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1.3 Potential Barriers to Oral Health Care Delivery and Financing—Continued
- Many oral health professionals lack adequate educational preparation
and clinical experience to successfully manage care for some
children with special health care needs. The
results of a national survey of U.S. and Canadian dental
schools in the late 1990s show that about half of the dental
schools in the United States provided students with less
than 5 hours of classroom instruction and less than 5 percent
of clinical time devoted to providing care for children with special
health care needs. At
the 2005 American Dental Education Association (ADEA) Annual
Session, ADEA passed a resolution to work with the American
Dental Association’s
Commission on Dental Accreditation to adopt or strengthen
accreditation standards ensuring that dental education programs
include both didactic instruction and clinical experiences
involving the management and treatment of individuals with
a variety of cognitive, medical, or physical disabilities, and that these
experiences are appropriate for the type of educational program in which
the student is enrolled.
- Fewer than 1 in 10 general dentists regularly provide care for children
with cerebral palsy or cognitive disabilities or those who
are medically compromised. About two-thirds of general dentists identify
patient behavior as the foremost reason for their unwillingness to provide
care for children with special health care needs.
- More than 20 percent of children with special health care needs have
conditions that create financial problems for their families. Parents
report multiple barriers to locating appropriate and affordable
oral health care for their children with special health care
needs. Complex
oral health procedures (e.g., crowns, bridges) or those requiring
general anesthesia are often not covered by insurance plans
and must be paid for out-of-pocket by families. Insurance
coverage for oral health care, even when available, does not ensure access
to care. Inadequate reimbursement rates may make it financially difficult
for dentists to provide care for children with special health care needs.
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