A Disability-Inclusive University-Based Oral Health Education Program for Adults with Cognitive Disabilities: Over a Decade of Experience in Special Care Dentistry

Abstract

To describe the development, structure, implementation, and long-term trajectory of a university-based, disability-inclusive oral health education program for adults with cognitive disabilities, including its educational strategies, clinical familiarization activities, participation patterns, and lessons learned from implementation.  A retrospective descriptive study was conducted using institutional records, course reports, teaching materials, faculty and facilitator documentation, and previously collected qualitative evidence. The program, implemented from 2015 to 2025 within an inclusive higher education initiative in Costa Rica, followed a progressive educational sequence combining accessible theoretical instruction, practical oral hygiene activities, individualized support, and familiarization with the dental environment. Undergraduate and postgraduate dental students participated voluntarily as facilitators under faculty supervision. A total of 199 course enrollments were recorded over the study period, with uninterrupted delivery, including adaptation to a virtual format during 2020 and 2021. Implementation documentation reflected recurring participant engagement in supervised oral hygiene activities, varying individual support needs, and the use of adapted communication, repetition, demonstrations, and individualized assistance across successive cohorts. Previously collected participant perspectives described learning experiences related to oral structures, dental caries, toothbrushing, dental floss, and mouthwash use. Because standardized outcome measures and pre- and post-intervention assessments were not available, these findings are interpreted descriptively and do not establish program effectiveness. This long-term experience documents the sustained implementation of a disability-inclusive oral health education program integrating accessible education, practical self-care activities, individualized support, progressive familiarization with the dental environment, and supervised participation of dental students. The model may inform the development and adaptation of similar university- and community-based initiatives. Prospective studies using standardized participant- and student-level outcomes are needed to evaluate its effects on oral health behaviours, experiences with dental care, and professional education.