Cambridge Institute for Global Oral Health (CIFGOH)

Clinical Immersion in the Care of Patients with Intellectual and Developmental Disabilities

 

 

Anecdotal information and evidence-based data indicate that individuals with intellectual and developmental disabilities (IDD) in many countries around the world experience significant difficulty accessing basic dental care. 

 

These same data have documented that, throughout the world, medical, nursing, dental and dental hygiene students are not being adequately trained in the care of this patient population, which would tend to indicate that this health care access problem is, at its core, a health care education problem. 

 

In 2007, in response to this global public health problem, clinicians at the Lee Specialty Clinic created the Mini-Residency in Developmental Dentistry, an innovative, clinical immersion program focused on the dental care of patients with IDD.

 

The mini-residency is a nationally-recognized continuing education program, developed for dentists who have graduated from a BDS, DMD, or DDS program (and their accompanying co-worker dental hygienists, dental therapists, or dental assistants), and who wish to obtain additional, focused training in Developmental Dentistry.  Based at the Lee Specialty Clinic in Louisville, Kentucky, the one-week program is designed to provide a clinical immersion experience in the interdisciplinary care of patients with IDD.

 

The curriculum features a mixture of clinical training and interdisciplinary case discussions.  The majority of clinical training takes place at the Lee Specialty Clinic, where the resident will work as an important member of an interdisciplinary clinical team comprised of neurologists, internists, psychiatrists, psychologists, nurses, dental hygienists, behavior analysts and an array of therapists and ancillary personnel.

 

The Lee Specialty Clinic has been designated by the Kentucky Board of Dentistry as an independent teaching facility.

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CLINIC ROTATION AND LECTURE SCHEDULE:

(Please note that the course sequences, times, and instructors are subject to change and the total number of continuing education hours will remain at 34 hours):

                                                                 

Monday              

8:00 AM – 10:00 AM                        Orientation 

10:00 AM – NOON                            Dental Services – Lee Specialty Clinic

NOON – 1:00 PM                              Lecture 1: Surveying the Landscape

1:00 PM – 2:00 PM                           Lecture 2:  The Five Essential Concepts

2:00 PM – 3:00 PM                           Dental Services – Lee Specialty Clinic

3:00 PM – 4:00 PM                           Therapeutic Services (SLP / OT) – Lee Specialty Clinic

 

Tuesday              

8:00 AM – NOON                              Dental Services – Lee Specialty Clinic

NOON – 1:00 PM                              Lecture 3: Medical Legal Issues

1:00 PM – 2:00 PM                           Lecture 4: Review of Common Neurodevelopmental Disorders I

2:00 PM – 3:00 PM                           Dental Services – Lee Specialty Clinic

3:00 PM – 4:00 PM                           Psychiatric / Behavioral Services – Lee Specialty Clinic

 

Wednesday        

8:00 AM – NOON                              Dental Services – Lee Specialty Clinic

NOON – 1:00 PM                              Lecture 5: Review of Common Neurodevelopmental Disorders II

1:00 PM – 4:00 PM                           Dental Services – Lee Specialty Clinic

 

Thursday            

8:00 AM – 10:00 AM                         Dental Services – Lee Specialty Clinic

10:00 AM – NOON                           Clinical Protocol Conference (Interdisciplinary Treatment Planning)

1:00 PM – 3:00 PM                           Dental Services – Lee Specialty Clinic                  

3:00 PM – 4:00 PM                          Therapeutic Services (PT) – Lee Specialty Clinic

 

Friday                  

9:00 AM – NOON                              Dental Services – Lee Specialty Clinic

1:00 – 3:00                                        Neurodevelopmental Diagnosis & Medical Services –Lee Specialty Clinic

 

 

 

Academic Program

 

Total CE Credit:       34 hours (Clinical Hours: 29 hours; Didactic Hours: 5 hours)

Clinical Educational Objectives:

 

Dr. Kristin Compton and Dr. Britni Robinson: Dental Services – Lee Specialty Clinic - (22-hours)

At the conclusion of the hands-on session, participants will be able to understand and perform:

• Examination, diagnosis, and treatment planning for patients with special health care needs

• Informed consent procedure for patients with special health care needs

• Basic dental prophylaxis, scaling, and topical fluoride procedures for patients with special health care needs

• The use of non-pharmacologic behavior management techniques for patients with special health care needs

• The use of nitrous oxide anxiolysis for patients with special health care needs

• Basic restorative dentistry and simple oral surgery procedures for patients with special health care needs

• The use of advanced behavior management and patient-safety techniques with protective stabilization

 

Mr. Jim Hisle: Therapeutic Services (Speech and Language Pathology/Occupational Therapy) – (1-hour)

At the conclusion of the hands-on session, participants will be able to understand:

• Effective interactions with physical therapists, occupational therapists, dentists, audiologists, behavior analysts, ophthalmologists, gastroenterologists, internists, family physicians, neurologists, podiatrists, nurses, otolaryngologists, dieticians, psychiatrists, and psychologists

• The utilization of evidence-based techniques including Fiberoptic Endoscopic Evaluation of Swallow (FEES) studies, myofascial / manual therapy, Lee Silverman Voice Therapy (LSVT), and Neuromuscular Electrical Stimulation

• General speech and language pathology and management of articulation, fluency, voice, swallowing, hearing, social pragmatics, cognition, and augmentative-alternative communication (AAC) for adults

• General occupational therapy and the management of patients with special health care needs

 

Dr. Patrick Swanson: Psychiatric/Behavioral Services – (1-hour)

At the conclusion of the hands-on session, participants will be able to understand:

• The perspective of the psychiatrist and other behavioral service providers with psychiatric assessment, patient-centered psychotherapy, and pharmacological intervention

• That stressful issues and conditions that can produce challenging behaviors in a patient with IDD, and working with that patient to develop positive responses to those stressors can significantly improve that patient’s quality of life

• How a behavior analysis team works closely as part of a multi-disciplinary team in achieving successful clinical outcomes, and reducing dependence on medication

• All behavioral services are provided with the understanding that each patient is unique

 

Dr. Henry Hood: Clinical Protocol Conference (Interdisciplinary Treatment Planning) – (2-hours)

At the conclusion of the hands-on session, participants will be able to understand:

• Individual patient case management during a multi-disciplinary clinical protocol meeting amongst the team of physical therapists, occupational therapists, dentists, audiologists, behavior analysts, ophthalmologists, gastroenterologists, internists, family physicians, neurologists, podiatrists, nurses, otolaryngologists, dieticians, psychiatrists, and psychologists

 

Mr. Jim Hisle: Therapeutic Services (Physical Therapy) – (1-hour)

At the conclusion of the hands-on session, participants will be able to understand:

• Effective interactions with physical therapists, occupational therapists, dentists, audiologists, behavior analysts, ophthalmologists, gastroenterologists, internists, family physicians, neurologists, podiatrists, nurses, otolaryngologists, dieticians, psychiatrists, and psychologists

• The delivery of physical therapy services to individuals with IDD

• General occupational therapy and the management of patients with special health care need

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Dr. Paula Robinson: Neurodevelopmental Diagnosis – (2-hours)

At the conclusion of the hands-on session, participants will be able to understand:

• The perspectives of the developmental physician for developing the patient history, examination, review of systems, and neurodevelopmental diagnosis

• The characterization and prevalence of a biomarker in individuals with intellectual disability and the characteristics of affected individuals

 

Didactic Educational Objectives:

 

Dr. Henry Hood: Lecture 1 – Surveying the Landscape – (1-hour)

At the conclusion of the course, participants will be able to:

• Define the terms: neurodevelopmental disorder and intellectual disability

• Gain understanding of the impact that increasing lifespan has had on these various subgroups

• Understand the impact of 16th Surgeon General David Satcher’s report Closing the Gap in identifying disparities in access to medical and dental care for special needs patients

• Identify the professional associations and academies involved in the care of patients with ND/ID

• Understand the importance of a biomedically-based language and approach in providing dental services to special needs populations

 

Dr. Henry Hood: Lecture 2 – The Five Essential Concepts – (1-hour)

At the conclusion of the course, participants will be able to:

• Identify the Five Essential Concepts of Developmental Medicine and Dentistry

• Understand the relationship between neurodevelopmental dysfunction, disorder-related complications, health consequences, and syndrome-specific conditions

• Apply the Five Essential Concepts of Developmental Medicine and Dentistry to clinical case studies

 

Dr. Henry Hood: Lecture 3 – Medical Legal Issues – (1-hour)

At the conclusion of the course, participants will be able to:

• Identify major medical / legal issues relevant to the delivery of dental services to special needs populations

• Understand the importance of the doctor-patient relationship in dealing with medical / legal issues relevant to special needs populations

• Understand the impact that intellectual disability has on the informed consent process, the obtaining of a health history, and patient compliance

• Understand the significance and the impact of the Americans with Disabilities Act, the Olmstead Decision, and community integration, with respect to people with neurodevelopmental disorders and intellectual disabilities (ND/ID)

 

Dr. Henry Hood: Lecture 4 – Review of Common Neurodevelopmental Disorders, Part 1 – (1-hour)

At the conclusion of the course, participants will be able to:

• Recall basic genetic terms and concepts

• Identify features of the more commonly occurring neurodevelopmental disorders, including: Fetal Alcohol syndrome; Fragile X Syndrome; Down syndrome; and Cerebral Palsy, and understand their relative prevalence in the general population

• Understand how intellectual disability, Autism and seizure disorders relate to the major neurodevelopmental illnesses

• Recognize the impact of intellectual disability and physical impairment on the delivery of dental care

• Understand the importance of appropriate radiographic imaging techniques adapted for the special needs population

• Understand the impact of poor periodontal health in the patient with ND/ID

• Understand the relationship between oral pathologies and multi-systemic conditions in the special needs population

• Understand the significant and positive impact that dentist / physician collaboration can have on the quality of dental care for special needs patients

• Understand the challenges facing America’s health care delivery systems in addressing the clinical needs of both outpatient and inpatient psychiatric populations

• Recognize the impact that various psychiatric illnesses have on dental health and on the delivery of dental services

• Understand the role of the dentist as an advocate for the psychiatric patient’s dental health

• Recognize clinically-observed behaviors associated with Autism Spectrum Disorder (ASD)

• Understand the unique challenges facing the dentist treating the patient with ASD

 

Dr. Henry Hood: Lecture 5 – Review of Common Neurodevelopmental Disorders, Part 2 – (1-hour)

At the conclusion of the course, participants will be able to:

• Identify physiological changes commonly observed in an aging population

• Recognize the impact that these changes – both physical and mental – have on an aging patient’s daily life, and on the delivery of dental care to that patient

• Understand the impact that polypharmacy has on this population

• Identify significant changes in the cardiovascular system of the aging patient, and the ramifications of those changes for the geriatric dentist

• Identify significant changes in the digestive systems of aging patients, and the impact these changes have on the delivery of dental services

• Identify the potential impact of dementia and depression on the doctor patient relationship

• Understand the role of the clinical geneticist on the special care team

• Understand the process by which a neurodevelopmental diagnosis is established

• Learn to correlate certain neurodevelopmental disorders with their classic phenotypic presentations

• Understand the impact that stigma can have on the health of people with neurodevelopmental disorders and intellectual disabilities

• Understand the impact that stigma can have on those clinicians who care for people with neurodevelopmental disorders and intellectual disabilities.

 

Intended Audience: Dentists, dental hygienists, and dental assistants (Note: Dental hygienists, and dental assistants must be accompanied with supervising co-worker dentist)

 

Prerequisites, previous training, and preparation for conference registration:

• All curricula are presented in English, and applicants must be fluent in the English Language

• Clinical supervision of dentist-, dental hygienist-, dental assistant-course participants:

  • The supervising and qualified dental- and medical-instructor(s) for each clinical session will assess the clinical capabilities of each course participant such that:

    • The qualified dental- and medical-instructors must assume responsibility for completion of treatment and may complete any treatment procedures initiated by a course participant, should any question of the course participant’s competence arise

    • Sufficient clinical supervision must be provided during patient treatment to ensure that the procedures are performed competently

• Dentists:

  • Must complete an application packet and provide required credentialing documentation

    • Lee Specialty Clinic application form

    • A photocopy of your current passport

    • A photocopy of your dental school diploma (with English translation)

    • A photocopy of your dental license (with English translation)

    • One letter of recommendation (Must be written in English by a dentist or physician)  

    • Lee Specialty Clinic Confidentiality form (see attachment)

    • Lee Specialty Clinic Hepatitis B Declination form (see attachment)

    • Tuberculosis Screening: 1_ QuantiFERON-TB or T-Spot blood test or 2) Mantoux tuberculin skin test (TST) with purified protein derivative (PPD) screening results completed within 1-year or less before the start date of the continuing education program

    • CPR certificate: Must be completed within 1-year or less before the start date of the continuing education program. If needed, register and pay for an online course at https://www.redcross.org/take-a-class/classes/adult-child-and-baby-first-aid%2Fcpr%2Faed-online/05453059.html

    • Toxicology Screening results: Urine specimen tested within 30-days or less before the start date of the continuing education program. Screening test must screen for the drugs listed below:

      1. Marijuana

      2. Cocaine

      3. Opiates

      4. 3,4-Methyl​enedioxy​methamphetamine (MDMA)

      5. Methadone

      6. Benziodiazepines

      7. Amphetamines

      8. Phencyclidine

      9. Morphine

      10. Barbiturates

      11. Oxycodone

    • Criminal Background Check (see attachment)

    • Must complete a short interview by phone-/video-conference with the course director(s)

 

• Dental Hygienists:

  • Must provide the name of the accompanying supervising dentist who will be participating in the course

  • Must complete an application packet and provide required credentialing documentation

    • Lee Specialty Clinic application form

    • A photocopy of your current passport

    • A photocopy of your dental hygiene school diploma (with English translation)

    • A photocopy of your dental hygiene license (with English translation)

    • One letter of recommendation (Must be written in English by a dentist or physician)  

    • Lee Specialty Clinic Confidentiality form (see attachment)

    • Tuberculosis Screening: 1_ QuantiFERON-TB or T-Spot blood test or 2) Mantoux tuberculin skin test (TST) with purified protein derivative (PPD) screening results completed within 1-year or less before the start date of the continuing education program

    • CPR certificate: Must be completed within 1-year or less before the start date of the continuing education program. If needed, register and pay for an online course at https://www.redcross.org/take-a-class/classes/adult-child-and-baby-first-aid%2Fcpr%2Faed-online/05453059.html

    • Toxicology Screening results: Urine specimen tested within 30-days or less before the start date of the continuing education program. Screening test must screen for the drugs listed below:

1. Marijuana

2. Cocaine

3. Opiates

4. 3,4-Methyl​enedioxy​methamphetamine (MDMA)

5. Methadone

6. Benziodiazepines

7. Amphetamines

8. Phencyclidine

9. Morphine

10. Barbiturates

11. Oxycodone

• Criminal Background Check (see attachment)

• Must complete a short interview by phone-/video-conference with the course director(s)

 

 

• Dental Assistants:

  • Must provide the name of the accompanying supervising dentist who will be participating in the course

  • Must complete an application packet and provide required credentialing documentation

    • Lee Specialty Clinic 2018 application form

    • A photocopy of your current passport

    • A photocopy of your dental assisting school diploma (with English translation)

    • A photocopy of your dental assisting license (with English translation)

    • One letter of recommendation (Must be written in English by a dentist or physician)  

    • Lee Specialty Clinic Confidentiality form (see attachment)

    • Tuberculosis Screening: 1_ QuantiFERON-TB or T-Spot blood test or 2) Mantoux tuberculin skin test (TST) with purified protein derivative (PPD) screening results completed within 1-year or less before the start date of the continuing education program

    • CPR certificate: Must be completed within 1-year or less before the start date of the continuing education program. If needed, register and pay for an online course at https://www.redcross.org/take-a-class/classes/adult-child-and-baby-first-aid%2Fcpr%2Faed-online/05453059.html

    • Toxicology Screening results: Urine specimen tested within 30-days or less before the start date of the continuing education program. Screening test must screen for the drugs listed below:

1. Marijuana

2. Cocaine

3. Opiates

4. 3,4-Methyl​enedioxy​methamphetamine (MDMA)

5. Methadone

6. Benziodiazepines

7. Amphetamines

8. Phencyclidine

9. Morphine

10. Barbiturates

11. Oxycodone

• Criminal Background Check (see attachment)

• Must complete a short interview by phone-/video-conference with the course director(s)

*None of the presenters reported any conflicts of interest.

*Cancellation/Refund Policy: Courses which do not receive sufficient enrollment are subject to cancellation. In the event a course is filled or cancelled, Cambridge Institute for Global Oral Health will refund the full tuition. A full refund, less a $500 administrative fee for each course registrant,  will be given for courses if written notification of withdrawal is received and confirmed 45 days prior to the date of the first course of the program.

 

REGISTRATION INFORMATION

• $3000 (USD) registration fee per participating dentist assistant (Fee does not include the cost of air and ground transportation, food or hotel lodging)

• $1500 (USD) registration fee per participating dental hygienist, dental therapist, or dental assistant (Fee does not include the cost of air and ground transportation, food or hotel lodging)

• To pay by credit card:

  • DENTISTS: Please submit your registration and payment at the link below:

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DENTIST REGISTRATION

 

 

DENTISTS: Please note that this registration link is for the dentist only. Please complete a registration form for each participating staff member at the link below for "Staff Member Registration"

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• STAFF MEMBERS: (Dental Hygienists, Dental Assistants, and Front Office Staff of course-registered dentist): Please submit your registration and payment at the link below:

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STAFF MEMBER REGISTRATION

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CDE program:                    Mini-Residency in Developmental Dentistry

 

Program Dates:                 

 

Cohort 1: Monday-Friday, 23rd-27th September 2019

Cohort 2: Monday-Friday, 4th-8th November 2019

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To inquire about scheduling custom program dates, please submit a request at the link, https://www.cifgoh.org/contact

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Location:

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Lee Specialty Clinic

4501 Louise Underwood Way

Louisville, KY 40216

 

Course Instructors:

 

Kristin Compton, DMD

Dental Director

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Dr. Kristin Compton began her dental career at Kool Smiles treating pediatric patients. She then spent five years as Director of Dental Services at the Orange Grove Center in Chattanooga, TN, a center for patients with intellectual and developmental disabilities. She led the Orange Grove Center’s dental rotations for Chattanooga State Dental Hygiene students.Dr. Compton became the Developmental Dentistry Director at the Lee Specialty Clinic in October 2014. In addition to managing the dental clinic and staff, she runs the Advanced Education in General Dentistry (AEGD) program in conjunction with Lutheran Medical Centers and New York University. In addition to her roles at LSC, Dr. Compton is also the Kentucky state clinical director for Special Smiles, Special Olympics, a program offers dental screenings for athletes participating in Special Olympics events. Dr. Compton is a 2003 graduate of Alice Lloyd College and a 2007 graduate of the University of Louisville School of Dentistry, where she remains an adjunct faculty member. She continued her education with a one year Fellowship in Developmental Dentistry at the Underwood and Lee Clinic under the direction of Dr. Henry Hood.

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Britni Robinson, DMD

Dental Faculty Member

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Britni Robinson, D.M.D. is a native of Chicago, IL. She attended Carleton College in Northfield, MN where she received her Bachelors in Studio Arts. After working for about two years after college she enrolled in the University Of Louisville School Of Dentistry where she received her D.M.D. in 2017. She developed a passion for treating patients with IDD in dental school when she had the opportunity to take a semester long class on treating patients with IDD taught by Dr. Henry Hood, CCO of Lee Specialty Clinic. This passion followed her from dental school, completing a 2 year AEGD residency program at Lee Specialty Clinic that focused on interdisciplinary health care treatment for this specific patient population. She is now practicing as a full time developmental dentist at Lee Specialty Clinic, clinical faculty for the AEGD residency program and adjunct faculty for the University Of Louisville School Of Dentistry.  

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Dr. Henry Hood, DMD

Chief Clinical Officer

 

Dr. Henry Hood is the Chief Clinical Officer at the Lee Specialty Clinic. Dr. Hood’s entire career has focused on clinical, teaching, research and advocacy work in the care of patients with IDD. Dr. Hood is a nationally-recognized leader in Developmental Dentistry. He is responsible for multiple pre-doctoral and postgraduate IDD dentistry clinical and didactic teaching programs. He has also written internationally-published book chapters and scientific articles on IDD dentistry. In 2014 the Kentucky Board of Dentistry recognized Dr. Hood’s leadership in special needs dental education by designating the Lee Specialty Clinic as an independent teaching institution. Dr. Hood has served as a forensic consultant in the evaluation of abuse, neglect, and death of community-based and institutionalized individuals with IDD. He has worked with multiple law enforcement and protective agencies in promoting the wellbeing of individuals with IDD in community and institutional settings. Dr. Hood is also the co-founder and Past President of the American Academy of Developmental Medicine and Dentistry, the nation’s first and only interdisciplinary professional organization of physicians and dentists with expertise in the care of patients with IDD. Dr. Hood is a graduate of The University of Louisville Dental School.

 

Patrick Swanson, MD

Medical Director, Developmental Psychiatrist

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Dr. Swanson graduated from the University of Iowa in 1979 with his B.A. in Psychology, and with graduate studies in Psychology and Chemistry.  He completed his medical training in 1988 at the University of Illinois College of Medicine, graduating as a Doctor of Medicine. In 1992, he completed his residency training in Psychiatry at the University of Cincinnati College of Medicine, and he is currently Board-Certified in both adult and child psychiatry.

Dr. Swanson has published scientific articles, and has lectured widely on issues related to psychiatry and psychiatric illness.  He has a rich background in both inpatient and outpatient adult and child psychiatric clinical settings, and he his current clinical work is largely focused on the psychiatric care of adolescents and adults with intellectual and developmental disabilities (IDD) at the Lee Specialty Clinic in Louisville, Kentucky. Shortly after joining the interdisciplinary team at the Lee Specialty Clinic, Dr. Swanson’s wife asked him how he liked his new position.  He replied, “I feel like I’ve died and gone to Heaven.”  At the Lee Specialty Clinic, Dr. Swanson brings his whole heart and his formidable clinical skill set to his work.  He is loved by his patients and his colleagues, and he is a passionate mentor to the students, residents and externs who come to the clinic to study under him.  His passion for the patient population is evident in every area in which he is active – patient care, teaching and research.

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Paula Robinson, MD

Medical Director, Bingham Gardens; Developmental Physician

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Dr. Paula Robinson joined the Lee Clinic in 2014 and has spent much of her career improving the lives and addressing the medical needs of patients with intellectual and developmental disabilities (IDD). Prior to joining the Lee Specialty Clinic, Dr. Robinson served the United States Air Force as a flight surgeon and family physician. Honorably discharged, Dr. Robinson moved to Virginia where she worked in private practice for some years before moving to Kentucky in 1993 with her husband, a Louisville native, and her family. Dr. Robinson has worked in both hospital and private practice settings in Kentucky. The mother of a child with IDD, she serves on the advisory board for the University of Kentucky study on aging with Down Syndrome. Dr. Robinson is a member of the American Academy of Developmental Medicine and Dentistry, and has spoken at numerous conferences for healthcare providers caring for patients with IDD. A board certified family physician, Dr. Robinson graduated from the University of Oklahoma College of Medicine in Oklahoma City. She completed a family medicine residency at Duke-Fayetteville Area Health Education Center in North Carolina.

 

Jim Hisle, PTA

Therapeutic Services Director

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Jim Hisle began his career in 1994 at Central State Hospital and The Bingham Intermediate Care Facility in Louisville, Kentucky. A lifelong entrepreneur as well as a dedicated therapist, Jim and a colleague started TheraCare Alliance, a therapy staffing company that now employs over 30 Physical Therapists, Occupational Therapists, and Speech Language Pathologists. TheraCare Alliance’s staff work extensively with individuals with intellectual and developmental disabilities. In 2008, Jim started The PrinceCare Group, Inc. and serves as the company’s President. The PrinceCare Group provides Adult Day Training and comprehensive therapeutic services in the community. At Lee Specialty Clinic, Jim provides physical therapy services and serves as our Therapeutic Services Director. Jim is a highly-regarded and important member of Lee’s team, having provided physical therapy services to individuals with IDD for 22 years. Jim is a graduate of Jefferson County Technical College and Indiana Wesleyan University, where he graduated with summa cum laude honors.

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Kristin Compton, DMD                  Dr. Britni Robinson                 Dr. Henry Hood, DMD                Patrick Swanson, MD              Paula Robinson, MD                Jim Hisle, PTA

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