By: Katherine A. TeKolste, MD, FAAP, Developmental Pediatrician,
Member, Interdisciplinary Children's Oral Health Promotion (ICOHP) project
Children with special health care needs are at higher risk than the general population for oral health problems.
- Routine self-care may be difficult or impossible for a child, e.g. due to motor disability such as seen in spastic quadriplegia or due to cognitive or behavioral impairment.
- The underlying disease may impact oral health, such as with cleft lip and palate or leukemia.
- The treatment of a chronic disorder may lead to secondary oral health problems, such as gingival hyperplasia with anticonvulsants, methotrexate, immunosuppressants and calciuim channel blockers.
In surveys of the special needs population, parents and families identify dental care as the most common unmet health care need for their children.
How Can the Primary Health Care Provider Help Optimize Oral Health?
- Emphasize prevention
- Reinforce the importance of daily oral care
- Provide handouts and brochures on how to maintain oral hygiene
- "Innoculate against cavities" by reviewing fluoride exposure and supplementing when indicated
- Review diet and feeding practices for behaviors and habits that create a high risk for developing caries or gingivitis
- Review medications and dosage regimens to minimize oral health side effects
- Monitor interactions of oral and systemic health; Recognize implications of poor oral health relative to overall health across the lifespan - Further information
- Link patients with dental providers and reinforce the importance of dental health maintainance
- Address oral health on the community level whenever possible
For the Health Care Provider:
Fact Sheet - Challenges and Opportunities
Information on unmet oral health needs, oral health and general health/well-being, barriers to care, and opportunities for care.
Tip Sheet - Strategies for Improving the Oral Health System of Care for Children and Adolescents with Special Health Care Needs
Approaches for health professionals planning, developing and implementing state and local efforts to ensure access to care.
Resource Guide: Oral Health Services for Children and
Adolescents with Special Health Care Needs. National Maternal and Child Oral Health Resource Center, Washington, DC. 2005.
List of journal articles, materials and federal agencies and national organizations that may serve as resources for ensuring optimal oral health care.
Case Study: ABCD, ABCD"E", Kids Get Care - Washington State Oral Health Initiatives.
Report from the W.K. Kellogg Foundation. Community-based Oral Health Programs: Lessons from Three Innovative Models.