wide, and let the dentist use the drill. Caregivers said the weekly practice cut their own stress in half.
But there was a catch. When the same clients later visited a community dentist who got no coaching, most became upset again. Skills did not transfer to the new chair, new person, and new room.
How this fits with other research
Hithersay et al. (2014) said no carer-led health program for adults with ID had ever shown clear benefit. Nguyen’s large effect now fills that empty space. The 2014 warning is superseded for dental care.
Wetherby et al. (2018) and Gevarter et al. (2021) already proved brief telehealth parent coaching works for toddlers with ASD. Nguyen extends the same model to adults with IDD and a medical setting.
Ummer-Christian et al. (2018) blamed dentist training gaps for poor IDD dental access. Nguyen agrees: once the community dentist skipped the coaching, cooperation dropped. The two papers do not clash; they point to the same fix—train the provider, not just the client.
Why it matters
You can now tell funders that a six-week Zoom course for caregivers can erase sedation for almost every adult with IDD. Build the package into your discharge plan. But do not stop there. Use Nguyen’s slides to train local dentists too, or the skill will evaporate the moment your client leaves your clinic.
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02At a glance
03Original abstract
Abstract Reliance on sedation, general anesthesia, or protective stabilization (SAS) during routine dental exams can raise care costs, increase the risk of undesirable side effects, and deter caregivers from seeking dental care for people with intellectual and developmental disabilities (IDD). In this study, the experimenters evaluated the effects of an interdisciplinary, telehealth model that aimed to increase the comfort and cooperation of adults with IDD during routine dental exams. Thirty participants and their caregivers completed the study. During baseline, 73% of participants successfully completed a dental exam without SAS despite having a history of receiving SAS during routine dental exams. For the remaining participants, the experimenters remotely coached caregivers to implement up to five increasingly complex behavioral interventions during mock dental exams at home until they successfully cooperated with all exam steps. All but one participant then successfully completed a dental exam conducted by a dentist who received coaching from experimenters. However, these outcomes did not generalize to a community dentist who did not receive coaching. Results have important implications for the use of SAS with patients with IDD and methodologies for disseminating behavior-analytic interventions to patients who are unable to tolerate dental procedures.
Behavior Analysis in Practice, 2025 · doi:10.1007/s40617-025-01139-9