MOBILE

Children with Special Health Care Needs

Recommendations

Foundational Articles

Bradshaw S, Bern D, Shaw K, Taylor B, et al. Improving health, wellbeing and parenting skills in parents of children with special health care needs and medical complexity ~ a scoping review. BMC Pediatr 2019;19:301. Available at: https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-019-1648-7. Accessed May 22, 2020.

National Center on Birth Defects and Developmental Disabilities, CDC. Communicating with and about people with disabilities. Available at: https://www.cdc.gov/ncbddd/disabilityandhealth/pdf/disabilityposter_ photos.pdf. Accessed March 2, 2020.

Craig MH, Scott JM, Slayton RL, Walker A, Chi DL. Preventive dental care use for children with special health care needs in Washington’s Access to Baby and Child Dentistry Program. J Am Dent Assoc 2019;150:42-8.

FDA Drug Safety Communication. FDA review results in new warnings about using general anesthetics and sedation drugs in young children and pregnant women. December 2016. Available at: http://www.fda.gov/ Drugs/DrugSafety/ucm532356.htm Accessed May 1, 2020.

Frank M, Keels MA, Quiñonez R, Roberts MW, Divaris K. Dental caries risk varies among sub-groups of children with special health care needs. Pediatr Dent 2019;41:378-83.

Khalid I, Chandrupatla SG, Kaye E, Scott T, Sohn W. Dental sealant prevalence among children with special health care needs: National Health and Nutrition Examination Survey (NHANES) 2013-2014. Pediatr Dent 2019;41:186-90.

Kovalesky MB, Unkel JH, Reinhartz J, Reinhartz D. Discrepancies between dental parent-derived health histories and medical electronic health records. Pediatr Dent 2019;41:371-5.

Lewis CW. Dental care and children with special health care needs: A population-based perspective. Acad Pediatr 2009;9:420-6.

McPherson M, Arango P, Fox H, Lauver C, et al. A New Definition of Children with Special Health Care Needs. Pediatrics 1988;1021:137-9.

Norwood KW, Slayton RL, Council on Children with Disabilities and Section on Oral Health. Oral health care for children with developmental disabilities. Pediatrics 2013; 31:614-9. World Report on Disability. Geneva: World Health Organization; 2011. Available at: https://www.who.int/ disabilities/world_report/2011/en/. Accessed, March 2, 2020.

Background

Treating children with special health care needs (SHCN) is an integral part of the practice of pediatric dentistry. Children with SHCN are defined as “those who have one or more chronic physical, Background developmental, behavioral, or emotional conditions, and who also require health and related services of a type or amount beyond that required by children generally.”

IAPD Recommendations

  1. Practitioners should speak about patients with disabilities using “People First Language.” For example: “a child who …”, “a child with …” or, “a child who has…”. Consensus-based statement > Global agreement 88%

  2. Pediatric dental offices should accommodate children with special health care needs (SHCNs) in the design of their offices (e.g., wheelchair accessibility), and consider having equipment to help the child cope with dental care (e.g., weighted blankets, sun glasses, noise cancellation headphones). Consensus-based statement > Global agreement 100%

  3. Parent/legal guardian-derived medical histories should be validated with the child’s primary medical provider or electronic medical record. Medical history updates should be obtained at each appointment. Consensus-based statement > Global agreement 94%

  4. Children with SHCNs are heterogeneous, therefore caries risk assessment in children with SHCNs should be individualized based on the underlying medical conditions and chronic medications. Consensus-based statement > Global agreement 100%

  5. Prevention strategies should be customized and emphasized in children with SHCN. Consensus-based statement > Global agreement 100%

  6. Children with SHCNs should be offered the same standard of dental care as children without SHCNs whenever possible. Deviations from the standard of care and rationale should be documented. Consensus-based statement > Global agreement 94%

  7. Children with SHCNs may require more surgical procedures than children without SHCNs. Consequently, dentists should consider combining oral rehabilitation with other surgeries in order to limit exposure to general anesthesia in children with SHCN. Consensus-based statement > Global agreement 94%

  8. Partnership between the pediatric dental home, and the child’s medical home should be encouraged to improve their oral and overall health. Consensus-based statement > Global agreement 94%

Other Recommendations