Addressing health disparities through dental-medical collaborations, part II. Cross-cutting themes in the care of special populations.

This article introduces the second group in a series of articles in this journal on dental-medical collaborations to reduce oral health disparities. This group targets the needs of the elderly and individuals with mental retardation, developmental disabilities, and other special health problems. Five themes are common to these populations: the importance of oral-systemic interactions and need for interprofessional collaboration in care and training; the possibility of diminished mental and motor capacities and ability to provide self-care; difficulty accessing appropriate dental care; complex social and cultural factors; and the lack of a sufficient evidence base on basic mechanisms and clinical interventions. Gaps in training of dental, medical, and other health professionals contribute to disparities. Few programs provide integrated, interdisciplinary approaches, despite the growing numbers of elderly and the increasing life span of individuals with developmental disabilities. The inability of many such individuals to advocate for themselves, limitations in financial mechanisms, and societal biases fuel health disparities. These articles propose recommendations for key changes in dental and other health professional training, advocate increased commitment to special populations in research agendas, and encourage collaboration across health professions and with community and advocacy groups. A strong emphasis on prevention must be a part of these changes.