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Key Facts

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

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  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.

National Maternal and Child Oral Health Resource Center. 2017. Key Facts: Focus on Oral Health Care for Children and Adolescents with Special Health Care Needs. Washington, DC: National Maternal and Child Oral Health Resource Center.