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Oral Health Care for Children and Adolescents with Special Health Care Needs

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This collection of selected resources offers high-quality information about children and adolescents with special health care needs. Use the tools below for further searching, or contact us for personalized assistance.

Key Facts

  Share these facts to help improve the oral health of pregnant women, children, adolescents, and their families.

Children with special health care needs (CSHCN) are defined by the Maternal and Child Health Bureau as “those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.” 1

  • Maintaining good oral health is a challenge for some CSHCN because of oral health risks, limited access to care, and competing demands such as meeting other more urgent health care needs. 2
  • Poor oral hygiene, low fluoride exposure, and altered oral flora are common among CSHCNs. 3
  • Access to oral health care may pose a challenge for CSHCN because of lack of dental insurance, inadequate dental insurance, or difficulty finding a dentist who is willing and able to care for this population. 4
  • Over 5 percent of CSHCN have unmet oral health care needs, and about 9 percent of CSHCN have unmet preventive oral health care needs. 5
  • The traditional oral-health-care delivery system is not able to deliver adequate services to children with special needs. 6
  • Dental school students need more opportunities to learn how to work with and provide oral health care for individuals with special health care needs. 7
  • A coordinated transition from a pediatric-centered to an adult-centered dental home is critical for extending the level of oral health and health trajectory established during childhood. 8
  • Caregivers who are more skilled at brushing the teeth of CSHCN and who have access to child-friendly toothbrushing supplies are more likely to brush the child’s teeth twice a day vs. less frequently. 9
  • An interdisciplinary, collaborative effort between dentists, nutritionists, physicians, and other health professionals is essential to provide optimal care for CSHCN. 10
  • New systems of care using interprofessional teams to integrate oral health services into social, educational, and general health systems are evolving to serve children with special health care needs. 6
  • Volunteer experiences, such as participating in Special Olympics Healthy Athlete events, may enhance health professionals’ knowledge, skill, and confidence in treating individuals with special health care needs. 11
  • Unmet need for preventive oral health care among children with autism spectrum disorder, developmental disability, and/or mental health conditions is associated with employment and financial burdens among caregivers of these children. 12

References

  1. McPherson M, Arango P, Fox H, Lauver C, McManus M, Newacheck PW, Perrin JM, Shonkoff JP, Strickland B. 1998. A new definition of children with special health care needs. Pediatrics 102(1 Pt 1):137–140.
  2. Nelson LP. 2011. Unmet dental needs and barriers to care for children with significant special health care needs. Pediatric Dentistry 33(1):29–36.
  3. Moursi AM, Fernandez JB, Daronch M, Zee L, Jones CL. 2010. Nutrition and oral health considerations in children with special health care needs: Implications for oral health care providers. Pediatric Dentistry 2(4):333–342.
  4. Norwood, KW, Slayton RL, Council on Children with Disabilities, Section on Oral Health. 2013. Oral health care for children with developmental disabilities. Pediatrics 131(3):614–619.
  5. Weiner RC, Wiener MA. 2012. Unmet dental and orthodontic need of children with special healthcare needs in West Virginia. Journal for Rural and Remote Research, Education, Practice and Policy 12:2069.
  6. Glassman P, Harrington M, Namakian M, Subar P. 2016. Interprofessional collaboration in improving oral health for special populations. Dental Clinics of North America 60(4):843–855.
  7. Al-Allaq T, DeBord TK, Liu H, Wang Y, Messadi D. 2015. Oral health status of individuals with cerebral palsy at a nationally recognized rehabilitation center. Special Care Dentistry 35(1):25–31.
  8. American Academy of Pediatric Dentistry, Council on Clinical Affairs. 2016. Policy on Transitioning from a Pediatric-Centered to an Adult-Centered Dental Home for Individuals with Special Health Care Needs.
  9. Campanaro M, Huebner CE, Davis BE. 2014. Facilitators and barriers to twice daily tooth brushing among children with special health care needs. Special Care Dentistry 34(4):185–192.
  10. Moursi AM, Fernandez JB, Daronch M, Zee L, Jones CL. 2010. Nutrition and oral health considerations in children with special health care needs: Implications for oral health care providers. Pediatric Dentistry 2(4):333–342.
  11. Freudenthal JJ, Boyd LD, Tivis R. 2010. Assessing change in health professions volunteers’ perceptions after participating in Special Olympics Healthy Athlete events. Journal of Dental Education 74(9):970–979.
  12. Wiener RC, Vohra R, Sambamoorthi U, Madhavan SS. 2016. Caregiver burdens and preventive dental care for children with autism spectrum disorder, developmental disability and/or mental health conditions: National Survey of CSHCN, 2009–2010. Maternal and Child Health Journal 20(12):2573–2580.

OHRC Publications

This section contains OHRC-produced materials.


Details

Balzer J. 2006. Promoting the oral health of children with special health care needs: In support of the national agenda. Washington, DC: National Maternal and Child Oral Health Resource Center, 4 pp

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This policy brief provides suggestions for oral-health-promotion activities that are consistent with the National Agenda for Children with Special Health Care Needs. The brief addresses the six critical indicators of a comprehensive system of care identified by the Maternal and Child Health Bureau: medical home, insurance coverage, screening, organization of services, family roles, and transition to adulthood. [Funded by the Maternal and Child Health Bureau]


Details

Barzel R, Holt K. 2012. Child and adolescent oral health issues. Washington, DC: National Maternal and Child Oral Health Resource Center, 8 pp

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This fact sheet provides health professionals with information on issues related to child and adolescent oral health. Topics include dental caries, access to care, children and adolescents with special health care needs, dental sealants, fluorides, nutrition, injury and violence, and tobacco. [Funded by the Maternal and Child Health Bureau]


Details

Barzel R, Holt K, Isman B. 2006. Special care: An oral health professional's guide to serving young children with special health care needs. Washington, DC: National Maternal and Child Oral Health Resource Center, 1 v

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This course is designed to help oral health professionals ensure that young children with special health care needs have access to comprehensive, family-centered, and community-based services. Continuing education credits from the Indian Health Service or the American Dental Hygienists' Association will be awarded upon successful completion of the course. [Funded by the Maternal and Child Health Bureau]


Details

Bertness J, Holt K, eds. 2011. Oral health services for children and adolescents with special health care needs: A resource guide (2nd ed.). Washington, DC: National Maternal and Child Oral Health Resource Center, 36 pp

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This resource guide provides information to help health professionals plan, develop, and implement efforts to ensure that children and adolescents with special health care needs receive optimal oral health care. The guide is divided into the following three sections: (1) journal articles, (2) materials (books, curricula, fact and tip sheets, guidelines, manuals, modules, papers, reports, and CD-ROMs), and (3) agencies and organizations that may serve as resources. Entries contain bibliographic information, an annotation, and contact information. [Funded by the Maternal and Child Health Bureau]


Details

Casamassimo P, Holt K, eds. 2016. Bright Futures: Oral health—Pocket guide (3rd ed.). Washington, DC: National Maternal and Child Oral Health Resource Center, 90 pp

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This pocket guide offers health professionals an overview of preventive oral health supervision for five periods—pregnancy and postpartum, infancy, early childhood, middle childhood, and adolescence. The pocket guide is designed to help health professionals implement specific oral health guidelines during these periods. For each period, information about family preparation, risk assessment, interview questions, screening, examination, preventive procedures, anticipatory guidance, measurable outcomes, and referrals are discussed. The content aligns with Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents (4th ed.). [Funded by the Maternal and Child Health Bureau]


Details

Holt K, Barzel R, Bertness J. 2014. Oral health for children and adolescents with special health care needs: Challenges and opportunities (2nd ed.). Washington, DC: National Maternal and Child Oral Health Resource Center, 6 pp

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This fact sheet focuses on the challenges to and opportunities for providing oral health care to children with special health care needs. Topics include factors that contribute to oral health problems in this population, unmet oral health care needs, barriers to oral health care, care coordination, work force development, and federal and national programs. [Funded by the Maternal and Child Health Bureau]

     


OHRC Library

This section contains recent materials, not including OHRC-produced materials.


Details

Agoratus L. 2014. Affordable Care Act (ACA): Why oral health is important for children with special health care needs and how to access it. Albuquerque, NM: Family Voices, 2 pp

National Center for Family / Professional Partnerships
Family Voices 3701 San Mateo Boulevard, N.W., Suite 103
Albuquerque, NM 87110

Telephone: (505) 872-4774
Secondary Telephone: (888) 835-5669
Fax: (505) 872-4780
Website: http://www.fv-ncfpp.org
Available from the website.

This tip sheet for parents of children with special health care needs (CSHCN) provides information about the importance of good oral health care for CSHCN. Topics include the Affordable Care Act, finding oral health care for CSHCN, resources for families who do not have health insurance, and partnering with oral health professionals.


Details

Association of State and Territorial Dental Directors. 2017. Silver diamine fluoride (SDF) fact sheet. Reno, NV: Association of State and Territorial Dental Directors, 2 pp

Association of State and Territorial Dental Directors
3858 Cashill Boulevard
Reno, NV 89509

Telephone: (775) 626-5008
Fax: (775) 626-9268
E-mail: info@astdd.org
Website: http://www.astdd.org
Available from the website.

This fact sheet defines silver diamine fluoride (SDF) and describes the evidence base for using SDF to control dental caries. Topics include indications, contraindications, and other considerations; recommended protocols; using SDF in addition to fluoride varnish, other professionally applied fluorides, or dental sealants; Medicaid reimbursement; and who can apply SDF.


Details

Odeh M. [2014]. Ensuring adequate marketplace provider networks: What's needed for children. Washington, DC: First Focus, 4 pp

First Focus
1400 Eye Street, N.W., Suite 650
Washington, DC 20005

Telephone: (202) 657-0670
Fax: (202) 657-0671
Website: http://www.firstfocus.net
Available from the website.

This document addresses the adequacy of provider networks in ensuring that all children have access to health services, including oral health services. The document discusses what constitutes adequate provider networks for children and discusses how such networks can be developed and assessed.


Details

Schubel J. 2017. Medicaid helps schools help children. Washington, DC: Center on Budget and Policy Priorities, 7 pp

Center on Budget and Policy Priorities
820 First Street N.E., Suite 510
Washington, DC 20002

Telephone: (202) 408-1080
Fax: (202) 408-1056
E-mail: center@cbpp.org
Website: http://www.cbpp.org
Available from the website.

This brief examines the role of Medicaid in funding critical health-related services for students with disabilities. Topics include providing reimbursement for health care services that are necessary for students with disabilities to succeed in school and ensuring schools' compliance with Individuals with Disabilities Education Act requirements, helping students to stay healthy and succeed academically, and connecting students to coverage. The brief also describes the long-term benefits of Medicaid for eligible children and the potential impact of spending reductions on students, local communities, and state budgets. The appendix contains a table on state and federal Medicaid spending in schools.


Details

Seattle Children's Hospital, Washington State Department of Health, Within Reach. 2017, 2016. Starting point guide: Resources for parents of children with special health care needs. Seattle, WA: Seattle Children's Center for Children with Special Needs, 31 pp

Seattle Children's Center for Children with Special Needs
P.O. Box 5371, M2-16
Seattle, WA 98105

Telephone: (206) 987-3736
Fax: (206) 884-5741
E-mail: cshcn@seattlechildrens.org
Website: http://www.cshcn.org
Available from the website.

This directory provides an overview of resources for families who have children with ongoing health conditions or special needs in Washington. Topics include tips from parents, legal help, child and respite care, child growth and development, community health, oral health, family support, financial information, health insurance information, hearing and vision services, information and referral, medical supplies and equipment, mental health, nutrition, recreation programs, school, and transportation. A form for use in case of an emergency is included.

     

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