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By Matt Skoufalos

Dr. Michael Millano, right, brought more than 40 volunteers and screened 160 athletes at a recent tournament.

Dr. Michael Milano, right, brought more than 40 volunteers and screened 160 athletes at a recent tournament.

Although Special Olympics is commonly known for its support of athletic competition among individuals with various disabilities, the nonprofit is also a critical source of primary health care screenings and preventive care for that same population.

Rachel McQuiston, Vice President of Communications for Special Olympics North Carolina, said most of the barriers to adults and children with intellectual disabilities getting the care they need are related to barriers of access or communication. In response, the agency is working to bridge the gap with free, non-invasive health screenings for athletes who participate in the games. The process helps to identify health issues among the population it serves as well as putting patients with intellectual disabilities in contact with medical professionals who may never have worked with such patients.

“The hope is that medical practitioners who are involved with our healthy athlete screenings will take that base that they’ve built and welcome people with intellectual disabilities into the medical community,” McQuiston said. “It may happen that they treat more people with intellectual disabilities, or treat them with more knowledge.”

One of seven healthy athletes disciplines, and probably the longest-running in North Carolina, is the Special Smiles initiative, which works to screen athletes for dental and oral health concerns. The others – Healthy Hearing, Open Eyes, Health Promotion, Medfest, and Strong Minds, Strong Bodies – help in the areas of hearing, vision, flexibility and conditioning, physical check-ups, and stress management, respectively.

“If you’re not healthy, you can’t compete well on the field,” McQuiston said. “That’s what inspired us to be more than just a sports organization. It’s very important that we’re looking at our athletes as athletes. That includes the way they’re eating, exercising, dental health, and Special Olympics as a worldwide organization has taken a very strong position on that. You can’t just focus on sports, you have to focus on the disciplines around sports as well.”


Every year, Special Smiles screens hundreds of athletes for dental issues at each of the state-level competitions held in North Carolina. The success of the program is owed in large part to the efforts of its certified clinical director, Dr. Michael Milano, a pediatric dentist who also teaches at the University of North Carolina as a clinical associate professor. For the past 20 years, Milano has given his time to support the efforts of Special Olympics, even traveling from Texas to Alaska to complete his clinical training for the organization. Moreover, Milano also routinely recruits a group of volunteers for every event, many of them UNC dental school students or residents, and performs the screenings with their assistance. At the organization’s fall tournament in High Point, North Carolina, Milano brought more than 40 volunteers, and screened 160 athletes – more than any other discipline at the event, McQuiston said – providing free dental exams, oral hygiene instruction, and free, custom mouth guards. The process is just as important to the athletes as it is to the organization, she said.

“Dr. Milano specifically and clinical directors in other fields have access to people that we as a nonprofit do not have access to,” McQuiston said. “Dr. Milano is an educator. He teaches other people how to be pediatric dentists. By getting them familiar with treating people with intellectual disabilities and communicating with them, he is setting it up so 20, 30, 40 years down the road, they’re doing this.”

“The fact that he’s continuing that legacy and that education for folks is very, very important,” she said. “If a resident goes back to school after a screening and treats more people with disabilities in school, they go to whatever town they came from, and now they are a practice that supports and welcomes people with intellectual disabilities. As each person leaves, they take it with them.”

McQuiston estimates that roughly 200,000 adults with intellectual disabilities live in North Carolina, and nearly 40,000 of whom are registered as Special Olympic athletes. Yet even with that volume of persons served through its efforts, she believes the organization has “a lot of work to do.”

“Generally speaking, people with intellectual disabilities, based on Special Olympics research, are more likely to have chronic health conditions than the general population,” she said. “We find that individuals with intellectual disabilities do have a higher rate of dental disease or cavities than individuals without intellectual disabilities. That’s the key part of healthy athlete screenings. We’re finding the problem, and then we’re helping to fix that problem.”

To that end, Milano has worked to compile a list of people throughout the state who are willing to treat athletes with special needs, sometimes at a greatly reduced cost, McQuiston said.

Milano described his experience with the program as “an absolute privilege” that he has found “incredibly rewarding” in his practice. Alongside working to lower the barriers to accessing care for individuals with disabilities, he said he’s refined his patient practice through years spent interacting with different kinds of people.

“If you’ve treated one patient with a particular condition or disability, you’ve treated just one patient with that disability,” Milano said. “As long as you approach each patient as an individual, it becomes a very rewarding experience because you find some way to connect with them.”

Milano said that working with Special Olympians has helped him hone his approach for patients of different developmental ages, noting that the “intellectual” and “chronological” ages of the people he has seen through the program are not always aligned.

“We use whatever we need to make that visit as easy as possible for them,” he said. “For that time, they’re our boss. We’re working for them.”

Although Milano is a teacher as well as a private practitioner, the philosophy he espouses can be extended beyond the educational setting. He hopes the techniques he is able to access from this perspective of service are carried out by the next generation of dentists, but also understands that even neurotypical patients can have a high degree of anxiety around the experience of visiting the dentist. That means it’s even more incumbent upon practitioners with extra training to vouchsafe the security of a compassionate experience for special-needs patients.

“Anyone who has the ability to help anyone who needs dental care, any way you can help them, do it,” he said. “You find that one individual who you can help, and maybe you provide care for them; donate to an organization that provides care; all of those things matter.”

“We fool ourselves and think we need to do the one big thing to change the world,” Milano said. “A lot of little steps can do it too.”

Those wishing to contribute to the efforts of Special Olympics North Carolina from a donor, sponsor, volunteer or clinical background are invited to contact health director Ellen Fahey at efahey@sonc.net.