Oral health professionals should use behavior guidance techniques consistent with their level of education and training and that fit the child’s needs. A dentist who is not comfortable managing a child’s behavior, in partnership with parents, should refer the child to another oral health professional with more knowledge, skill, and experience. (See module 5, Behavior Guidance.)

Potential barriers to oral health care delivery and financing may include the following issues and concerns:

• CSHCN are almost twice as likely to have unmet oral health care needs as their peers without special health care needs across all income levels. 8
• A majority (67 percent) of parents of CSHCN report that dentists lack necessary knowledge about how to treat CSHCN or are unwilling to treat them. 9
• Nearly all U.S. dental hygiene programs include material about the treatment of individuals with special health care needs during their classroom-based educational efforts, but less than 50 percent of programs require students to gain clinical experiences with these individuals. 10
• More CSHCN have seen a dentist for oral health care within the last 12 months than have children without special health care needs (83 percent vs. 76 percent), yet the prevalence of unmet oral health care needs is almost twice as high among CSHCN as it is among their counterparts without special health care needs (4 percent vs. 2 percent). 8
• More than 20 percent of CSHCN have conditions that create financial problems for their families. 11
• Higher levels of parent burden are associated with significantly lower odds of preventive oral health care use for CSHCN, regardless of whether the child has a functional limitation. 12
• Some consumer protections in the Patient Protection and Affordable Care Act contained in health plans do not extend to dental plans. For example, health plans cannot charge higher premiums or refuse coverage because of a preexisting health condition. Dental plans, however, are allowed to charge more or to deny coverage. 9