Special Smiles is the dental health discipline of the Special Olympics Healthy Athletes program that provides athletes with intellectual disabilities the opportunity to take charge of their oral health, said Dr. Steven Perlman, a clinical professor of pediatric dentistry at the Boston University Henry M. Goldman School of Dental Medicine. Special Smiles provides comprehensive oral health care information and offers free dental screenings and instructions on correct brushing and flossing techniques to Special Olympics athletes.
“Special Smiles is taking care of an invisible population,” Dr. Perlman said. “Our dental screenings may be the only time people with intellectual disabilities encounter a health professional in an entire year, and in many cases their entire life, because they fall through the cracks in the health care system. I’m proud to share that over the last 20 years, we have conducted over 289,000 Special Smiles screenings globally for our Special Olympics athletes, with over 130,000 of those screenings completed in the United States.”
Dr. Perlman now serves as a global clinical adviser with Special Olympics, working with Special Olympics health staff and discipline managers to oversee the strategic growth of Special Smiles and provide clinical guidance on protocols and materials. He leads clinical director trainings at major Special Olympics events and within regions as needed.
“My charge is to try to provide access to care and address educating the dental professional on how to provide care to people with intellectual disabilities,” he said. “For people with intellectual disabilities, there is a much higher burden of disease because they might not have the physical dexterity or capacity to take care of their own oral health care needs.”
Dr. Perlman first became involved with the Special Olympics through its founder, Eunice Kennedy Shriver. In 1993, Ms. Shriver sought out Dr. Perlman to treat her sister Rosemary Kennedy, who had an intellectual disability, and he restored her entire dentition without the removal of any teeth.
“After I treated Rosemary, Ms. Shriver met with me and we talked about the health disparities that exist for people with intellectual disabilities and the huge gaps in access to services and access to equitable care,” Dr. Perlman said. “Athletes sometimes had access, but they didn’t have access to quality care. Within two weeks of treating Rosemary, Ms. Shriver had me meet with her to talk about dental care for treating people with intellectual disabilities. She wanted me to make sure people with intellectual disabilities worldwide had access. She made me promise to never leave the movement.
“I had a practice, I had patients, but I was inspired by her. We did it together. I created the Special Smiles program at her request.”
In 1995, at the Special Olympics World Games, in New Haven, Connecticut, Dr. Perlman and others created the Special Olympics’ first health clinic, eye clinic and oral health clinic, all located in the middle of the Olympic village.
“What we found was stunning,” Dr. Perlman said. “Almost 30% of the athletes screened in those clinics had visual problems or could not see, despite having been treated previously by a doctor. Almost 20% were in severe [dental] pain. These are athletes that had been screened by doctors, had been prepared to come to the games, yet notwithstanding that they were walking around with acute pain so severe that it was interfering with their daily lives. Almost 15% of the athletes screened on this occasion had to be referred immediately to the emergency room for care of serious health conditions either related to their oral health care or to their eyes.”
Inspired, Dr. Perlman further committed himself to the movement.
In 2002, Dr. Perlman helped co-found The American Academy of Developmental Medicine and Dentistry to provide a forum for health care professionals who provide clinical care to people with neurodevelopmental disorders and intellectual disabilities.
Alicia Bazzano, M.D., Ph.D, is chief health officer of the Special Olympics, and commended Dr. Perlman and his colleagues for their work.
“Oral health care is critical for everyone regardless of age, insurance or disability, and people with intellectual disabilities are not the exception,” Dr. Bazzano said. “We have shown that people with intellectual disabilities have higher rates of gingivitis and periodontal disease than the general population and this results in negative health consequences. The causes of these disparities include lack of provider education, communication challenges, difficulties with oral hygiene and low reimbursement. Everyone should have access to quality health care. Special Olympics is working hard to eliminate these health disparities for people with intellectual disabilities by providing oral health screenings and education, training professionals and working to ensure equitable access to quality health for all, so that we can get to health equity that is inclusive of people.”
Dr. Perlman agrees.
“We need to focus more on the preventive side of dental care and both educate and empower athletes to take better care of themselves,” he said. “Ultimately, this is about the quality of their lives.”
Special Olympics holds competitions at the local, state, country, region and world level every year. In all, more than 70,000 Special Olympics competitions are held every year. To learn more about the Special Olympics, visit specialolympics.org.