Dental Care and Children with Special Health Care Needs: A Population-Based Perspective

Department of Pediatrics, Division of General Pediatrics, University of Washington, Seattle, Washington 98195, USA.
Academic pediatrics (Impact Factor: 2.23). 11/2009; 9(6):420-6. DOI: 10.1016/j.acap.2009.09.005
Source: PubMed

ABSTRACT This paper grew out of a project reviewing progress in children's oral health after Oral Health in America: A Report of the Surgeon General was published in 2000. It includes a summary of advances in national surveillance of children with special health care needs (CSHCN), and presents more recent data on unmet dental care need among CSHCN. To that end, we used the 2006 National Survey of Children with Special Health Care Needs to determine the prevalence of unmet dental care need among CSHCN and to compare this within subgroups of CSHCN, as well as to children without special health care needs, and to results from the previous iteration of this survey. Dental care remains the most frequently cited unmet health need for CSHCN. More CSHCN had unmet needs for nonpreventive than preventive dental care. CSHCN who are teens, poorer, uninsured, had insurance lapses, or are more severely affected by their condition had higher adjusted odds of unmet dental care needs. CSHCN who were both low income and severely affected had 13.4 times the adjusted odds of unmet dental care need. In summary, CSHCN are more likely to be insured and to receive preventive dental care at equal or higher rates than children without special health care needs. Nevertheless, CSHCN, particularly lower income and severely affected, are more likely to report unmet dental care need compared with unaffected children. Despite advances in knowledge about dental care among CSHCN, unanswered questions remain. Recommendations are provided toward obtaining additional data and facilitating dental care access for this vulnerable population.

Download full-text


Available from: Charlotte Lewis, Apr 28, 2015
1 Follower
  • Source
    • "With the exception of MPS IV patients, there was considerable heterogeneity in the prevalence of predisposing dental anomalies and poor hygiene and in the incidence of decay and gingivitis between and within classes of MPS. Therefore, given the serious challenges in providing dental treatments, and considering the evidence from the literature about increased oral health needs in vulnerable groups of patients (Lewis 2009; Shaw et al. 1986; Purohit et al. 2010) the authors recommend that dental professionals should consider all patients with an MPS disorder as being at highrisk of dental disease. Failure by parents and carers to access dental care needs to be addressed. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: As one of the 4 United Kingdom national centres for Lysosomal Storage Disorders, Birmingham Children's Hospital (BCH) cares for 49 patients with a mucopolysaccharide (MPS) disorder. Presently, their oral health needs have never been fully investigated. Enzyme therapies are revolutionising medical treatment, and will prolong life expectancy. Therefore, oral health and its impact on quality of life are increasingly important. Hypothesis: Patients with an MPS disorder have greater oral health needs in comparison with the general population. Design: Forty-six patients with an MPS disorder were investigated for caries, gingival health and enamel opacities. Questionnaires to establish the utilisation of dental services and assess the perceived difficulties in achieving adequate oral health care were completed. Results: Patients with an MPS disorder have specific oral health needs depending on the type of MPS experienced. This study found 76% of patients with MPS IV had experienced dental caries and they all showed evidence of a generalised unspecified enamel defect. Subjects with MPS I, II and III did not have an increased caries rate; 50% of the study group had received dental treatment in the past, of which 74% (17, n = 23) required a general anaesthetic. Conclusion: The MPS disorders can have a significant effect on the developing dentition. Subjects with MPS IV do have an increased oral health need in comparison with the general population and the other MPS groups due to their increased caries rate and enamel defects. Further research is required to fully assess their needs and investigate any structural tooth defects.
    01/2012; 2:51-8.
  • [Show abstract] [Hide abstract]
    ABSTRACT: This paper describes an experimental route planner for an autonomous vehicle. Given a high level mission specification (an unordered list of way-points to visit and surveys to run), the system works out a route connecting the mission tasks and issues intermediate level motion commands that describe that route. This planner is implemented in Flavors and is based on the Blackboard Control Architecture. which separates the domain specific issues from the control issues of a problem solving effort. This separation allows the planner to reason about what strategies to apply during the problem solving exercise. The control subsystem allows the planner to adopt one of two planning strategies according to an input parameter in the mission specification. The system forms a basis for context sensitive planning, which is an important issue for an autonomous vehicle. The planner is being translated into Common Lisp for installation on board an autonomous vehicle in late summer 1987.
    Unmanned Untethered Submersible Technology, Proceedings of the 1987 5th International Symposium on; 07/1987
  • Journal of pediatric nursing 10/2010; 25(5):441-3. DOI:10.1016/j.pedn.2010.06.005 · 0.92 Impact Factor
Show more