Transitioning Adolescent Patients with Special Health Care Needs from Pediatric to Adult Dental Care

Oral Health Care for Children and Youth With Developmental Disabilities: Clinical Report

Oral health is an essential component of overall health for all individuals. The oral health of children and youth with developmental disabilities (CYDD) involves unique characteristics and needs of which pediatricians and pediatric clinicians can be aware. Risk for oral disease in CYDD is multifactorial and includes underlying medical conditions, medications, and ability to participate in preventive oral health care and treatment, and lack of access to providers is common for this population despite being eligible for Medicaid. Pediatric clinicians are uniquely positioned to support the oral health needs of CYDD and their families through the medical home. This clinical report aims to inform pediatric clinicians about the unique oral health needs of CYDD. It provides guidance on assessing caries risk and periodontal status using structured screening instruments; understanding dental trauma, the role of diet and caries risk, trauma prevention, and malocclusion; and providing anticipatory guidance on oral hygiene that includes tooth brushing, use of fluoridated toothpaste, assessing community water fluoridation, advocating for a dental home by 1 year of age, and transition to adult dental care as part of adolescent health care. It also highlights special considerations for dental treatment rendered under sedation or general anesthesia that CYDD may need. Pediatric clinicians can help reduce risk of CYDD developing dental disease by understanding the unique needs of their patients and their barriers to accessing oral health care in their community, communicating with the child's dental home, and advocating for safe and accessible dental procedures.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2021 dental literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to coverage of this broad topical area. Specific subject areas addressed, in order of the appearance in this report, include COVID-19 and the dental profession (new); prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence daily dental treatment decisions with an emphasis on future trends in dentistry. With the tremendous volume of dentistry and related literature being published daily, this review cannot possibly be comprehensive. Rather, its purpose is to update interested readers and provide important resource material for those interested in pursuing greater details on their own. It remains our intent to assist colleagues in negotiating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the patients and dental problems they encounter.

Caregivers’ Perspectives on Transitioning Dental Care for Adolescents with Special Healthcare Needs–A Cross-Sectional Study

Introduction

Few studies have investigated the concerns of caregivers of adolescents with special health-care needs (ASHCN) regarding the barriers and challenges of transitioning from a pediatric to an adult-based dental home. The purpose of this study was to assess these perceptions.

Methods

A 23-question survey was administered to guardians of ASHCN who presented to the pediatric dental clinic at the University of Maryland. Question types were either multiple choice, Likert scale responses, or open-ended. A descriptive analysis and Fisher's exact test were performed. Keywords were evaluated from the open-ended answers.

Results

Twenty-seven caregivers completed the survey over a six-month period. Sixty-six percent of caregivers were aware that dental needs change as child ages and thought that transitioning was a logical next step, 78% had concerns about transitional care, and 70% did not have the desire to transition. Fisher's exact analysis comparing awareness of transition versus the desire to transition was p < 0.10.

Conclusion

Most caregivers were aware of the changing dental needs of ASHCN and believed transitioning was a logical step. Many caregivers lacked readiness and perceived multiple barriers to transitioning. Awareness of the need to transition from pediatric to adult-based dental homes was not correlated with the readiness to transition.