Oral Health Equity for California

State budget must address the access crisis in special needs dental care.

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Patients with special health care needs face a variety of barriers due to their behavioral or physical limitations that limit access to oral health care. Special health care needs include intellectual or developmental disabilities, physical disabilities, or cognitive declines like dementia and Alzheimer’s. With another record-breaking budget surplus, this is the year for lawmakers to address this crisis. Our coalition is urging the state to make a one-time investment that would substantially improve access to dental care permanently, changing the lives of California’s special needs population.


‘Like torture’: For Californians with special needs, getting to see a dentist can take years



Patients with special needs often lack access to even basic oral health care because traditional dental offices are not equipped to provide the specialized services needed to accommodate mobility issues or physical challenges. Depending on the severity of the disability, daily health care routines can be a challenge to complete. Even diagnosing dental conditions may require some level of stabilization or sedation.

More intensive, restorative procedures can require deep sedation and general anesthesia. Treating special needs patients requires a setting with significant physical capacity and specialized adaptive equipment.

In sum, there is a mismatch between the needs of these patients and the existing dental system.

The current dental care settings for these patients, such as dental schools and specialized clinics, are often backlogged with significant waitlists for treatment. These delays have been exacerbated by the COVID-19 pandemic. Moreover, the complexity of treating patients with behavioral complications often requires extra appointments, adding to the backlog.

The existing surgical capacity at dental schools in urban areas often means that medically vulnerable patients and their families must drive hours to find a dentist able to provide them with even. basic dental care. The system is a patchwork, and many special needs patients are falling through the cracks.

For the state to create real equity in the healthcare system, the special needs population must receive more attention. This is an access crisis that has been unresolved for years, affecting both children and adults. Access can often be difficult for those with private commercial insurance due to the shortage of specialized clinic locations, and is even more challenging for those with Medi-Cal. Despite the overall progress of the Medi-Cal program over the last five years, the state has not targeted substantial funding for the special needs population and access to care has only worsened for these patients.


Special needs patient advocates are requesting a one-time, $50 million investment from budget surplus funding to create the infrastructure at California’s dental schools, dental clinics, and surgery centers that will address this need.

The funds would be allocated to pay for the construction, expansion or adaptation of specialty dental clinics in California.

Development of physical infrastructure will be done via a grant program, facilitated by the CA Health Facility Financing Authority. These grants would be used specifically for building/capital outlay – not ongoing funding. A $50 million investment from the state’s budget surplus would be awarded in grants ranging from $1 million to $5 million to create at least 10 permanent sites specific to special needs dental care.

The new sites will increase the geographic density of settings accessible to patients with special needs throughout the state, alleviating the tremendous backlog and allowing patients to receive the care they need without lengthy delays or travel.

Our Coalition