Better Oral Health for Kids with Special Needs

Webinar June 5, 2015

Jay Balzer, DMD, MPHConsultant, ASTDD

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Better Oral Health for Kids with Special Needs

Webinar June 5, 2015

Jay Balzer, DMD, MPHConsultant, ASTDD

Today’s Topics

Who are kids with special needs?

Eleven online resources

Preventing oral disease

Locating the right dental office

Talking to the dentist

Maintaining oral health

Who Are Head Start Kids with Disabilities?

Office of Head Start definition: Children with an IFSP or IEP

IFSP = Individual Family Service Plan IFSP focuses on the child and family and the services that a family needs to help them enhance the development of their child.

IEP = Individual Education Plan IEP focuses on the educational needs of the child.

Some Oral Health Concerns of Kids with Disabilities

Child with poor motor control—unable to hold toothbrush

Child with cognitive/motor disability—swallows toothpaste

Child is orally “defensive”—won’t allow toothbrush in mouth

Child takes meds that are sweetened—promotes decay

Child takes meds that reduce saliva—promotes decay

Examples of Kids with “Special Needs”

Kids with physical but no intellectual disability—wheelchair

Kids with intellectual but no physical disability—autism

Kids with intellectual and physical disability—developmental

Kids with complex medical condition—hemophilia

Kids with learning disability—can’t pay attention due to toothache

Kids with no disability but high need for services—asthma

Kids with exceptional fear of the dentist—uncooperative

Kids with dental disability—advanced decay, constant pain

Oral Health Resources for Kids with Special Needs

Resource #1

Head Start National Center on Health

Oral Health Home Page

http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/oral-health

Resource #2

Brush Up on Oral Health Newsletters

http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/oral-health/policies-procedures/buoh.html

Resource #3

National Maternal and Child Oral Health Resource Center

http://www.mchoralhealth.org/Topics/cshcn.html

Resource #4

American Academy of PediatricsChildren’s Oral Health

http://www2.aap.org/commpeds/dochs/oralhealth/index.html

Resource #5

Association of State and Territorial Dental Directors

Children with Special Health Care Needs

http://www.astdd.org/children-with-special-health-care-needs

Resource #6

American Academy of Pediatric Dentistry

http://www.aapd.org

Resource #7

Special Care Dentistry Association

http://www.scdaonline.org

Resource #8

Family VoicesFamily to Family Networking

State Contactshttp://www.familyvoices.org/states

Oral Healthhttp://www.familyvoices.org/work/oral

Resource #9

Children’s Hospitals

https://www.childrenshospitals.org/Directories/Hospital-Directory

Resource #10

Special Olympics—Special Smiles

http://resources.specialolympics.org/Topics/Healthy_Athletes/Disciplines/Special_Smiles.aspx

Resource #11

National Institute of Dental and CraniofacialResearch (NIDCR)

Children’s Oral Healthhttp://www.nidcr.nih.gov/oralhealth/OralHealthInformation/ChildrensOralHealth/

Special NeedsPractical Oral Care for People with Developmental Disabilities

http://www.nidcr.nih.gov/oralhealth/OralHealthInformation/SpecialNeeds/

Preventing Oral DiseaseMany Opportunities

Healthy water: community water fluoridation

Healthy home: safe diet and oral care

Healthy Head Start: healthy habits and healthy food

Curriculum and program-based services in Head Start

Healthy teeth: prompt referral to treatment

Locating the Right Dental Office for Kids with Special Needs

The right office

The wrong office

No office at all

The Right Office

Physically accessible and friendly

Inquires about the child’s condition

Inquires about prior dental experience

Explains treatment plan and alternatives

Adult allowed in treatment room

Interpretation services for families

The Wrong Office

Accessibility barriersDoes not engage parent in discussion Does not go slow with fearful childDoes not allow parent in treatment roomDoes not explain treatment optionsIf unable to treat, does not refer

How to Find the Right Dental Office

Ask your family dentistAsk other community dentists Ask parents who have had successUse online and other directories

Some Online Dentist Directories

Insure Kids Now (search widget)—dentists who accept Medicaid http://www.insurekidsnow.gov

American Academy of Pediatric Dentists—dentists who treat kids http://www.aapd.org

Special Care Dentistry Assoc—dentists who welcome special patients http://www.scdaonline.org/?Referral

Your state dental association directory—example from Colorado https://www.cdaonline.org/find-a-dentist/directorysearch

Special Needs Dentist Directory—example from Virginia http://www.vdh.virginia.gov/OFHS/childandfamily/dental/dentaldirectory/Home.aspx

Talking to the DentistBe Informed

Some AAPD policies and guidelines that are pertinent to kids with special needs:

AAPD Policies and Guidelines: Homepage http://www.aapd.org/policies

More AAPD Policies and Guidelines

Management of Patients with Special Health Care Needs http://www.aapd.org/media/Policies_Guidelines/G_SHCN.pdf

Policy on Interim Therapeutic Restorations http://www.aapd.org/media/Policies_Guidelines/P_ITR.pdf

Protective Stabilization for Pediatric Patients http://www.aapd.org/media/Policies_Guidelines/G_Protective.pdf

More AAPD Policies and Guidelines

Ethical responsibility to treat or refer http://www.aapd.org/media/Policies_Guidelines/P_Ethic.pdf

Transition from pediatric to adult care http://www.aapd.org/media/Policies_Guidelines/

P_Transitioning.pdf

Recipe for Maintaining Oral Health

Healthy Community Community water fluoridation

Healthy HomeHealthy diet and home care

Healthy SchoolsHealthy food, drink and play

Quality Dental HomeUsed regularly

Thank You

Contact me with questions

Jay Balzer, DMD, MPHConsultant, ASTDDbalzerjay@gmail.com