Designing Inclusive Spaces for Education in Dentistry

Dental care is a core component of a person’s health and wellness. Unfortunately, accessing dental care can be challenging for many, including people with disabilities. A 2017 report from the National Council on Disability, “Neglected for Too Long: Dental Care for People with Intellectual and Developmental Disabilities,” found that adults with I/DD are at higher risk for poor oral health and face substantial challenges to accessing care, including a shortage of appropriately trained professionals.

This report contributed to direct regulation changes with The Commission on Dental Accreditation approving new standards that require all U.S. dental schools to train students to treat individuals with I/DD and other special needs populations. Schools that grant dental degrees such as general dentistry, orthodontics, dental hygiene and assistant programs must now provide clinical training for this population or risk losing accreditation. 

This standard has a direct impact on the dental clinical training environment. Dental offices can be uncomfortable for many patients — even more so for those who experience sensory sensitivity and can be adversely affected by the lights, sounds, textures and experience of the office. 

Design Considerations for Creating Inclusive Spaces for Dentistry Education

As designers who specialize in places of dental education, we care deeply about creating optimal dental learning and clinical training environments to support students in gaining experience treating people with disabilities. Further, we believe in creating safe, supportive spaces for people to receive treatment, that go beyond compliance with the Americans with Disabilities Act and truly address the diverse communities they serve. The following principles have been developed through direct experience working on this special project type.

Create Opportunities to Learn

Create broad opportunities for students to gain experience treating people with disabilities. Diffuse these spaces throughout all aspects of patient care, including within dental specialties. Every subtype of operatory grouping should be equipped with at least one room that can accommodate diverse patient types with ease without making them feel as if they’re being treated differently. 

Be Selective with Finishes 

Use low-arousal finishes that are broadly appealing, and avoid using finishes that are too vibrant or stimulating. In public areas, pay attention to sound-absorptive materials that can be used to minimize ambient noise. Balance design choices for both pediatric and adult care to make the experience feel inclusive for all ages. Appealing to a broad range of styles and keeping ideas timeless but not clinical will ensure longevity and relevance long after opening day. 

Make Restroom Access Effortless

Provide single-user and family restrooms adjacent to the treatment spaces to minimize the need to travel. All patient types appreciate privacy, and it is especially necessary for those with special physical needs.

Furnish Opportunities for Respite

This can take the form of multisensory rooms that contain no clinical features. Consider devices like bubble tubes, dimmable and coloured lights, soft flooring and furniture, weighted blankets, music or projection. To make a room more comfortable, equip an operatory or two with features the patient can customize. Feeling in control of your environment is critical for reducing anxiety for all dentistry patients, especially those with sensory processing differences. 

Design an Inclusive Operatory

Use indirect lighting wherever possible to reduce visual glare and provide opportunities for patient control over their environment. This is easily attainable with colour-changing and dimmable lights, over-the-chair monitors, tablet computers, headphones and glasses or headsets. Visual and auditory privacy should be provided in at least some of the operatories. Full-height walls and doors that provide acoustic isolation minimize noise transfer from dental tools and voices. 

For people who use wheelchairs, a “wheelchair tipper” eliminates the need to transfer into a traditional dental chair, eliminating a potentially stressful maneuver. Provide enough space for mobility aids, caregivers and family members to fit comfortably in the room. 

Side-Step the Scary Stuff

Wheeling in tanks and medical devices can raise anxiety in the dental environment. The use of nitrous oxide and other anesthetics should be seamless and integrated into the operatory design, so there’s no need to bring in additional equipment — pipe mixed gases under the floor directly to the dental chair to avoid trip hazards and tubes. Rear delivery systems are preferable to reduce patient apprehension about seeing dental tools. The delivery system can be kept out of sight and out of reach for the patient while maintaining ease of access for the practitioner.

Toward an Inclusive Future

With advances in standards for accreditation in dental education programs, schools have been given an opportunity to elevate both the care and the training they provide. Likewise, designers of these spaces have been allowed to be at the forefront of developing the standards and tools that will make these spaces successful. We hope to continue our involvement in this field. We are passionate about designing the environments in which students are training to be inclusive for those with disabilities and provide an atmosphere that drives dental care and education toward a future where every patient experience is at the forefront.