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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 CSHCN. 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

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 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]


Details

Holt K, Barzel R, eds. 2017. Oral health services for children and adolescents with special health care needs: A resource guide (3rd. ed.). Washington, DC: National Maternal and Child Oral Health Resource Center, 17 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 for health professionals to assist them in planning, developing, and implementing efforts to ensure that children and adolescents with special health care needs receive optimal oral health care. The guide describes materials, including brochures, fact sheets, guides, manuals, and reports. It also lists federal agencies, resource centers, and national professional associations that may serve as resources. [Funded by the Maternal and Child Health Bureau]


Details

National Center on Early Childhood Health and Wellness. 2012–. Brush up on oral health. Elk Grove Village, IL: National Center on Early Childhood Health and Wellness, monthly

Early Childhood Learning and Knowledge Center
Telephone: (866) 763-6481
E-mail: health@ecetta.info
Website: https://eclkc.ohs.acf.hhs.gov/hslc
Available from the website.

This tip sheet series provides Head Start staff with information on current practice, practical tips for promoting oral health to share with parents, and recipes for healthy snacks that children can make with Head Start staff or at home with their parents. Topics include children with special health care needs, community water fluoridation, dental caries, dental home, fluoride varnish, health literacy, home visiting, injury, nutrition, pregnancy, school readiness, and tobacco.


Details

National Maternal and Child Oral Health Resource Center. 2018. Special care: An oral health professional's guide to serving 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 series of modules provides oral health professionals with information about children with special health care needs and oral health, oral health supervision, prevention of oral disease, and behavior guidance. The curriculum can help fulfill the dental education and dental hygiene education programs requirement on the management and treatment of patients with special health care needs. The curriculum can be taken for continuing education credit at no charge or for no credit (self-assessment). [Funded by the Maternal and Child Health Bureau]


Details

Silva S, Zimmerman B, Holt K. 2009. Oral health for children with special health care needs: Priorities for action—Recommendations from an MCHB expert meeting. Washington, DC: National Maternal and Child Oral Health Resource Center, 19 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 document summarizes a meeting held on April 15-18, 2008, in Washington, DC, to discuss strategies and key partners for improving the oral health of children with special health care needs and the oral health care delivery system for this population in three priority areas: medical home and dental home interface, education and training, and financing. A companion presentation is also available. [Funded by the Maternal and Child Health Bureau]

     


OHRC Library

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


Details

McMillen Health. 2016. Healthy baby teeth for children with special needs: Prenatal through childhood. Fort Wayne, IN: McMillen Health, 37 pp

McMillen Center for Health Education
600 Jim Kelley Boulevard
Fort Wayne, IN 46816

Telephone: (888) 240-7268
Secondary Telephone: (260) 456-4511
Website: http://mcmillenhealth.org
$49.99.

This flip chart is designed to be used by early interventionists, home visitors, and others who work with parents of children with special needs from prenatal through childhood. It can be used one-on-one or group teaching with parents. Pages correspond to the age of the child, a specific stage, or a specific disability. Topics include prenatal, taking care of the baby's and child's mouth, baby bottle tooth decay, finding and planning a trip to the dentist, tooth decay, tooth brushing, intellectual and physical disabilities, preventing falls, mouth and tooth injuries, cleft lip and palate, autism spectrum disorder, cerebral pals, Down syndrome, and g-tube and tracheostomy. Links to short videos and parent handouts are available.


    Details

    Special Care Advocates in Dentistry. 2013. SAID professional modules. [no place]: Special Care Advocates in Dentistry, multiple items

    Special Care Advocates in Dentistry
    Southern Association of Institutional Dentists Website: http://saiddent.org
    Available from the website.

    This series of 15 modules is designed to help oral health professionals meet their clients’ special needs. Topics include intellectual disability; clinical concerns related to providing oral health care for clients with intellectual disability; Down syndrome; cerebral palsy; using sedation, dental restraints and positioning devices, and general anesthesia; oral manifestations in genetic syndromes; providing oral health care for people with mental illness in institutional and outpatient settings; treatment planning; preventive dentistry; providing services to people with disabilities who reside in the community; administrative issues in the practice of dentistry in institutional settings; and research needs and opportunities.


    Details

    Virginia Department of Health. 2018. A healthy mouth for people with special health care needs. Richmond, VA: Virginia Department of Health, 1 p

    Virginia Department of Health
    P.O. Box 2448
    Richmond, VA 23218

    Telephone: (804) 864-7000
    E-mail: questions@vdh.virginia.gov
    Website: http://www.vdh.state.va.us
    Available from the website.

    This brochure provides information about how to keep the mouths of people with special health care needs (SHCN) healthy. The brochure explains why people with SHCN are more likely than those without SHCN to have oral health problems. The brochure offers tips for keeping a healthy mouth, planning dental visits, and finding a dentist that will treat people with SHCN. The brochure is written in simple language.

         

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