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 Results
of the 1994-1995 National Health Interview
Survey on access to care and use of
services by children with special
health care needs indicate that, among
this population, the most prevalent
unmet need is dental care.
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Despite reductions in oral disease in
the United States during the past decades, some infants
and young children with special health care needs
continue to experience oral health problems.[3]
Dental
caries, periodontal disease, and other oral-facial
conditions present unique problems in the oral health
management of infants and young children with special
health care needs. Because these conditions are often
chronic, they can complicate other physically or mentally
disabling conditions.
Infants’ and young children’s
oral health may be affected negatively by
- Medications (e.g., gingival overgrowth is a side
effect of medications such as phenytoin sodium,
which is used to treat epilepsy)[3]
- Special diets (e.g., therapeutic diet, limited
diet because of food aversion or allergies)[3]
- Decreased saliva flow[3]
- Motor problems that cause difficulty in cleaning
the mouth thoroughly on a daily basis[3]
- Parents’ lack of confidence about performing
oral care for their child because they have inadequate
information about oral growth and development[4]
- Lack of access to preventive care[3]
In addition, some conditions are associated
with increased risk for various oral health problems.
For example,
- Children with developmental disabilities are at
increased risk for enamel irregularities, gum infections,
tooth eruption (teething) delays, moderate to severe
malocclusion (improper bite), and oral infection.[5]
- Children with Down syndrome are at increased
risk for periodontal disease, xerostomia
(dry mouth), fissuring of the tongue and lips, and
malocclusion
(improper alignment of the jaws and teeth).[6]
- Children with cleft lip or cleft palate are at
increased risk for tooth decay, gingivitis, and
malocclusion.[7]
Oral health problems affect infants
and young children with special health care needs
in the same way they affect all children, and yet
in some cases the problems may be more severe. One
primary concern is that because these children have
a number of other needs (e.g., physical, developmental,
or emotional needs), oral health may not be regarded
as a priority.[3]
Tooth decay may progress because these infants and
young children may not receive treatment in a timely
manner, or at all. This can be due to a shortage of
dentists trained or willing to work with this population,
insufficient or no reimbursement for care, and/or
behavior management issues. Many of these infants
and young children may not be referred to a dentist
until an oral health problem affects their overall
health.
Results of the 1994-1995 National Health
Interview Survey on access to care and use of services
by children with special health care needs indicate
that, among this population, the most prevalent unmet
need is dental care. Among the uninsured respondents,
23.9 percent reported unmet dental care needs, 12.3
percent reported unmet prescriptions and/or eyeglasses
needs, 10.5 percent reported unmet medical care needs,
and 3.4 percent reported unmet mental health care
needs.[8] |
