Tufts dental clinic serving people with intellectual disabilities for 34 years may close

From The Boston Globe:

For 34 years Tufts University has provided comprehensive dental care to severely mentally disabled patients who have long been ignored by private practitioners.

Now dental care for 2,100 patients with autism, brain injuries, and mental retardation is in doubt as the Waltham clinic where they are treated prepares to close this June.

The Waltham dental clinic, the largest of its kind in Massachusetts, is located in Fernald Development Center, which the state will close June 30 as a cost-saving measure. The center’s closing is forcing Tufts to shutter the dental clinic, and when it goes, advocates say, patients who are difficult to treat will have few places to turn for fillings, crowns, or partial dentures.

“Where will they go?’’ said Marilyn Meagher, who heads the advocacy group Fernald League for the Retarded Inc. “These are extremely handicapped people. It is going to be very devastating for them.’’

Most of the patients live in group homes, and their disabilities can be so severe that many can’t sit still or follow simple instructions. Some have seizures. Others spit, kick, and thrash about when receiving care.

“The perception of someone approaching you with a toothbrush can be very traumatic,’’ said Darren Drag, who runs the Tufts special needs dental program. “These are people who may not understand that we are trying to help them.’’

Caregivers, practitioners, and advocates hail the Tufts clinic’s expertise in tackling the behavioral and medical problems that arise. Tufts specialists in this field spend an extra three years in dental school learning to deal with developmentally disabled people.

Felicia Xiang, a dentist at the clinic, said the staff members have the space, flexibility, and time to work with such patients.

“We use a lot of patience,’’ said Xiang. “Some patients are sensitive to touch and noise. Anything can scare them.’’

As news of the closing spread this week, state and Tufts University officials sought to allay concerns, saying they are working to ensure that dental care will be available at other Tufts clinics.

“We are not anticipating an interruption in services,’’ said Jean McGuire, an assistant secretary for the Executive Office of Health and Human Services.

But the other clinics — in Palmer, Shrewsbury, Taunton, and other towns — are farther away for many patients and smaller than the Waltham facility. Advocates worry that the system can’t absorb the displaced patients.

Joseph Castellana, executive associate dean at Tufts University School of Dental Medicine, said officials are reviewing possibilities for expanding services at the other clinics.

“The state and the school of dental medicine are working every day trying to find ways to ensure that there is no diminishing of service to this population,’’ he said.

Tufts officials are hoping to continue collaborating with the Department of Public Health, and the state plans to keep funding at $1.2 million in the next fiscal year, the same as last year.

Tufts Dental Facilities was established in 1976 after a lawsuit demanded that Massachusetts improve dental care for people with developmental and acquired disabilities in the institutional system. Tufts and the state formed a partnership, operating seven clinics that serve 9,000 patients, staffed by 25 dentists, 11 hygienists, and 58 practitioners who specialize in treating people with disabilities.

In Waltham last week, the green dental chairs were empty. A few people sat in a waiting room, including one woman in a wheelchair who was wearing a helmet and protective facial gear.

Marit Pyle, an 87-year-old Boxford mother, said the clinic took her daughter, Kristine, 55, who has Down syndrome, when no one else would.

“I’m very sad about this,’’ Pyle said about the closing. “I’m worried about what is going to happen next.’’

She and others contend that many private dentists won’t take MassHealth, the state’s insurance system, and there are too few options for the vulnerable.

“I’ve been in this business for 38 years,’’ said Susan Shalit, a house manager at a group home in Lexington who took Ann Murphy, a 45-year-old woman with Down syndrome, to the clinic for her regular dental cleaning. “I can remember when there was nothing, because no one would take them.’’