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Despite having a high prevalence of functionally compromising malocclusions, individuals with intellectual and developmental disabilities do not regularly receive necessary orthodontic treatment. Patients with behavior challenges are unlikely to be offered this treatment option. However, with appropriate behavior management interventions and pharmacologic sedation, orthodontic treatment becomes a possibility for clinicians to consider. Parents will likely seek out clinicians who can provide this type of advanced orthodontic care. Additional training is now becoming available as accredited Fellowship Programs in Craniofacial and Special Care Orthodontics are developed. Hopefully, the clinical examples described in this article will no longer be unique in the area of special care dentistry.