Journal of the American Dental Association (1939) · 2026
Oral health and economic impact of the Special Olympics Special Smiles screening and referral program: A decision-analytical evaluation.
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Halasa Rappel Yara, Goldblatt Alie, Yin Michelle
Аннотация
BACKGROUND: People with intellectual and developmental disabilities experience high rates of untreated oral disease and lower dental care use than the general population. Special Olympics Special Smiles (SOSS) provides community-based dental screenings, oral hygiene instruction, and referrals to improve access to care. This study estimated the oral health and economic impact of SOSS screening and referral activities.
METHODS: We developed a decision model to compare outcomes for people who participated in SOSS and those who did not. The model used program and national data to estimate dental care visits, oral health outcomes, and treatment costs. Key outcomes were change in dental care use, untreated caries, periodontal disease, and cost.
RESULTS: Assuming 25% referral compliance, SOSS increased the proportion of people who saw a dentist in the past year from 44% to 52%. Participation was associated with reduced caries index (0.12 tooth per person), and fewer cases of periodontal disease (49 cases prevented per 10,378 participants). Although modest at the person level, this corresponds to 1,234 averted untreated lesions, with potential reductions in pain and need for invasive care. Estimated savings from avoided dental care treatment ($793,713) exceeded program costs ($174,862), resulting in a benefit to cost ratio of 4.54. Results were consistent across referral completion rates.
CONCLUSIONS: SOSS screening and referral activities were associated with improved use, reduced oral disease, and net cost savings.
PRACTICAL IMPLICATIONS: Community-based screening and referral programs may offer a scalable, sustainable approach to improving oral health and reducing disparities among people with intellectual and developmental disabilities.
METHODS: We developed a decision model to compare outcomes for people who participated in SOSS and those who did not. The model used program and national data to estimate dental care visits, oral health outcomes, and treatment costs. Key outcomes were change in dental care use, untreated caries, periodontal disease, and cost.
RESULTS: Assuming 25% referral compliance, SOSS increased the proportion of people who saw a dentist in the past year from 44% to 52%. Participation was associated with reduced caries index (0.12 tooth per person), and fewer cases of periodontal disease (49 cases prevented per 10,378 participants). Although modest at the person level, this corresponds to 1,234 averted untreated lesions, with potential reductions in pain and need for invasive care. Estimated savings from avoided dental care treatment ($793,713) exceeded program costs ($174,862), resulting in a benefit to cost ratio of 4.54. Results were consistent across referral completion rates.
CONCLUSIONS: SOSS screening and referral activities were associated with improved use, reduced oral disease, and net cost savings.
PRACTICAL IMPLICATIONS: Community-based screening and referral programs may offer a scalable, sustainable approach to improving oral health and reducing disparities among people with intellectual and developmental disabilities.