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Alwadi MA, AlJameel AH, Baker SR, Owens J. Access to oral health care services for children with disabilities: a mixed methods systematic review. BMC Oral Health 2024; 24:1002. [PMID: 39192235 DOI: 10.1186/s12903-024-04767-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Accepted: 08/16/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Children with disabilities experience poorer oral health and frequently have complex needs. The accessibility of oral health care services for children with disabilities is crucial for promoting oral health and overall well-being. This study aimed to systematically review the literature to identify the barriers and facilitators to oral health care services for children with disabilities, and to propose priority research areas for the planning and provision of dental services to meet their needs. METHODS This was a mixed methods systematic review. Multiple databases searched included MEDLINE, Scopus, PsycINFO, EMBASE, and CINAHL. The search strategy included Medical Subject Heading (MeSH) terms related to children, disabilities, and access to oral health. Eligibility criteria focused on studies about children with disabilities, discussing the accessibility of oral health care. RESULTS Using Levesque's framework for access identified barriers such as professional unwillingness, fear of the dentist, cost of treatment, and inadequate dental facilities. Facilitators of access offered insight into strategies for improving access to oral health care for children with disabilities. CONCLUSION There is a positive benefit to using Levesque's framework of access or other established frameworks to carry out research on oral healthcare access, or implementations of dental public health interventions in order to identify gaps, enhance awareness and promote better oral health practices. The evidence suggests that including people with disabilities in co-developing service provision improves accessibility, alongside using tailored approaches and interventions which promote understanding of the importance of dental care and increases awareness for professionals, caregivers and children with disabilities. TRIAL REGISTRATION Protocol has been registered online on the PROSPERO database with an ID CRD42023433172 on June 9, 2023.
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Affiliation(s)
- Maram Ali Alwadi
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
- King Salman Center for Disability Research, Riyadh, Saudi Arabia.
| | - AlBandary Hassan AlJameel
- Department of Periodontics & Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sarah R Baker
- Dentistry and Society, School of Clinical Dentistry, Academic Unit of Oral Health, University of Sheffield, Sheffield, United Kingdom
| | - Janine Owens
- NIHR Applied Research Collaborative Greater Manchester (NIHR ARC GM), University of Manchester, Manchester, United Kingdom
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Malik KE, Scarbro S, Yu J, Chin K, Braun PA, Feinstein JA. Differences in the Oral Health of Children with Medical Complexity. Acad Pediatr 2024:S1876-2859(24)00288-2. [PMID: 39096999 DOI: 10.1016/j.acap.2024.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/18/2024] [Accepted: 07/26/2024] [Indexed: 08/05/2024]
Abstract
OBJECTIVES Children with medical complexity (CMC), a subgroup of children with special health care needs (CSHCN) with the most serious medical conditions and disabilities, are at risk for negative effects from poor oral health. CSHCN have high rates of poor oral health including cavities. This study aimed to compare oral health status between CMC and CSHCN. METHODS This was a cross-sectional analysis of the 2016-17 National Survey of Child Health data. CMC and CSHCN were identified using validated algorithms. The primary outcome was oral health status; secondary outcomes included dental service use. Bivariate analyses compared prevalence and service use by medical complexity status. Multivariable logistic regression assessed oral health outcomes by complexity, adjusting for influencing variables. RESULTS Of 16,178 CSHCN ages 1-17 years, 6% were CMC and 94% were non-CMC CSHCN. Compared to CSHCN, CMC had a higher prevalence of fair/poor teeth conditions (19% vs 9%; p<0.001) and higher odds for fair/poor teeth conditions after adjusting for socioeconomic factors (aOR: 1.54; 95% CI: 1.01-2.34). There was no statically significant difference between groups when assessing cavities, toothache, or receipt of most preventive dental services. CONCLUSION 1 in 5 CMC are reported by caregivers as having poor oral health including cavities, despite high rates of receiving preventive dental services. After adjusting for socioeconomic factors, medical complexity remained associated with fair or poor teeth conditions. Understanding potentially modifiable targets could further help families of CMC prioritize dental needs and potentially reduce negative effects on overall health.
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Affiliation(s)
- Kristina E Malik
- Adult and Child Center for Outcomes Research & Delivery Science (ACCORDS) and Department of Pediatrics, University of Colorado and Children's Hospital Colorado, 13123 East 16th Avenue, Aurora, CO 80045.
| | - Sharon Scarbro
- Adult and Child Center for Outcomes Research & Delivery Science (ACCORDS), University of Colorado and Children's Hospital Colorado, 1890 N Revere Ct, Aurora, CO 80045.
| | - Justin Yu
- Department of Pediatrics, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA 15224.
| | - Katherine Chin
- Department of Pediatric Dentistry, University of Colorado and Children's Hospital Colorado, 13065 East 17th Avenue Aurora, CO 80045.
| | - Patricia A Braun
- Adult and Child Center for Outcomes Research & Delivery Science (ACCORDS) and Department of Pediatrics, University of Colorado and Denver Health and Hospital, 501 28th St. Denver, CO 80205.
| | - James A Feinstein
- Adult and Child Center for Outcomes Research & Delivery Science (ACCORDS) and Department of Pediatrics, University of Colorado and Children's Hospital Colorado, 13123 East 16th Avenue, Box 032, Aurora, CO 80045.
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Põld A, Kientega DF, Garé JV, Listl S. A mixed methods evaluation of the effectiveness of an oral health training program for disability care workers in Burkina Faso. BMC Oral Health 2024; 24:33. [PMID: 38184531 PMCID: PMC10771690 DOI: 10.1186/s12903-023-03837-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/27/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND While efforts to improve the oral health of vulnerable populations have received little attention in general, the situation of children with disabilities in low- income countries (LICs) remains especially challenging. The present study evaluated the effectiveness of an oral health training provided to disability care workers in Ouagadougou, Burkina Faso thereby contributing to closing the knowledge gap in disability research in relation to oral health in LICs. METHODS This was a single-arm pre-post study following an embedded mixed methods design using the New World Kirkpatrick training effectiveness evaluation model. For the purposes of this study, three levels of the Kirkpatrick (KP) evaluation were considered: reaction, learning and behaviour. RESULTS A total of 44 care workers from 6 disability centres participated in the study. Care worker post-training scores (Md = 17) were significantly higher compared to pre-training scores (Md = 13) [Wilcoxon signed-ranks test: Z= -5.53, p < .001, r = .59.] The median value for care worker confidence in applying training material in their everyday job was 7 out of 10 points (IQR = 3). At the 1-month training follow-up, 3 centres had implemented daily toothbrushing for people with disabilities. CONCLUSION These findings suggest that tailored training led to an increase in care worker confidence and motivation to implement oral health activities, in knowledge about oral health and a partial implementation uptake of daily toothbrushing in disability centres. Further long-term evaluations with dental care provision in rural and urban settings are needed to lower the high oral disease burden of people with disabilities in Burkina Faso.
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Affiliation(s)
- Ave Põld
- Institute of International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- Section for Translational Health Economics, Department for Conservative Dentistry, Heidelberg University Hospital, Heidelberg, Germany.
| | - Dan Filwendé Kientega
- Department of Public Health, Training and Research Unit in Health Sciences, Joseph KI-ZERBO University, Ouagadougou, Burkina Faso
| | - Jocelyne Valérie Garé
- Department of Public Health, Training and Research Unit in Health Sciences, Joseph KI-ZERBO University, Ouagadougou, Burkina Faso
| | - Stefan Listl
- Section for Translational Health Economics, Department for Conservative Dentistry, Heidelberg University Hospital, Heidelberg, Germany
- Department of Dentistry - Quality and Safety of Oral Health Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
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Ismail AF, Adnan NH, Suhaidi NNS, Mokhtar IW, Yusof MYPM, Mallineni SK. Accuracy of different dental age assessment methods to determine chronological age among children with special needs. J Indian Soc Pedod Prev Dent 2024; 42:64-70. [PMID: 38616429 DOI: 10.4103/jisppd.jisppd_47_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/01/2024] [Indexed: 04/16/2024] Open
Abstract
AIM This study aimed to validate the accuracy of dental age (DA) based on the dental development of permanent teeth in children with special needs using Demirjian, Willems, and London Atlas methods and to correlate the dental and chronological age (CA) of children with special needs in Malaysia. MATERIALS AND METHODS The panoramic radiographic images belonging to children with special needs from the two teaching dental hospitals in Malaysia aged between 5 and 16 years were included in the study. The evaluation was performed by two observers using three methods (London Atlas, Demirjian, and Willems methods) to estimate the accurate DA. The outcome was determined by comparing the mean of the DA and CA. RESULTS A total of 52 panoramic radiographs were available for the analysis. The London Atlas and Demirjian methods overestimated the DA with a mean of 0.05 and 0.20 years, respectively, while the Willems method underestimated by 0.19 years. The London Atlas method was highly precise and accurate, while Demirjian and Willems methods were the least precise and accurate. CONCLUSION The London Atlas method of DA estimation is highly accurate and valid for children with special needs in the Malaysian population, followed by the Willems and Demirjian methods.
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Affiliation(s)
- Ahmad Faisal Ismail
- Department of Paediatric Dentistry and Dental Public Health, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Nur Haffiszah Adnan
- Department of Paediatric Dentistry and Dental Public Health, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Nur Nadiatul Sofia Suhaidi
- Department of Paediatric Dentistry and Dental Public Health, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Ilham Wan Mokhtar
- Department Paediatric Dentistry and Special Care, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
| | - Mohd Yusmiaidil Putera Mohd Yusof
- Department Paediatric Dentistry and Special Care, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
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Tran NC, Wells CR, Atchison KA, Bhoopathi V. A national sample of developmentally disabled adolescents with obesity and their utilization of preventive dental care services. FRONTIERS IN ORAL HEALTH 2023; 4:1285416. [PMID: 38024150 PMCID: PMC10665891 DOI: 10.3389/froh.2023.1285416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background Previous literature indicates that adolescents with developmental disabilities and obesity may have more oral health complications than healthy adolescents. However, dental care utilization among adolescents with developmental disabilities (DDs) and obesity is unclear. We investigated the differences in the utilization of preventive dental services between this high-risk group of adolescents and those with no DDs or obesity. Methods Parent-reported data of adolescents 10-17 years (n = 68,942) from the 2016 to 2019 National Survey of Children's Health was used. In addition to descriptive and bivariate statistics, we ran three multiple logistic regression models guided by Andersen's Behavioral Model of Health Services Use, predicting the use of dental cleanings, fluoride treatments, and dental sealants. Results Among adolescents with DDs and obesity, dental cleanings, fluoride treatments, and dental sealant utilization prevalence were 76%, 48%, and 21%, respectively. In comparison, adolescents with no DDs or obesity had a prevalence of 83%, 50%, and 19%, respectively. Multiple logistic regression analysis showed that adolescents with DDs and obesity did not significantly differ in their receipt of dental cleanings (p = .07), fluoride treatments (p = .55), and dental sealants (p = .23) compared to those with neither DDs nor obesity. Adolescents with DDs but no obesity were 22% and 30% more likely to receive fluoride treatments (p < .0001) and dental sealants (p < .0001), respectively. Conclusions Fewer than half of adolescents with DDs and obesity utilized fluoride treatments, and less than one quarter utilized dental sealants but used all three preventive services at the same rate as those with no DDs or obesity. Implications This study identified no differences in preventive dental care services utilization in adolescents with developmental disabilities (DDs) and obesity compared to those without DDs and obesity. However, the utilization of preventive dental services in this population is influenced by the federal poverty level and family background.
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Affiliation(s)
- Nini C. Tran
- Section of Pediatric Dentistry, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Christine R. Wells
- Statistical Methods and Data Analytics, Office of Advanced Research Computing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Kathryn A. Atchison
- Section of Public & Population Health, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Vinodh Bhoopathi
- Section of Public & Population Health, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
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Srivastava S, Sahin M, Buxbaum JD, Berry-Kravis E, Soorya LV, Thurm A, Bernstein JA, Asante-Otoo A, Bennett WE, Betancur C, Brickhouse TH, Passos Bueno MR, Chopra M, Christensen CK, Cully JL, Dies K, Friedman K, Gummere B, Holder JL, Jimenez-Gomez A, Kerins CA, Khan O, Kohlenberg T, Lacro RV, Levy LA, Levy T, Linnehan D, Loth E, Moshiree B, Neumeyer A, Paul SM, Phelan K, Persico A, Rapaport R, Rogers C, Saland J, Sethuram S, Shapiro J, Tarr PI, White KM, Wickstrom J, Williams KM, Winrow D, Wishart B, Kolevzon A. Updated consensus guidelines on the management of Phelan-McDermid syndrome. Am J Med Genet A 2023; 191:2015-2044. [PMID: 37392087 PMCID: PMC10524678 DOI: 10.1002/ajmg.a.63312] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/04/2023] [Accepted: 05/18/2023] [Indexed: 07/02/2023]
Abstract
Phelan-McDermid syndrome (PMS) is a genetic condition caused by SHANK3 haploinsufficiency and characterized by a wide range of neurodevelopmental and systemic manifestations. The first practice parameters for assessment and monitoring in individuals with PMS were published in 2014; recently, knowledge about PMS has grown significantly based on data from longitudinal phenotyping studies and large-scale genotype-phenotype investigations. The objective of these updated clinical management guidelines was to: (1) reflect the latest in knowledge in PMS and (2) provide guidance for clinicians, researchers, and the general community. A taskforce was established with clinical experts in PMS and representatives from the parent community. Experts joined subgroups based on their areas of specialty, including genetics, neurology, neurodevelopment, gastroenterology, primary care, physiatry, nephrology, endocrinology, cardiology, gynecology, and dentistry. Taskforce members convened regularly between 2021 and 2022 and produced specialty-specific guidelines based on iterative feedback and discussion. Taskforce leaders then established consensus within their respective specialty group and harmonized the guidelines. The knowledge gained over the past decade allows for improved guidelines to assess and monitor individuals with PMS. Since there is limited evidence specific to PMS, intervention mostly follows general guidelines for treating individuals with developmental disorders. Significant evidence has been amassed to guide the management of comorbid neuropsychiatric conditions in PMS, albeit mainly from caregiver report and the experience of clinical experts. These updated consensus guidelines on the management of PMS represent an advance for the field and will improve care in the community. Several areas for future research are also highlighted and will contribute to subsequent updates with more refined and specific recommendations as new knowledge accumulates.
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Affiliation(s)
- Siddharth Srivastava
- Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
- Rosamund Stone Zander Translational Neuroscience Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Mustafa Sahin
- Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
- Rosamund Stone Zander Translational Neuroscience Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Joseph D. Buxbaum
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elizabeth Berry-Kravis
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Biochemistry, Rush University Medical Center, Chicago, IL, USA
| | | | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | | | - Afua Asante-Otoo
- Rehabilitation Medicine Department, NIH Clinical Center, Bethesda, MD, USA
| | - William E. Bennett
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Catalina Betancur
- Sorbonne Université, INSERM, CNRS, Neuroscience Paris Seine, Institut de Biologie Paris Seine, Paris, France
| | - Tegwyn H. Brickhouse
- Department of Dental Public Health & Policy, School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA
| | - Maria Rita Passos Bueno
- Departamento de Genética e Biologia Evolutiva, Centro de Estudos do Genoma Humano e Células-tronco, Instituto de Biociências, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maya Chopra
- Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
- Rosamund Stone Zander Translational Neuroscience Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Celanie K. Christensen
- Division of Developmental Medicine, Department of Pediatrics, Riley Children’s Health, Indianapolis, IN, USA
- Division of Child Neurology, Department of Neurology, Riley Children’s Health, Indianapolis, IN, USA
| | - Jennifer L. Cully
- Department of Pediatrics, College of Medicine and Division of Dentistry and Orthodontics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Kira Dies
- Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
- Rosamund Stone Zander Translational Neuroscience Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Kate Friedman
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - J. Lloyd Holder
- Department of Pediatrics-Neurology, Baylor College of Medicine, Houston, TX, USA
| | | | - Carolyn A. Kerins
- Department of Pediatric Dentistry, School of Dentistry, Texas A&M University, Dallas, TX, USA
| | - Omar Khan
- National Institute of Neurological Disease and Stroke, Bethesda, MD, USA
| | | | - Ronald V. Lacro
- Department of Cardiology, Boston Children’s Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | | | - Tess Levy
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Eva Loth
- Kings College London, London, UK
| | - Baharak Moshiree
- Department of Medicine, Wake Forest/Atrium Health, Charlotte, NC, USA
| | - Ann Neumeyer
- Lurie Center for Autism, Massachusetts General Hospital, Lexington MA, USA, Harvard Medical School, Boston, MA USA
| | - Scott M. Paul
- Rehabilitation Medicine Department, NIH Clinical Center, Bethesda, MD, USA
| | - Katy Phelan
- Genetics Laboratory, Florida Cancer Specialists and Research Institute, Fort Myers, FL, USA
| | - Antonio Persico
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Robert Rapaport
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Jeffrey Saland
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Swathi Sethuram
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | | | - Phillip I. Tarr
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Kerry M. White
- Division of Developmental Medicine, Department of Pediatrics, Riley Children’s Health, Indianapolis, IN, USA
- Department of Medical and Molecular Genetics, Riley Children’s Health, Indianapolis, IN, USA
| | - Jordan Wickstrom
- Sinai Rehabilitation Center, Lifebridge Health, Baltimore, MD, USA
| | - Kent M. Williams
- Department of Pediatrics, The Ohio State University School of Medicine, Columbus, OH, USA
| | | | | | - Alexander Kolevzon
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Bulusu A, Cleary SD. Comparison of dental health status in children with autism spectrum disorder vs other developmental disabilities: Results from 2016 national survey of Children's health. PEDIATRIC DENTAL JOURNAL 2023. [DOI: 10.1016/j.pdj.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Ronis SD, Selvaraj D, Albert JM, Koroukian SM, Nelson S. Dental Caries in Medicaid-Insured Preschool Children With or Without Special Health Care Needs in Northeast Ohio. JAMA Netw Open 2023; 6:e230999. [PMID: 36853605 PMCID: PMC9975899 DOI: 10.1001/jamanetworkopen.2023.0999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
IMPORTANCE Children with special health care needs (CSHCN) are recognized to be at increased risk of developing dental caries (decay). Evidence is mixed regarding the association of preventive oral health care delivered by pediatric primary care clinicians with caries experience among CSHCN. OBJECTIVE To investigate caries experience, including untreated decay, among Medicaid-enrolled preschoolers with or without special health care needs. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used baseline data from the Pediatric Providers Against Cavities in Children's Teeth study, a cluster-randomized hybrid effectiveness-implementation trial conducted among 1022 Medicaid-enrolled preschoolers aged 3 to 6 years attending well-child visits at 18 participating community pediatric primary care practices in northeast Ohio. Baseline data were collected from November 1, 2017, to August 31, 2019, with statistical analyses conducted from April to August 2022. EXPOSURES Presence of special health care needs, as assessed by applying the Pediatric Medical Complexity Algorithm to International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes, was abstracted from electronic medical records. CSHCN were defined as having either noncomplex chronic disease (presence of only 1 nonprogressive chronic condition, or multiple nonprogressive chronic conditions in a single body system) or complex chronic disease (presence of any progressive chronic condition, malignant neoplasm, or significant chronic conditions involving multiple body systems). MAIN OUTCOMES AND MEASURES Untreated dental decay and caries experience as assessed through clinical dental examinations using International Caries Detection and Assessment System criteria. RESULTS A total of 1022 children aged 3 to 6 years from 18 practices were enrolled in the study. The mean (SD) age of the study population was 4.3 (1.1) years, 554 (54.2%) were boys, and of 988 with data on race and ethnicity, 451 (45.6%) were Black. Of these, 301 of 1019 (29.5%) had a likely special health care need (225 with noncomplex chronic conditions and 76 with complex chronic conditions). The most frequent chronic conditions included asthma (n = 209) and mental or behavioral health disorders (n = 146), including attention-deficit/hyperactivity disorder, autism, and developmental delays. Overall, 296 children (29.0%) had untreated decay, and 378 (37.0%) had caries experience (decayed and filled teeth). Accounting for sociodemographic characteristics, CSHCN had 34% reduced odds of untreated decay (adjusted odds ratio [AOR], 0.66 [95% CI, 0.48-0.92]) compared with those with without chronic disease. In addition, caries experience was lower among CSHCN (AOR, 0.79 [95% CI, 0.60-1.04]). CONCLUSIONS AND RELEVANCE In this cross-sectional study of Medicaid-enrolled children who attended well-child visits as preschoolers, untreated dental decay was lower among CSHCN compared with those without chronic conditions. This study suggests that CSHCN may have had better access to the various types of dental care facilitated in medical settings.
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Affiliation(s)
- Sarah D. Ronis
- UH Rainbow Center for Child Health & Policy, Cleveland, Ohio
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - David Selvaraj
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio
| | - Jeffrey M. Albert
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Siran M. Koroukian
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Suchitra Nelson
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
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The Oral Health Status and Treatment Needs of Pediatric Patients Living with Autism Spectrum Disorder: A Retrospective Study. Dent J (Basel) 2022; 10:dj10120224. [PMID: 36547040 PMCID: PMC9777396 DOI: 10.3390/dj10120224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/08/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The objective of this retrospective study was to assess the oral health status and treatment needs of children with ASD and to explore the differences in risk factors and oral health care status and the risk factors for treatment under GA. METHODS Dental charts of children between 6 and 14 years of age who were examined at a dental facility associated with the College of Dentistry, University of Saskatchewan between 2016 to 2019 were assessed. Children who were identified as having ASD, as well as an age- and gender-matched control group consisting of otherwise healthy children were included in the study. RESULTS The sample included 346 dental records, with 173 children having a diagnosis of ASD. Children diagnosed with ASD had significantly higher experience with caries (91.3% vs. 65.9%, p = 0.003) and severity (mean DMFT/dmft = 8.18 ± 1.62 vs. 4.93 ± 0.58 p = 0.007). Children with ASD were also older when visiting the dentist for the first time (age of 5.97 ± 1.18 vs. 2.79 ± 1.09, p = 0.02)). Children with ASD were less likely to brush once a day (66.5% vs. 88.4%, p = 0.02), were more likely to have bruxism (35.8% vs. 10.4%, p = 0.003) and were less likely to have class I occlusion (64.7% vs. 80.9%, p = 0.03). Findings from the logistic regression analysis revealed that children with ASD were also 2.13 times more likely to receive a referral for general anesthesia when all other variables were held constant (p = 0.03). CONCLUSIONS This research demonstrates that children diagnosed with ASD may face more barriers with access to oral health care, leading to poorer outcomes and greater treatment dental needs.
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Hu K, Da Silva K. Access to oral health care for children with fetal alcohol spectrum disorder: a cross-sectional study. BMC Oral Health 2022; 22:497. [DOI: 10.1186/s12903-022-02561-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/04/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
Individuals with developmental disabilities, including Fetal Alcohol Spectrum Disorder (FASD), often suffer from poorer oral health than the general population as they experience challenges with accessing care. However, few studies have investigated access to oral health care specific to children diagnosed with FASD. Thus, the objective of this cross-sectional study is to examine the use of oral health care services by children diagnosed with FASD in Saskatchewan, Canada, and to identify perceived barriers that affect their access to oral health care.
Methods
Parents or caregivers for children with FASD under the age of 16 were recruited through community organizations. Between July 2020 and January 2021, 189 participants completed a 64-item questionnaire that assessed sociodemographic characteristics, oral health care utilization, and perceived barriers to care.
Results
Most children (85%) had visited the dentist within the last 24 months. 55% of children had required sedation for some treatment. 43% of caregivers experienced frustration trying to access care for their child. Common barriers were cost (63%), location (55%), the child’s behaviour (78%) and caregiver anxiety (60%). 35% of caregivers believed their dentist lacked adequate knowledge of FASD. Univariate analysis reveals that income, caregiver education, residence location, and insurance status were significantly associated with reporting barriers. Multivariate logistic regression analysis reveals that caregivers who reported a high school education (OR=1.23; 95% CI 1.03 – 1.38); or public insurance (OR=1.33; 95% CI 1.24 – 1.42) or out-of-pocket payments (OR=1.37, 95% CI 1.20 – 1.46); or rural (OR=1.19, 95% CI 1.07 – 1.26) or remote (OR=1.23; 95% CI=1.12 – 1.31) residences were more likely to report difficulties accessing oral health care.
Conclusion
Our findings indicate that children with FASD experience various barriers to accessing oral health care. Social determinants of health were significant variables that increased likelihood of barriers. Like other vulnerable populations, cost and clinic location are notable barriers. Oral health care providers’ assessment and management of children with FASD are noteworthy for future research.
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Phillips SB, May OW, Stager CG, Gregg A. An Assessment of Pediatric Primary Care Providers’ and Parents’ Dental Health Knowledge and Practices. J Pediatr Health Care 2022; 37:227-233. [PMID: 37141221 DOI: 10.1016/j.pedhc.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION One in five children aged < 5 years has experienced caries, making it the most prevalent chronic disease in childhood. The failure to address a child's dental health can lead to short-term and long-term complications and problems with permanent dentition. Primary care pediatric providers are in the position to participate in the prevention of caries because of the frequency they see young children before establishing a dental home. METHOD A retrospective chart review and two surveys were developed to collect data from health care providers and parents of children aged < 6 years about their dental health knowledge and practices. RESULTS While providers report being comfortable discussing dental health with patients, review of medical records shows inconsistent discussion and documentation of dental health. DISCUSSION There appears to be a lack of education regarding dental health among parents and health care providers. Primary care providers are not effectively communicating the importance of childhood dental health and are not routinely documenting dental health information.
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Affiliation(s)
- Sara B Phillips
- Sara B. Phillips, Assistant Professor, Department of Pediatrics, College of Community Health Sciences, The University of Alabama, Tuscaloosa, AL..
| | - Olivia W May
- Olivia W. May, Associate Professor, Department of Pediatrics, College of Community Health Sciences, The University of Alabama, Tuscaloosa, AL
| | - Catanya G Stager
- Catanya Stager, Post-Doc Fellow, Department of Community Medicine and Population Health, The University of Alabama, Tuscaloosa, AL
| | - Abbey Gregg
- Abbey Gregg, Assistant Professor, Department of Community Medicine and Population Health and the Institute for Rural Health Research, The University of Alabama, Tuscaloosa, AL
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12
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Atchison KA, Bhoopathi V, Wells CR. Hospital emergency department visits made by developmentally disabled adolescents with oral complications. FRONTIERS IN ORAL HEALTH 2022; 3:955584. [PMID: 36046122 PMCID: PMC9420940 DOI: 10.3389/froh.2022.955584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/28/2022] [Indexed: 11/20/2022] Open
Abstract
Purpose We used Andersen's Behavioral Model in a cross-sectional study to determine the factors associated with utilization of the emergency department (ED), controlling for whether an adolescent has a developmental disability (DD) and one or more oral complications (toothaches, decayed teeth, bleeding gums, eating or swallowing problems). Methods Data from the 2016–2019 National Survey of Children's Health (NSCH) was used for this secondary data analysis study. We used frequencies and percentages to describe the sample characteristics. Chi-square tests were used for bivariate analyses. Multivariable logistic regression modeling was conducted to predict ED visits by adolescents aged 10–17 controlling for predisposing, enabling, and need variables. Results The sample consisted of 68,942 adolescents who were primarily male, non-Hispanic White, and born in the U.S. Parents reported that 69% of the adolescents had neither a DD nor an oral complication; 10% had no DD but experienced one or more oral complication; 16% had a DD but no oral complication; and 5% had both DDs and one or more oral complication. Adolescents with both a DD and an oral complication reported the highest level of ED visits at 33%, compared to 14% of adolescents with neither DD nor oral complication. Regression analysis showed that adolescents with a DD and oral complication (OR: 2.0, 95% CI: 1.64–2.54, p < 0.0001), and those with DDs but no oral complications (OR: 1.45, 95% CI: 1.25–1.68, p < 0.0001) were at higher odds of having an ED visit compared to those with neither a DD nor an oral complication. Not having a Medical Home increased the likelihood of ED visits by 14% (p = 0.02). Those with private insurance (OR: 0.63, 95% CI: 0.53–0.75, p < 0.0001) and those from a family where the highest level of education was some college and above (OR: 0.85, 95% CI: 0.73–0.98, p = 0.03) were less likely than their counterparts to have had an ED visit. Conclusion Adolescents with DDs and oral complications utilize ED visits more frequently than those with neither DDs nor oral complications. Integrating the dental and medical health systems and incorporating concepts of a Patient-Centered Medical Home could improve overall health care and reduce ED visits for adolescents.
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Affiliation(s)
- Kathryn A. Atchison
- Section of Public & Population Health, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
- *Correspondence: Kathryn A. Atchison
| | - Vinodh Bhoopathi
- Section of Public & Population Health, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Christine R. Wells
- Statistical Methods and Data Analytics, Office of Advanced Research Computing, University of California, Los Angeles, Los Angeles, CA, United States
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13
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Haller K, Stolfi A, Duby J. Comparison of unmet health care needs in children with intellectual disability, autism spectrum disorder and both disorders combined. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:617-627. [PMID: 35357055 PMCID: PMC9314009 DOI: 10.1111/jir.12932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 02/11/2022] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The purpose of this study was to assess the unmet health care needs of children with intellectual disability (ID) compared with children with autism spectrum disorder (ASD) and whether access to health insurance coverage is a contributing factor. Children with ID may be masked in the health care system due to increased diagnosis and awareness of ASD. The needs, unmet needs and insurance coverage of children with ID alone, ASD alone, and co-occurring ID and ASD were assessed in this study. METHODS The 2016 to 2019 United States' Census Bureau National Survey of Children's Health was used to determine differences in unmet needs, care not received and health insurance coverage during the past year for children with ID and/or ASD. Adjusted odds ratios and 95% confidence intervals for care not received were determined controlling for sex, insurance, race, age and parents' highest education level. RESULTS Children with ID were nearly four times more likely not to receive needed medical care as children with ASD. Results were similar for unmet hearing and mental health care. Children with both ID and ASD were more likely to have unmet health care but less likely to have unmet medical care compared with children with ASD alone. There were no significant differences for unmet dental or vision care. Children with ID were 3.58 (95% confidence interval: 1.6-8.0) times more likely to have inconsistent health insurance compared with children with ASD. CONCLUSIONS Children with ID alone are more likely to have unmet medical, hearing and mental health care needs than children with ASD alone. Children with co-occurring ID and ASD have a large amount of general unmet health care needs but less unmet medical needs. Children with ID are less likely to have consistent health insurance than children with ASD. This hinders the ability of children with ID to receive quality care. Further research is needed to determine if the diagnosis of ASD in children in the United States is negatively affecting children with ID alone.
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Affiliation(s)
- K. Haller
- Department of PediatricsWright State University Boonshoft School of MedicineDaytonOHUSA
| | - A. Stolfi
- Department of PediatricsWright State University Boonshoft School of MedicineDaytonOHUSA
| | - J. Duby
- Department of PediatricsWright State University Boonshoft School of MedicineDaytonOHUSA
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14
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Obeidat R, Noureldin A, Bitouni A, Abdellatif H, Lewis-Miranda S, Liu S, Badner V, Timothé P. Oral health needs of U.S. children with developmental disorders: a population-based study. BMC Public Health 2022; 22:861. [PMID: 35488224 PMCID: PMC9055681 DOI: 10.1186/s12889-022-13237-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 04/11/2022] [Indexed: 11/20/2022] Open
Abstract
Background Children with Special Health Care Needs (CSHCN) have higher rates of oral diseases and tooth decay compared with the general population. Children with developmental disorders/ disabilities (DD) are a subset of CSHCN whose oral health has not been specifically addressed. Therefore, this study had two objectives: to describe the oral health needs (OHN) of children with DD compared with children without DD; and to assess barriers to access to care, utilization of dental services, and their association with oral health needs for children with DD. Methods This cross-sectional study utilized a sample of 30,530 noninstitutionalized children from the 2018 National Survey of Children’s Health (NSCH). Analysis was conducted using descriptive and inferential statistics. Results The analysis identified 6501 children with DD and 24,029 children without DD. Children with DD had significantly higher prevalence of OHN (20.3% vs. 12.2%, respectively), unmet dental needs (3.5% vs 1.2%), and utilization of any dental visits (86.1% vs 76.1%), (P-value < . 001). The adjusted logistic model identified four factors that contributed to the higher odds of OHN among children with DD: poverty (< 100% of the Federal Poverty Level (AOR = 2.27, CI: 1.46–3.51), being uninsured (AOR = 2.12, 95% CI: 1.14–3.95), a high level of disability (AOR = 1.89, CI: 1.23–2.78), and living in the western United States (AOR = 1.61, CI: 1.09–2.37. Conclusion Despite higher utilization of dental services, children with DD had poorer oral health and more unmet dental needs than children without DD. Advocacy efforts and policy changes are needed to develop affordable access that assesses, as early as possible, children with DD whose conditions impact their ability a great deal so that their potential OHN may be alleviated more effectively.
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Affiliation(s)
- Raghad Obeidat
- Public Health Sciences Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA.
| | - Amal Noureldin
- Public Health Sciences Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA
| | - Anneta Bitouni
- Department of Comprehensive Dentistry, Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA
| | - Hoda Abdellatif
- Princess Nourah Bint, Abdulrahman University, Riyadh, Saudi Arabia
| | - Shirley Lewis-Miranda
- Department of Comprehensive Dentistry, Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA
| | - Shuling Liu
- Statistical Collaboration Center, Texas A&M University, 155 Ireland Street, College Station, TX, 77843, USA
| | - Victor Badner
- Depts. of Dentistry and Epidemiology and Population Health, Albert Einstein College of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, Bronx, New York City, NY, 10461, USA
| | - Peggy Timothé
- Public Health Sciences Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA
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15
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Parmar A, Shannon K, Casas M, Orkin J. Dental care in children with medical complexity: A retrospective study. Paediatr Child Health 2022; 27:141-146. [PMID: 35712035 PMCID: PMC9191913 DOI: 10.1093/pch/pxab112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/18/2021] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives Children with medical complexity (CMC) are defined by complex, chronic multi-system disease with significant medical fragility. Limited research exists on dental care in CMC, which is an important part of oral health and overall health. Objectives of this study were to (1) determine the frequency and type of dental visits at a tertiary paediatric hospital of all CMC between 2015 and 2020 and (2) identify the factors associated with dental visits. Methods A retrospective chart review of the electronic records of CMC who were seen at a paediatric hospital from 2015 to 2020 was completed. The number and type of dental visits, demographic and clinical information were reviewed. Poisson regression models were used to test the association between the outcome (number of dental visits) and potential factors associated with receiving dental care. Results Four hundred and eighty-seven CMC (mean age=7.3 ± 4.6 years, 43.7% female) were included in this study. CMC were seen by dentists at the hospital 4.4 ± 3.8 times since 2015, which is approximately once per year over a 5-year period. Dental visits were mostly preventative (66.4% of all visits). CMC had more dental visits if they had dental care funding compared to no funding if they were living in a community with a population >100,000 people and if they were being followed by a greater number of sub-specialists. Conclusions This study highlights the importance of funding, access to paediatric dental specialists, and care coordination support to improve access to dental care for CMC to optimize oral health.
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Affiliation(s)
- Arpita Parmar
- Department of Paediatrics, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada,Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada,Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Kelsey Shannon
- Department of Paediatrics, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada,Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Michael Casas
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada,Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada,Department of Dentistry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Julia Orkin
- Correspondence: Julia Orkin, Medical Director, Complex Care Program, Staff Paediatrician, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario M5G 1X8, Canada. Telephone 416-813-7654, fax (416)-813-5663, e-mail:
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16
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de Castelo Branco Araújo T, Nogueira BR, Mendes RF, Júnior RRP. Oral health-related quality of life in children and adolescents with cerebral palsy: paired cross-sectional study. Eur Arch Paediatr Dent 2022; 23:391-398. [PMID: 35124753 DOI: 10.1007/s40368-022-00694-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the impact of oral health conditions on the Oral Health-Related Quality of Life (OHRQoL) in children and adolescents with Cerebral Palsy (CP) and compare with children and adolescents without CP. METHODS This was a paired cross-sectional study, consisting of 121 children and adolescents with CP and 121 without CP, aged 6 to 14 years. Caregivers filled a socioeconomic-demographic and the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Physical examination of the oral cavity assessed the dental caries experience, need for treatment, consequences of untreated dental caries, presence of dental trauma, bruxism and malocclusion. A descriptive analysis and Kruskal-Wallis and Mann-Whitney tests (p < 0.05) were performed. Variables with p values ≤ 0.20 in the bivariate analysis were included in the adjusted model analysis. Variables with a p value < 0.05 remained in the final Poisson Regression model. RESULTS Caries experience had a negative impact on the quality of life of both groups, with and without CP. Presence of gastroesophageal reflux and difficulty to opening the mouth also had a negative impact on the OHRQoL of the group with CP. CONCLUSION Children and adolescents with CP suffered a greater negative impact on OHRQoL than individuals without CP. Difficulty in opening the mouth and the presence of GER had a negative effect on the quality of life of individuals with CP, while dental caries had a negative impact on the OHRQoL of children and adolescents of both groups.
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Affiliation(s)
- T de Castelo Branco Araújo
- Postgraduate Program in Dentistry, Federal University of Piauí-UFPI, Minister Petrônio Portella Campus, Bloc 5, Teresina, PI, 64049-550, Brazil.
| | - B R Nogueira
- Department of Restorative Dentistry, Federal University of Piauí-UFPI, Teresina, PI, Brazil
| | - R F Mendes
- Postgraduate Program in Dentistry, Federal University of Piauí-UFPI, Minister Petrônio Portella Campus, Bloc 5, Teresina, PI, 64049-550, Brazil.,Department of Restorative Dentistry, Federal University of Piauí-UFPI, Teresina, PI, Brazil
| | - R R P Júnior
- Postgraduate Program in Dentistry, Federal University of Piauí-UFPI, Minister Petrônio Portella Campus, Bloc 5, Teresina, PI, 64049-550, Brazil.,Department of Restorative Dentistry, Federal University of Piauí-UFPI, Teresina, PI, Brazil
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17
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Positive Parenting Styles Tied to Less Unmet Dental Needs in Children with Developmental Disabilities. J Autism Dev Disord 2022; 52:5395-5402. [PMID: 35037185 DOI: 10.1007/s10803-021-05351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
This study aimed to identify factors, particularly positive parenting styles, associated with unmet dental needs, defined as no dental visit for the past 12 months, in children with developmental disabilities (DD). Participants included 263 primary caregivers of children with DD. Children exposed to less positive parenting styles were more than two times (aOR, 2.19, 95%CI, 1.12-4.32) more likely to have unmet dental needs. Children who were male (aOR, 1.88, 95%CI, 1.04-3.41), aged < 4 years (aOR, 2.95, 95%CI, 1.2-7.27) or aged ≥ 11 years (aOR, 2.65, 95%CI, 1.25-5.64), had higher illness severity (aOR, 2.04, 95%CI, 1.09-3.81), had primary caregivers with less than or equal to high school education (aOR, 2.45, 95%CI, 1.13-5.30) were also more likely to have unmet dental needs.
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18
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Kotsanos N, Marks LAM, Arapostathis KN, Kubota K. Disabilities, Neuropsychiatric Disorders, and Syndromes in Childhood and Adolescence. Pediatr Dent 2022. [DOI: 10.1007/978-3-030-78003-6_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Kasemkhun P, Smutkeeree A, Jirarattanasopha V. A retrospective comparison of dental treatment under general anesthesia versus non-pharmacological approach in patient with special health care needs. J Dent Sci 2021; 17:1238-1243. [PMID: 35784144 PMCID: PMC9236891 DOI: 10.1016/j.jds.2021.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/29/2021] [Indexed: 12/04/2022] Open
Abstract
Background/purpose The unmet dental needs are still at the highest rate in patients with special health care needs (SHCN) owing to their physical conditions, lack of cooperation, anxiety and dental fear. This study was aimed to investigate the differences in characteristics and outcomes of dental treatment between general anesthesia (GA) and non-pharmacological approach (NP) in patients with SHCN. Materials and methods This study reviewed the dental chart records of SHCN patients from 2005 to 2019. The dental chart records were divided into two subgroups: GA and NP groups. The demographic data, recall behavior and treatment outcomes were analyzed and compared between groups. The comparisons between groups were analyzed by Pearson's chi-squared test, Fisher's exact test and Mann–Whitney U test at a significant level of 0.05. Results Two hundred and sixty-one patients aged 2.2–43.1 years with mean age 14.22 ± 8.64 years old were included. The proportion of cases treated under GA (62%) and NP (38%) was 1.6:1. General anesthesia group had significantly higher in mean ages, caries experience, definitely negative behavior and treatment needs than NP group (P < 0.001). Moreover, recall rates in GA group were significantly lower than NP group (P < 0.001) without a significant difference in regularity. New caries occurrence (P = 0.015) with faster rate (P = 0.035), and behavior changes was significantly found in GA group (P = 0.007) after 24 months of recall. Conclusion Patients with SHCN who were at older age and had high caries experience with definitely negative behavior and numerous treatment needs were more justifiably for GA. A significant new caries occurrence with faster rate tended towards SHCN patients who underwent GA.
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Affiliation(s)
- Pornpailin Kasemkhun
- Corresponding author. Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Bangkok 10400, Thailand. Fax: +662 2007820.
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20
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Lebrun-Harris LA, Canto MT, Vodicka P, Mann MY, Kinsman SB. Oral Health Among Children and Youth With Special Health Care Needs. Pediatrics 2021; 148:peds.2020-025700. [PMID: 34290133 DOI: 10.1542/peds.2020-025700] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We sought to estimate the prevalence of oral health problems and receipt of preventive oral health (POH) services among children and youth with special health care needs (CYSHCN) and investigate associations with child- and family-level characteristics. METHODS We used pooled data from the 2016-2018 National Survey of Children's Health. The analytic sample was limited to children 1 to 17 years old, including 23 099 CYSHCN and 75 612 children without special health care needs (non-CYSHCN). Parent- and caregiver-reported measures of oral health problems were fair or poor teeth condition, decayed teeth and cavities, toothaches, and bleeding gums. POH services were preventive dental visits, cleanings, tooth brushing and oral health care instructions, fluoride, and sealants. Bivariate and multivariable logistic regression analyses were conducted. RESULTS A higher proportion of CYSHCN than non-CYSHCN received a preventive dental visit in the past year (84% vs 78%, P < .0001). Similar patterns were found for the specific preventive services examined. However, CYSHCN had higher rates of oral health problems compared with non-CYSHCN. For example, decayed teeth and cavities were reported in 16% of CYSHCN versus 11% in non-CYSHCN (P < .0001). In adjusted analyses, several factors were significantly associated with decreased prevalence of receipt of POH services among CYSHCN, including younger or older age, lower household education, non-English language, lack of health insurance, lack of a medical home, and worse condition of teeth. CONCLUSIONS CYSHCN have higher rates of POH service use yet worse oral health status than non-CYSHCN. Ensuring appropriate use of POH services among CYSHCN is critical to the reduction of oral health problems.
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Affiliation(s)
| | | | | | - Marie Y Mann
- Division of Services for Children with Special Health Care Needs, Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland
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21
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Gibson N, Blackmore AM, Chang AB, Cooper MS, Jaffe A, Kong W, Langdon K, Moshovis L, Pavleski K, Wilson AC. Prevention and management of respiratory disease in young people with cerebral palsy: consensus statement. Dev Med Child Neurol 2021; 63:172-182. [PMID: 32803795 PMCID: PMC7818421 DOI: 10.1111/dmcn.14640] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 01/31/2023]
Abstract
Respiratory illness is the leading cause of mortality in children with cerebral palsy (CP). Although risk factors for developing chronic respiratory illness have been identified, comprehensive clinical care recommendations for the prevention and management of respiratory illness do not currently exist. We invited over 200 clinicians and researchers from multiple disciplines with expertise in the management of respiratory illness in children with CP to develop care recommendations using a modified Delphi method on the basis of the RAND Corporation-University of California Los Angeles Appropriateness Method. These recommendations are intended for use by the wide range of practitioners who care for individuals living with CP. They provide a framework for recognizing multifactorial primary and secondary potentially modifiable risk factors and for providing coordinated multidisciplinary care. We describe the methods used to generate the consensus recommendations, and the overall perspective on assessment, prevention, and treatment of respiratory illness in children with CP. WHAT THIS PAPER ADDS: The first consensus statement for preventing and managing respiratory disease in cerebral palsy (CP). Risk factors for respiratory disease in CP should be identified early. Individuals with CP at risk of respiratory disease require regular assessment of risk factors. Effective partnerships between multidisciplinary teams, individuals with CP, and families are essential. Treatment of respiratory disease in individuals with CP must be proactive.
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Affiliation(s)
- Noula Gibson
- PhysiotherapyPerth Children’s HospitalNedlandsWAAustralia
- Research, Ability CentreMount LawleyWAAustralia
| | | | - Anne B Chang
- Department of Respiratory and Sleep MedicineQueensland Children’s HospitalQueensland University of TechnologyBrisbaneQLDAustralia
| | - Monica S Cooper
- Department of Neurodevelopment and DisabilityThe Royal Children’s HospitalMelbourneVICAustralia
| | - Adam Jaffe
- School of Women’s and Children’s HealthUNSW MedicineUNSWSydneyNSWAustralia
| | - Wee‐Ren Kong
- Department of PhysiotherapyWomen’s and Children’s HospitalAdelaideSAAustralia
| | - Katherine Langdon
- Paediatric RehabilitationPerth Children’s HospitalNedlandsWAAustralia
| | - Lisa Moshovis
- Therapy and Health ServicesAbility CentreMount LawleyWAAustralia
| | | | - Andrew C Wilson
- Respiratory MedicinePerth Children’s HospitalNedlandsWAAustralia
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22
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Sruthi KS, Yashoda R, Puranik MP. Oral health status and parental perception of child oral health-related quality of life among children with cerebral palsy in Bangalore city: A cross-sectional study. SPECIAL CARE IN DENTISTRY 2021; 41:340-348. [PMID: 33512001 DOI: 10.1111/scd.12568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/01/2021] [Accepted: 01/05/2021] [Indexed: 11/29/2022]
Abstract
AIM To assess and compare the oral health status and parental perception of child oral health-related quality of life (OHRQoL) among children with and without cerebral palsy (CP). METHODS AND RESULTS A cross-sectional comparative study was conducted among 300 children aged 5-15 years with and without CP in Bangalore city. Oral health status was assessed using WHO 2013 criteria, and malocclusion was assessed using Angle's classification of malocclusion. Parental perception of child OHRQoL was assessed using parental caregivers perceptions questionnaire. Chi-square test, Student's t-tests and logistic regression were applied. Majority of the study participants were males with a mean age of 10 years. Caries experience, gingivitis, dental trauma, and dental erosion were significantly higher among children with CP than the comparison group. Mean parental perception of child OHRQoL score among CP was significantly higher than that of comparison group (P < .001). Odds of having caries experience, gingivitis, dental trauma, and Angle's Class II/III malocclusion were significantly higher among CP children with poor OHRQoL compared to those without these conditions. CONCLUSION Oral health status among children with CP was poor than the children without CP. Parents perceived poor OHRQoL among children with CP when compared to those without CP. Hence CP has an impact on oral health necessitating preventive care.
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Affiliation(s)
- K S Sruthi
- Department of Public Health Dentistry, Government Dental College and Research Institute, Bangalore, India
| | - R Yashoda
- Department of Public Health Dentistry, Government Dental College and Research Institute, Bangalore, India
| | - Manjunath P Puranik
- Department of Public Health Dentistry, Government Dental College and Research Institute, Bangalore, India
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23
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Da Silva K, Wood D. The oral health status and treatment needs of children with fetal alcohol spectrum disorder. Clin Oral Investig 2020; 25:3497-3503. [PMID: 33150509 DOI: 10.1007/s00784-020-03671-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/29/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the oral health status and treatment needs of children with fetal alcohol spectrum disorder (FASD). METHODS In this retrospective study, the records of children between the ages of 6 and 14 who attended the College of Dentistry, University of Saskatchewan between 2016 and 2019 were reviewed. Demographic and clinical data was collected and compared for children who were identified as having FASD and a healthy control group. RESULTS From our total sample of 252 dental records, 68 children were identified with FASD. When compared to controls, children with FASD were significantly older at their first dental visit, and more dependent on public dental insurance. Children with FASD also had a significantly higher caries experience (97% vs 64.7%) and severity (DMFT/dmft score = 7.18 ± 1.79 vs 2.93 ± 0.98). Additionally, the results of our logistic regression model indicate that children with FASD were 4.71 times more likely (OR 4.71, 95% CI 1.58 -14.03) to be referred for treatment under general anesthesia (GA) when all other factors were controlled. CONCLUSIONS Children with FASD may be at a higher risk for poor oral health outcomes and have more extensive treatment needs. Our results indicate that they may also be at a higher risk for treatment under GA. CLINICAL RELEVANCE Oral healthcare providers need to be award of the unique needs of children with FASD to better prevent and manage their oral disease.
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Affiliation(s)
- Keith Da Silva
- College of Dentistry, University of Saskatchewan, 123-105 Wiggins Road, Saskatoon, SK, S7N 5E4, Canada.
| | - Dempsey Wood
- College of Dentistry, University of Saskatchewan, 123-105 Wiggins Road, Saskatoon, SK, S7N 5E4, Canada
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24
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Mogenot M, Hein-Halbgewachs L, Goetz C, Ouamara N, Droz-Desprez D, Strazielle C, Albecker S, Mengus B, Strub M, Manière MC, Richardin P, Wang S, Piga G, Dalstein A, Anastasio D. Efficacy, tolerability, and safety of an innovative medical device for improving oral accessibility during oral examination in special-needs patients: A multicentric clinical trial. PLoS One 2020; 15:e0239898. [PMID: 32986784 PMCID: PMC7521731 DOI: 10.1371/journal.pone.0239898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/23/2020] [Indexed: 11/30/2022] Open
Abstract
Background People with special needs have high unmet oral healthcare needs, partly because dentists find it difficult to access their oral cavity. The Oral Accessibility Spatula aims to improve oral accessibility. This prospective multicenter interventional open-label non-randomized patient-self-controlled trial assessed the ability of the spatula to improve the oral accessibility of special-needs patients during dental examinations. Methods The cohort was a convenience sample of minor and adult patients with special needs due to physical, intellectual, and/or behavioral disorders who underwent dental check-up/treatment in five French tertiary hospitals/private clinics in 2016–2018 and evinced some (Venham-Score = 2–4) but not complete (Venham-Score = 5) resistance to oral examination. After inclusion, patients underwent oral examination without the spatula and then immediately thereafter oral examination with the spatula. Primary outcome was Oral Accessibility Score (0–12 points; higher scores indicate visualization and probing of the tooth sectors). Secondary outcomes were patient toleration (change in Venham-Score relative to first examination), safety, and Examiner Satisfaction Score (0–10; low scores indicate unsatisfactory examination). Results The 201 patients were mostly non-elderly adults (18–64 years, 65%) but also included children (21%), adolescents (11%), and aged patients (3%). One-quarter, half, and one-quarter had Venham-Score = 2, 3, and 4 at inclusion, respectively. The spatula significantly improved Oral Accessibility Score (4.8 to 10.8), Venham-Score (3.1 to 2.6), and Examiner Satisfaction Score (3.4 to 7.2) (all p<0.001). There were no severe spatula-related adverse events. Conclusion The spatula significantly improved oral access, was safe and well-tolerated by the patients, and markedly improved oral examination quality.
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Affiliation(s)
- Mathieu Mogenot
- Department of Odontology, Metz-Thionville Regional Hospital, Bel-Air Hospital, Thionville, France
| | | | - Christophe Goetz
- Clinical Research Support Unit, Metz-Thionville Regional Hospital, Mercy Hospital, Metz, France
| | - Nadia Ouamara
- Clinical Research Support Unit, Metz-Thionville Regional Hospital, Mercy Hospital, Metz, France
| | | | | | - Sylvie Albecker
- Handident Alsace Network, St François Clinic, Haguenau, France
| | - Brigitte Mengus
- Handident Alsace Network, St François Clinic, Haguenau, France
| | - Marion Strub
- Department of Odontology, Strasbourg Regional University Hospital, Strasbourg, France
| | - Marie-Cécile Manière
- Department of Odontology, Strasbourg Regional University Hospital, Strasbourg, France
| | - Pascal Richardin
- Department of Odontology, Metz-Thionville Regional Hospital, Mercy Hospital, Metz, France
| | - Stéphane Wang
- Department of Odontology, Metz-Thionville Regional Hospital, Mercy Hospital, Metz, France
| | - Giuseppa Piga
- Clinical Research Support Unit, Metz-Thionville Regional Hospital, Mercy Hospital, Metz, France
| | - Amélie Dalstein
- Department of Odontology, Emile-Durkenheim Hospital, Epinal, France
| | - Daniel Anastasio
- Department of Odontology, Metz-Thionville Regional Hospital, Bel-Air Hospital, Thionville, France
- * E-mail:
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25
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Fadel HT, Baghlaf K, Ben Gassem A, Bakeer H, Alsharif AT, Kassim S. Dental Students' Perceptions before and after Attending a Centre for Children with Special Needs: A Qualitative Study on Situated Learning. Dent J (Basel) 2020; 8:dj8030069. [PMID: 32635365 PMCID: PMC7557815 DOI: 10.3390/dj8030069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/27/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives: To develop an in-depth understanding of the perceptions and experiences of senior dental students before and after fieldwork visits to a centre for children with special needs. Methods: A qualitative study utilised open-ended questions and involved 39 fifth-year dental students. A thematic analysis of the collected responses was undertaken, and a hierarchy of themes and subthemes were developed. Results: Analysis of the pre-visit responses revealed three main themes and a number of subthemes: 'negative expectations', 'positive expectations', and 'pain expectations'. Similarly, four main themes with a number of subthemes emerged from the post-visit responses: 'positive perceptions', 'negative perceptions', 'oral problems observed', and 'recommendations'. Conclusions: Within the study limits, different perspectives were extracted. Prior to the fieldwork visit, students expressed their lack of self-confidence and inadequate preparation. Following the situated learning visit experience, students' perceptions of managing special needs children was positively influenced. Students were happy to be exposed to such an experience, but hoped for better organisation and specialised supervision in the future.
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Affiliation(s)
- Hani T. Fadel
- Department of Preventive Dental Sciences, Taibah University Dental College & Hospital, Prince, Naif Ibn Abdulaziz Road, Al-Madinah Al-Munawwarah 42353, Saudi Arabia; (H.T.F.); (H.B.); (A.T.A.); (S.K.)
| | - Khlood Baghlaf
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah 80209, Saudi Arabia
- Correspondence: ; Tel.: +966-126400000 (ext. 24500)
| | - Afnan Ben Gassem
- Department of Pediatric Dentistry and Orthodontics, Taibah University Dental College & Hospital, Prince, Naif Ibn Abdulazia, Al-Madinah Al-Munawwarah 42353, Saudi Arabia;
| | - Hala Bakeer
- Department of Preventive Dental Sciences, Taibah University Dental College & Hospital, Prince, Naif Ibn Abdulaziz Road, Al-Madinah Al-Munawwarah 42353, Saudi Arabia; (H.T.F.); (H.B.); (A.T.A.); (S.K.)
| | - Alla T. Alsharif
- Department of Preventive Dental Sciences, Taibah University Dental College & Hospital, Prince, Naif Ibn Abdulaziz Road, Al-Madinah Al-Munawwarah 42353, Saudi Arabia; (H.T.F.); (H.B.); (A.T.A.); (S.K.)
| | - Saba Kassim
- Department of Preventive Dental Sciences, Taibah University Dental College & Hospital, Prince, Naif Ibn Abdulaziz Road, Al-Madinah Al-Munawwarah 42353, Saudi Arabia; (H.T.F.); (H.B.); (A.T.A.); (S.K.)
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26
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Lee ZL, Gan WY, Lim PY, Hasan R, Lim SY. Associations of nutritional status, sugar and second-hand smoke exposure with dental caries among 3- to 6-year old Malaysian pre-schoolers: a cross-sectional study. BMC Oral Health 2020; 20:164. [PMID: 32493338 PMCID: PMC7268511 DOI: 10.1186/s12903-020-01152-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dental caries in primary teeth is a serious oral health concern among children. It can lead to detrimental impacts on a child's growth, development, and quality of life. Therefore, this cross-sectional study aimed to examine the prevalence of dental caries and its associations with nutritional status, sugar and second-hand smoke exposure among pre-schoolers. METHODS A total of 26 pre-schools in Seremban, Malaysia were randomly selected using the probability proportional to size sampling. Dental examination was performed by a dentist to record the number of decayed teeth (dt). Weight and height of the pre-schoolers were measured. The mother-administered questionnaire was used to gather information pertaining to the sociodemographic characteristics and second-hand smoke exposure. Total sugar exposure was calculated from a 3-day food record. RESULTS Among the 396 participating pre-schoolers, 63.4% of them had at least one untreated caries, with a mean ± SD dt score of 3.56 ± 4.57. Negative binomial regression analysis revealed that being a boy (adjusted mean ratio = 1.42, 95% CI = 0.005-0.698, p = 0.047), exposed to second-hand smoke (adjusted mean ratio = 1.67, 95% CI = 0.168-0.857, p = 0.004) and those who had more than 6 times of daily total sugar exposure (adjusted mean ratio = 1.93, 95% CI = 0.138-0.857, p = 0.013) were significantly associated with dental caries among pre-schoolers. CONCLUSION A high prevalence of dental caries was reported in this study. This study highlights the need to reduce exposure to second-hand smoke and practice healthy eating behaviours in reducing the risk of dental caries among pre-schoolers.
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Affiliation(s)
- Zhi Ling Lee
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor Darul Ehsan, Malaysia
| | - Wan Ying Gan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor Darul Ehsan, Malaysia.
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor Darul Ehsan, Malaysia
| | - Ruhaya Hasan
- School of Dental Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Sing Ying Lim
- Department of Paediatric Dental, Tuanku Ja'afar Hospital, Jalan Rasah, Bukit Rasah, 70300, Seremban, Negeri Sembilan, Malaysia
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27
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Kranz AM, Ross R, Sorbero M, Kofner A, Stein BD, Dick AW. Impact of a Medicaid policy on preventive oral health services for children with intellectual disabilities, developmental disabilities, or both. J Am Dent Assoc 2020; 151:255-264.e3. [PMID: 32081299 DOI: 10.1016/j.adaj.2019.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/06/2019] [Accepted: 12/01/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Integrating preventive oral health services (POHS) into medical offices may ease access to care for children with intellectual and developmental disabilities (IDD). The authors examined the impact of state policies allowing delivery of POHS in medical offices on receipt of POHS among Medicaid enrollees with IDD. METHODS The authors used 2006 through 2014 Medicaid data for children with IDD aged 6 months through 5 years from 38 states. IDD were defined using 14 condition codes from Centers for Medicare & Medicaid Services Chronic Conditions Data Warehouse. The length of the state's medical POHS policy (no policy, < 1 year, 1 year, 2 years, 3 years, or ≥ 4 years) was interacted with an indicator that the child was younger than 3 years. The authors used logistic regression models to estimate the likelihood that a child received POHS in a medical office or in a medical or dental office in a given year. RESULTS Among 447,918 children with IDD, 1.6% received POHS in medical offices. Children younger than 3 years in states with longer-enacted policies had higher rates of receiving POHS. For example, the predicted probability of receiving POHS was 40.6% (95% confidence interval, 36.3% to 44.9%) for children younger than 3 years in states with a medical POHS policy for more than 4 years compared with 30.6% (95% confidence interval, 27.8% to 33.5%) for children in states without a policy. CONCLUSIONS State Medicaid policies allowing delivery of POHS in medical offices increased receipt of POHS among Medicaid-enrolled children with IDD who were younger than 3 years. PRACTICAL IMPLICATIONS Few children with IDD receive POHS in any setting. Efforts are needed to reduce barriers to POHS for publicly insured children with IDD.
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Preventive care services and health behaviors in children with fragile X syndrome. Disabil Health J 2019; 12:564-573. [PMID: 31118158 DOI: 10.1016/j.dhjo.2019.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/27/2019] [Accepted: 04/12/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND This is the first description of preventive care services specifically received by children and young adults with fragile X syndrome (FXS). We compare these rates to those of other pediatric populations and identify care disparities within our cohort. OBJECTIVE Describe the frequency of preventive care services and health behaviors by young people with FXS, and identify disparities in care. METHODS We assessed four preventive care outcomes and the total number of preventive care guidelines met among individuals under 21 years from the ongoing Fragile X Online Registry with Accessible Research Database (N = 406) using data from 2012 to 2015. We used adjusted odds ratios (AORs) from multiple logistic regression models to describe associations between demographic factors and preventive care outcomes. RESULTS Seventy-five percent of our sample met dental care guidelines, 55.4% met influenza vaccination guidelines, 92.1% met immunization guidelines, and 24.4% met physical activity (PA) guidelines. Compared to children six to 10 years, younger children were less likely to have seen a dentist as recommended (AOR: 0.26) and young adults aged 16-20 were less likely to have received immunizations (AOR: 0.14) or to have engaged in recommended PA (AOR: 0.29). Black participants (AOR: 0.25) were less likely to have received an influenza vaccination than white participants. Individuals with autism (AOR: 0.25) were less likely to have sufficient PA, while individuals with hypersensitivity were more likely to have sufficient PA (AOR: 2.37) than unaffected individuals. CONCLUSIONS The proportion of young people with FXS that meet basic recommendations in preventive care guidelines varies according to health condition and demographic characteristics. This proportion could be increased for some groups, particularly in the cases of influenza vaccination and physical activity.
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29
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Gray D, Dunning N, Holder A, Marks L. Oral health status of athletes with an intellectual disability competing in the Special Olympics GB National Games 2017. Br Dent J 2019; 226:423-426. [PMID: 30903068 DOI: 10.1038/s41415-019-0049-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background The aim of this paper is to describe the oral health status of athletes with intellectual disabilities competing in the Special Olympics, GB National Games, held in Sheffield in August 2017.Methods and materials A convenience sample of athletes who participated in the Special Olympics Special Smiles screening programme was used. All data was recorded on validated Healthy Athletes screening forms.Results Of the 692 athletes that participated, 14% had untreated decay, 51.9% had at least one filling and 28.6% had signs of gingivitis. Furthermore, 6.2% reported pain from their mouth and 2.7% were found to require urgent treatment. Overall, 90.3% reported to clean their mouths at least once per day and 0.7% were found to be edentulous.Discussion The findings from this screening highlighted lower rates of decay, pain and urgent treatment need in comparison to Special Olympic screenings worldwide.Conclusion The oral health of athletes competing in the GB National Games 2017 was better than noted at most Special Olympic events throughout the world. There is little data published on the oral health of individuals with learning disabilities in the UK. These results provide valuable baseline data to monitor and review the oral health of Special Olympic athletes within Great Britain.
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Affiliation(s)
- Deborah Gray
- Specialty Registrar in Special Care Dentistry, Department of Community and Special Care Dentistry, Sheffield Teaching Hospitals NHSFT, Sheffield, UK.
| | - Nicole Dunning
- Consultant in Special Care Dentistry, Department of Community and Special Care Dentistry, Sheffield Teaching Hospitals NHSFT, Sheffield, UK
| | - Adam Holder
- DCT2 in Special Care Dentistry, Department of Community and Special Care Dentistry, Sheffield Teaching Hospitals NHSFT, Sheffield, UK
| | - Luc Marks
- Chair Oral Health in Special Needs, Ghent University Hospital, Ghent, Belgium
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30
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Salama FS, Al-Balkhi BK. Effectiveness of educational intervention of oral health for special needs on knowledge of dental students in Saudi Arabia. Disabil Health J 2019; 13:100789. [PMID: 31495647 DOI: 10.1016/j.dhjo.2019.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/23/2019] [Accepted: 03/08/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND It is critical to educate dental students on the essential aspects of oral care for persons with special health care needs (shcn) as they acquire more dental diseases and 80% not receiving routine dental care. OBJECTIVE/HYPOTHESIS To evaluate awareness and knowledge of dental students concerning oral-health care for persons with shcn, and to assess the effectiveness of an educational intervention in improving their knowledge. METHODS Students completed an evaluation in the form of pre-post questionnaires that were answered before and immediately after the 30- minute dvd educational intervention regarding the oral health care of persons with shcn. ancova test where used to adjust for the pre knowledge and dependent t-tests were used. RESULTS The mean ± sd of pre-test scores of all students was 15.46 ± 2.97, which increased to 18.09 ± 3.37 on the post-test. the post knowledge scores by dental class (adjusted for the pre knowledge) showed weak-significate anacova f test p value was (p < 0.050) however there was weak significant difference between the combined five years when compared (p < 0.050). however multiple comparison test (scheffe test) showed weak significance between d2 and d3 (p < 0.067). in addition, there was weak significant difference between post scores for each year when compared (p < 0.05). CONCLUSIONS The educational intervention was effective in providing all five levels of dental students with the basic instructive information needed to care for persons with shcn. about 62% of students from all five years rated their knowledge as being minimal and about 98% reported they would use the information provided in the educational intervention.
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Affiliation(s)
- Fouad S Salama
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Saudi Arabia.
| | - Bader K Al-Balkhi
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Saudi Arabia
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31
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Zollino M, Zweier C, Van Balkom ID, Sweetser DA, Alaimo J, Bijlsma EK, Cody J, Elsea SH, Giurgea I, Macchiaiolo M, Smigiel R, Thibert RL, Benoist I, Clayton-Smith J, De Winter CF, Deckers S, Gandhi A, Huisman S, Kempink D, Kruisinga F, Lamacchia V, Marangi G, Menke L, Mulder P, Nordgren A, Renieri A, Routledge S, Saunders CJ, Stembalska A, Van Balkom H, Whalen S, Hennekam RC. Diagnosis and management in Pitt-Hopkins syndrome: First international consensus statement. Clin Genet 2019; 95:462-478. [PMID: 30677142 DOI: 10.1111/cge.13506] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/20/2018] [Accepted: 01/09/2019] [Indexed: 02/06/2023]
Abstract
Pitt-Hopkins syndrome (PTHS) is a neurodevelopmental disorder characterized by intellectual disability, specific facial features, and marked autonomic nervous system dysfunction, especially with disturbances of regulating respiration and intestinal mobility. It is caused by variants in the transcription factor TCF4. Heterogeneity in the clinical and molecular diagnostic criteria and care practices has prompted a group of international experts to establish guidelines for diagnostics and care. For issues, for which there was limited information available in international literature, we collaborated with national support groups and the participants of a syndrome specific international conference to obtain further information. Here, we discuss the resultant consensus, including the clinical definition of PTHS and a molecular diagnostic pathway. Recommendations for managing particular health problems such as dysregulated respiration are provided. We emphasize the need for integration of care for physical and behavioral issues. The recommendations as presented here will need to be evaluated for improvements to allow for continued optimization of diagnostics and care.
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Affiliation(s)
- Marcella Zollino
- Fondazione Policlinico Universitario A.Gemelli, IRCCS, UOC Genetica.,Università Cattolica Sacro Cuore, Istituto di Medicina Genomica, Roma, Italy
| | - Christiane Zweier
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ingrid D Van Balkom
- Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, The Netherlands.,Rob Giel Research Centre, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - David A Sweetser
- Division of Medical Genetics and Metabolism, Massachusetts General Hospital for Children, Boston, Massachusetts
| | - Joseph Alaimo
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Emilia K Bijlsma
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Jannine Cody
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Sarah H Elsea
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Irina Giurgea
- Sorbonne Université, INSERM, UMR_S 933, Assistance Publique Hôpitaux de Paris, Département de Génétique Médicale, Hôpital Trousseau, Paris, France
| | - Marina Macchiaiolo
- Rare and Genetic Diseases Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - Robert Smigiel
- Department of Pediatrics, Division of Pediatrics and Rare Disorders, Wroclaw Medical University, Wroclaw, Poland
| | - Ronald L Thibert
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ingrid Benoist
- Dutch Pitt-Hopkins Syndrome Foundation, Vlaggeschip, Oosterhout, The Netherlands
| | - Jill Clayton-Smith
- Manchester Centre for Genomic Medicine, St Mary's Hospital, and Division of Evolution and Genomic Sciences School of Biological Sciences, University of Manchester, Manchester, UK
| | - Channa F De Winter
- Organisation for Individuals with Intellectual Disabilities, Trajectum, Zwolle, The Netherlands
| | - Stijn Deckers
- Department of Pedagogical Sciences, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Anusha Gandhi
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Sylvia Huisman
- Department of Pediatrics, Academic Medical Centre, Amsterdam UMC, Amsterdam, The Netherlands
| | - Dagmar Kempink
- Department of Orthopedic Surgery, Sophia Children's Hospital, UMCR, Rotterdam, The Netherlands
| | - Frea Kruisinga
- Department of Pediatrics, Academic Medical Centre, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Giuseppe Marangi
- Fondazione Policlinico Universitario A.Gemelli, IRCCS, UOC Genetica.,Università Cattolica Sacro Cuore, Istituto di Medicina Genomica, Roma, Italy
| | - Leonie Menke
- Department of Pediatrics, Academic Medical Centre, Amsterdam UMC, Amsterdam, The Netherlands
| | - Paul Mulder
- Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, The Netherlands.,Rob Giel Research Centre, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Ann Nordgren
- Karolinska Center for Rare Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Carol J Saunders
- Center for Pediatric Genomic Medicine, Children's Mercy Hospital, Kansas City, Missouri
| | | | - Hans Van Balkom
- Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Sandra Whalen
- Sorbonne Université, INSERM, UMR_S 933, Assistance Publique Hôpitaux de Paris, Département de Génétique Médicale, Hôpital Trousseau, Paris, France
| | - Raoul C Hennekam
- Department of Pediatrics, Academic Medical Centre, Amsterdam UMC, Amsterdam, The Netherlands
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Kim G, Carrico C, Ivey C, Wunsch PB. Impact of sensory adapted dental environment on children with developmental disabilities. SPECIAL CARE IN DENTISTRY 2019; 39:180-187. [PMID: 30729554 DOI: 10.1111/scd.12360] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/18/2018] [Accepted: 01/18/2019] [Indexed: 11/29/2022]
Abstract
AIMS This was a pilot study assessing the impact of a sensory adapted dental environment (SADE) on children with developmental disabilities (DD) receiving routine dental care. METHODS A crossover study of 22 children with DD, aged 6 through 21, was conducted at a University Pediatric Dental clinic. Each participant was randomized to a sequence of two dental cleanings on a 3- to 4-month recall schedule, one with a regular dental environment (RDE) and one with SADE. Outcomes included physiological measures (heart rate and oxygen saturation) and cooperation (Frankl scores). RESULTS Study subjects completed 36 visits. None of the physiological measures differed at either time point between the two treatment settings. The Frankl scores were significantly higher with SADE setting than RDE (P = 0.0368). Forty-six percent of parents strongly agreed that they would prefer the SADE for their child's next visit. CONCLUSION SADE may be associated with improved behavior in children with DD.
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Affiliation(s)
- Gail Kim
- Department of Pediatric Dentistry, Virginia Commonwealth University, Richmond, Virginia.,Private Practice, Charlottesville, Virginia
| | - Caroline Carrico
- Department of Oral Health Promotion and Community Outreach, Virginia Commonwealth University, Richmond, Virginia
| | - Carole Ivey
- Department of Occupational Therapy, Virginia Commonwealth University, Richmond, Virginia
| | - Patrice B Wunsch
- Department of Pediatric Dentistry, Virginia Commonwealth University, Richmond, Virginia
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33
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Craig MH, Scott JM, Slayton RL, Walker AL, 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; 150:42-48. [PMID: 30528747 PMCID: PMC6321780 DOI: 10.1016/j.adaj.2018.08.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/27/2018] [Accepted: 08/29/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Preschool-aged children with special health care needs (CSHCN) from low-income households are at increased risk of developing poor oral health. The study goal was to assess preventive dental care use for CSHCN enrolled in Medicaid within Washington state's Access to Baby and Child Dentistry (ABCD) program. METHODS The authors analyzed 2012 Medicaid eligibility and claims files for children younger than 6 years in the ABCD program (N = 206,488). The authors used medical diagnosis and eligibility data to identify each child's special needs status (no or yes). The outcome was preventive dental care use (no or yes). The authors used modified Poisson regression models to estimate crude and covariate-adjusted prevalence rate ratios. RESULTS Of the 206,488 children in the study, 2.1% were CSHCN, and 114,570 used preventive dental care (55.5%). CSHCN used preventive care at rates similar to those of children without special health care needs (SHCN) (54.7% and 55.5%, respectively; P = .32). After adjustment for confounding variables, CSHCN were significantly less likely to use preventive dental care than were children without SHCN (prevalence rate ratio, 0.91; 95% confidence interval, 0.88 to 0.94; P < .001). Older preschool-aged children were significantly more likely to use preventive dental care than were younger preschool-aged children. A significantly higher proportion of preventive medical care users also used preventive dental care. CONCLUSIONS CSHCN who were enrolled in Medicaid in Washington's ABCD program were less likely to use preventive dental care than were children without SHCN who were enrolled in Medicaid. PRACTICAL IMPLICATIONS Future intervention research investigators should evaluate ways to improve access to preventive dental care for CSHCN. Additional strategies may be needed to improve oral health behaviors for preschool-aged CSHCN receiving Medicaid.
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Kikuchi K, Yasuoka J, Tuot S, Yem S, Chhoun P, Okawa S, Murayama M, Huot C, Yi S. Improving overall health of children living with HIV through an oral health intervention in Cambodia: study protocol for a randomized controlled trial. Trials 2018; 19:673. [PMID: 30522512 PMCID: PMC6282380 DOI: 10.1186/s13063-018-3047-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 11/11/2018] [Indexed: 12/31/2022] Open
Abstract
Background Currently, the number of children living with HIV is the highest ever. This has led to an increased focus on a healthy life expectancy in this population. Improving oral health status may contribute to improved immunity, which could in turn lead to greater overall health in this population. This study aims to evaluate the effectiveness of an oral health intervention in improving oral health and immune status among children living with HIV in Cambodia. Methods A randomized controlled trial will be conducted in Phnom Penh from May 2018 to April 2020. Among 520 dyads of children living with their respective caregivers, half will be randomly allocated to the intervention group and the other half to the control group. Children aged 3–15 years who are currently receiving antiretroviral therapy at the National Pediatric Hospital will be recruited. In addition, 260 HIV-uninfected children (age-matched to the intervention group) will be recruited from the communities. They, together with their caregivers, will comprise the second control group. The main components of the intervention will include oral health education sessions for the children, as well as daily oral self-care under the supervision of their caregivers. The primary study outcome will be the change in oral health status including the number of decayed, missing, or filled permanent teeth, and the secondary outcome will be CD4 count. The effects of the intervention will be assessed by comparing outcome indicators between the children in the intervention and those in the control groups. Discussion This trial will investigate the effects of an oral health intervention on the improvement of oral health and immune status among children living with HIV and determine the differences compared with the control groups. This intervention would encourage the promotion of oral health interventions among children living with HIV and thus contribute to delaying the onset of AIDS. Trial registration Current Controlled Trials, International Standard Randomized Controlled Trial Number Register, ISRCTN15177479. Registered on 17 January 2018. Electronic supplementary material The online version of this article (10.1186/s13063-018-3047-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kimiyo Kikuchi
- Institute of Decision Science for a Sustainable Society, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Junko Yasuoka
- Research and Education Center for Prevention of Global Infectious Diseases of Animals, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Sovannary Tuot
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Sokunthea Yem
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Pheak Chhoun
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Sumiyo Okawa
- Department of Community and Global Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | | | | | - Siyan Yi
- KHANA Center for Population Health Research, Phnom Penh, Cambodia.,Center for Global Health Research, Touro University California, Vallejo, CA, USA.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Casamassimo PS, Flaitz CM, Hammersmith K, Sangvai S, Kumar A. Recognizing the Relationship Between Disorders in the Oral Cavity and Systemic Disease. Pediatr Clin North Am 2018; 65:1007-1032. [PMID: 30213346 DOI: 10.1016/j.pcl.2018.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Oral health is integral to general health. The oral cavity may harbor manifestations of systemic disease and can be the harbinger of early onset. Primary care providers (PCPs) can therefore use the oral cavity to support working diagnoses. Conversely, systemic diseases and treatments can affect oral health and require interactions between PCPs and dental providers. Acute oral manifestations of systemic disease may involve teeth and/or gums. This article reviews oral and systemic disease connections for some diseases, identifies issues that benefit patients through medical-dental collaboration, and highlights some nondental oral injuries that might confront PCPs or emergency medical providers.
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Affiliation(s)
- Paul S Casamassimo
- The Ohio State University College of Dentistry, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Catherine M Flaitz
- The Ohio State University College of Dentistry, Nationwide Children's Hospital, Columbus, OH, USA
| | - Kimberly Hammersmith
- The Ohio State University College of Dentistry, Nationwide Children's Hospital, Columbus, OH, USA
| | - Shilpa Sangvai
- The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - Ashok Kumar
- The Ohio State University College of Dentistry, Nationwide Children's Hospital, Columbus, OH, USA
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Nutritional and dental issues in patients with intellectual and developmental disabilities. J Am Dent Assoc 2018; 149:317-321. [DOI: 10.1016/j.adaj.2017.11.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/06/2017] [Accepted: 11/11/2017] [Indexed: 11/23/2022]
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Wiener RC, Vohra R, Sambamoorthi U, Madhavan SS. Caregiver Burdens and Preventive Dental Care for Children with Autism Spectrum Disorder, Developmental Disability and/or Mental Health Conditions: National Survey of CSHCN, 2009-2010. Matern Child Health J 2018; 20:2573-2580. [PMID: 27465058 DOI: 10.1007/s10995-016-2083-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective The purpose of this study is to examine the burdens of caregivers on perception of the need and receipt of preventive dental care for a subset of children with special health care needs-children with Autism Spectrum disorder, developmental disability and/or mental health conditions (CASD/DD/MHC). Methods The authors used the 2009-2010 National Survey of CSHCN. The survey included questions addressing preventive dental care and caregivers' financial, employment, and time-related burdens. The associations of these burdens on perceptions and receipt of preventive dental care use were analyzed with bivariate Chi square analyses and multinomial logistic regressions for CASD/DD/MHC (N = 16,323). Results Overall, 16.3 % of CASD/DD/MHC had an unmet preventive dental care need. There were 40.0 % of caregivers who reported financial burden, 20.3 % who reported employment burden, and 10.8 % who reported time burden. A higher percentage of caregivers with financial burden, employment burden, and time-related burden reported that their CASD/DD/MHC did not receive needed preventive dental care (14.1, 16.5, 17.7 % respectively) compared to caregivers without financial, employment, or time burdens (9.0, 9.6 %, 11.0 % respectively). Caregivers with financial burden (adjusted multinomial odds ratio, 1.38 [95 % CI 1.02, 1.86] and employment burden (adjusted multinomial odds ratio, 1.45 [95 % CI 1.02, 2.06] were more likely to report that their child did not receive preventive dental care despite perceived need compared to caregivers without financial or employment burdens. Conclusions for practice Unmet needs for preventive dental care were associated with employment and financial burdens of the caregivers of CASD/DD/MHC.
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Affiliation(s)
- R Constance Wiener
- Dental Practice and Rural Health, School of Dentistry, West Virginia University, Robert C. Byrd Health Sciences Center Addition 104a, PO Box 9448, Morgantown, WV, 26506, USA.
| | - Rini Vohra
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, 26505 9510, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, 26505 9510, USA
| | - S Suresh Madhavan
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, 26505 9510, USA
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Natapov L, Dekel-Markovich D, Granit-Palmon H, Aflalo E, Zusman SP. Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel. Public Health Nurs 2017; 35:64-69. [DOI: 10.1111/phn.12367] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Lena Natapov
- Dental Services Department; Division of Dental Health; Ministry of Health; Jerusalem Israel
| | | | | | - Efrat Aflalo
- Division of Dental Health; Ministry of Health; Jerusalem Israel
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Al‐Nowaiser AM, Al Suwyed AS, Al Zoman KH, Robert AA, Al Brahim T, Ciancio SG, Al Mubarak SA, El Meligy OA. Influence of full mouth rehabilitation on oral health-related quality of life among disabled children. Clin Exp Dent Res 2017; 3:171-178. [PMID: 29744197 PMCID: PMC5839220 DOI: 10.1002/cre2.78] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 07/19/2017] [Accepted: 07/31/2017] [Indexed: 11/06/2022] Open
Abstract
The efficacy of full mouth rehabilitation (FMR) on oral health-related quality of life of physically disabled children was assessed. This prospective study was performed at Dental Department of Sultan Bin Abdulaziz Humanitarian City, Riyadh, and King Abdulaziz University Hospital, Jeddah, Saudi Arabia, during May 2012 to September 2014. A total of 186 physically disabled children aged 11-14 years were assigned to a test group (n = 97) or a control group (n = 89). FMR was applied for test group children at baseline and 3 months' visits, whereas those in the control group did not receive FMR. Both group children received dental kits and oral hygiene instructions. Children were asked to complete the Child Perceptions Questionnaire, whereas Parental-Caregiver Perceptions Questionnaire and Family Distress Domain questionnaire were completed by the parents/caregivers at baseline and 6 months' visits. Children in both groups showed positive trends in oral symptoms at 6 months compared with those at baseline. However, when they were compared to control, significant improvement in oral symptoms was observed in the test group at 6 months' visit (p < .05). Also when they were compared to control, significant improvements were observed in the functional limitation, emotional, and social well-being subscales of the Child Perceptions Questionnaire and on the Parental-Caregiver Perceptions Questionnaire scales at the end of the study (p < .05). Compared to the parents/caregivers of the control children, the parents/caregivers of the test-group children reported insignificant but positive trends in Family Distress Domain at the end of the study (p < .05). FMR in children reduced oral-related problems subsequently to a better oral health-related quality of life.
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Affiliation(s)
| | | | - Khalid H. Al Zoman
- Dental DepartmentKing Faisal Specialist Hospital & Research CenterSaudi Arabia
| | - Asirvatham A. Robert
- Department of Endocrinology and DiabetesDiabetes Treatment Center, Prince Sultan Military Medical CitySaudi Arabia
| | - Tarfa Al Brahim
- Department of NutritionPrincess Nourah bint Abdulrahman UniversitySaudi Arabia
| | - Sebastian G. Ciancio
- Department of Periodontics and Endodontics, School of Dental MedicineState University of New York at BuffaloNew YorkUSA
| | | | - Omar A. El Meligy
- Pediatric Dentistry DepartmentKing Abdulaziz UniversitySaudi Arabia
- Pediatric Dentistry and Dental Public Health DepartmentAlexandria UniversityEgypt
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Singhal S, McLaren L, Quinonez C. Trends in emergency department visits for non-traumatic dental conditions in Ontario from 2006 to 2014. Canadian Journal of Public Health 2017; 108:e246-e250. [PMID: 31583607 DOI: 10.17269/cjph.108.5950] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/18/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE In Canada, non-traumatic dental conditions (NTDCs) presenting in emergency departments (EDs) are dealt with by non-dental professionals who are generally not equipped to deal with such emergencies, resulting in an inefficient usage of heath care resources. This study aimed to assess the burden of ED visits for NTDCs in Ontario by observing trends from 2006 to 2014. METHODS Aggregate data for Ontario were obtained from the Canadian Institute for Health Information's National Ambulatory Care Reporting System. Data were examined for the whole of Ontario and stratified by 14 Local Health Integration Networks. Descriptive analysis was conducted for both number of people and number of visits, stratified by sex and age groups (0-5, 6-18, 19-64, and 65+ years). Numbers were also examined by neighbourhood stratifications, including urban/rural, income quintile and immigrant tercile. RESULTS Over the study period, an upward trend of visiting EDs for NTDCs was observed. Approximately 403 628 people in Ontario made 482 565 visits over the period of nine years. On average, 341 per 100 000 people, per year, visited. Young children, people living in neighbourhoods with lower income and higher immigrant concentration, and people living in the rural regions, visited EDs more for NTDCs during 2006-2014. CONCLUSION The upward and inequitable trends of utilization of EDs for NTDCs reinforce recognition of the important need for both universal and targeted approaches for primary prevention of dental conditions. To enhance equitable access to dental care, policy advocacy is required for publicly funding essential and emergency dental services for all.
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Affiliation(s)
- Sonica Singhal
- Dental Public Health, University of Toronto, 124 Edward Street, Toronto, ON, M5G 1G6, Canada. .,Health Promotion, Chronic Disease and Injury Prevention Department, Public Health Ontario, Toronto, ON, Canada.
| | - Lindsay McLaren
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Carlos Quinonez
- Dental Public Health, University of Toronto, 124 Edward Street, Toronto, ON, M5G 1G6, Canada
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Drążewski D, Grzymisławska M, Korybalska K, Czepulis N, Grzymisławski M, Witowski J, Surdacka A. Oral Health Status of Patients with Lysosomal Storage Diseases in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030281. [PMID: 28282939 PMCID: PMC5369117 DOI: 10.3390/ijerph14030281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/20/2017] [Accepted: 03/02/2017] [Indexed: 01/20/2023]
Abstract
Patients with lysosomal storage diseases (LSDs) suffer from physical and mental disabilities, which together with poor access to professional care may lead to impaired oral health. This cross-sectional case-control study characterized the status of oral health in patients with LSDs in Poland. Thirty-six children and young adults with various forms of LSDs were examined. The data were compared with those from age- and sex-matched healthy controls. Exemplary cases were presented to highlight typical problems in oral care associated with LSDs. When possible, saliva was collected and analyzed for total protein, inflammatory mediators, and antioxidant status. Generally, patients with LSDs had significantly higher prevalence of caries, inferior gingival status, and inadequate oral hygiene. The severity of oral health impairment in mucopolysaccaridoses, the most common LSD in Poland, was similar to that seen in patients with mannosidoses or Pompe disease. Saliva could be collected only from few less handicapped patients. In MPS, it did not appear to differ significantly from the controls, but in patients with Pompe disease it contained lower concentrations of vascular endothelial growth factor (VEGF) and monocyte chemoattractant protein-1 (MCP-1), but higher levels of tumor necrosis factor receptors 1 and 2 (TNF-R1, TNF-R2) and myeloperoxidase (MPO). In conclusion, Polish patients with LSDs have an inadequate level of oral hygiene and substantially deteriorated oral health.
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Affiliation(s)
- Damian Drążewski
- Department of Conservative Dentistry and Periodontology, Poznan University of Medical Sciences, 60-812 Poznan, Poland.
| | | | - Katarzyna Korybalska
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznan, Poland.
| | - Natasza Czepulis
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznan, Poland.
| | - Marian Grzymisławski
- Department of Metabolic Disease, Nutrition and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland.
| | - Janusz Witowski
- Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznan, Poland.
| | - Anna Surdacka
- Department of Conservative Dentistry and Periodontology, Poznan University of Medical Sciences, 60-812 Poznan, Poland.
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Oral health care offered to people with disabilities in the primary health care network: what do dentists say? J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0757-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Yuan N, Sterni LM. Outpatient Care of the Ventilator Dependent Child. Respir Med 2016. [DOI: 10.1007/978-1-4939-3749-3_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tan SH. Unmet Health Care Service Needs of Children With Disabilities in Penang, Malaysia. Asia Pac J Public Health 2015; 27:41S-51S. [PMID: 26122314 DOI: 10.1177/1010539515592461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Information on unmet health care needs reveal problems that are related to unavailability and inaccessibility of services. The study objectives were to determine the prevalence, and the reasons for unmet service needs among children with disabilities in the state of Penang, Malaysia. Caregivers of children with disabilities aged 0 to 12 years registered with the Penang Social Welfare Department in 2012 answered a self-administered mailed questionnaire. A total of 305 questionnaires were available for analysis (response rate 37.9%). Services that were very much needed and yet highly unmet were dental services (49.6% needed, 59.9% unmet), dietary advice (30.9% needed, 63.3% unmet), speech therapy (56.9% needed, 56.8% unmet), psychology services (25.5% needed, 63.3% unmet), and communication aids (33.0% needed, 79.2% unmet). Access problems were mainly due to logistic issues and caregivers not knowing where to obtain services. Findings from this study can be used to inform strategies for service delivery and advocacy for children with disabilities in Penang, Malaysia.
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Salama F, Al-Balkhi B, Abdelmegid F. Dental students' knowledge of oral health for persons with special needs: a pilot study. ScientificWorldJournal 2015; 2015:568464. [PMID: 25950019 PMCID: PMC4407527 DOI: 10.1155/2015/568464] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 03/22/2015] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The purpose of this pilot study was to assess the knowledge and awareness of dental students with respect to oral health care of the person with special health care needs (SHCN) and evaluate effectiveness of an education program on improving their knowledge. METHOD An evaluation consisting of a questionnaire was answered before and immediately after a 30-minute educational presentation in the form of a DVD that includes a PowerPoint and a video of oral health care for individuals with SHCN. The questionnaire was based on the materials and information presented in the DVD and included 26 questions (true/false/I do not know). RESULTS The mean (± SD) score on the pretest was 10.85 (± 5.20), which increased to 16.85 (± 5.47) on the posttest. This difference was statistically significant (P < 0.001). Forty percent of the students surveyed reported that they were very satisfied with the educational part of the presentation, while 50% were somewhat satisfied. Thirty percent of students expressed that the educational intervention used is very effective. CONCLUSIONS Viewing the educational intervention was effective in informing the sophomore students and providing them with instructive basic information on person with SHCN. Dental colleges should increase students' knowledge, training, and exposure to individuals with SHCN.
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Affiliation(s)
- Fouad Salama
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Bader Al-Balkhi
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Faika Abdelmegid
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Huebner CE, Chi DL, Masterson E, Milgrom P. Preventive dental health care experiences of preschool-age children with special health care needs. SPECIAL CARE IN DENTISTRY 2014; 35:68-77. [PMID: 25082666 DOI: 10.1111/scd.12084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study examined the preventive dental health care experiences of young children with special needs and determined the feasibility of conducting clinical dental examinations at a community-based early intervention services center. METHODS Study methods included 90 parent interviews and dental examinations of their preschool-age children. RESULTS Thirteen percent of the children received optimal preventive care, defined as twice daily tooth brushing with fluoridated toothpaste and two preventive dental visits in the prior 12 months; 37% experienced care that fell short in both areas. Optimal care was more common among children of parents who reported tooth brushing was not a struggle and those with a personal dentist. Parents' opinion of the study experience was generally positive. CONCLUSIONS Few children with special needs receive effective preventive care early, when primary prevention could be achieved. Barriers to optimal care could be readily addressed by the dental community in coordination with early intervention providers.
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Affiliation(s)
- Colleen E Huebner
- Department of Health Services, Northwest Center to Reduce Oral Health Disparities, University of Washington, Seattle, Washington
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Campanaro M, Huebner CE, Davis BE. Facilitators and barriers to twice daily tooth brushing among children with special health care needs. SPECIAL CARE IN DENTISTRY 2013; 34:185-92. [PMID: 24252060 DOI: 10.1111/scd.12057] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The oral hygiene routines of preschool-age children with special health care needs (CSHCN) were examined to identify caregiver behaviors and beliefs associated with twice daily tooth brushing. METHODS Ninety caregivers of CSHCN, ages 23 to 62 months, were interviewed to determine supports or barriers to tooth brushing. RESULTS Ninety-eight percent of caregivers had begun brushing their child's teeth and half reported brushing twice daily. Caregivers' brushing skills and the availability of child-friendly supplies were associated with twice daily versus less frequent brushing (p = .02). CONCLUSIONS This study adds insight into the challenges of establishing daily oral health care for children who must rely on others for their care. The facilitators and barriers to tooth brushing by caregivers of CSHCN are similar to those noted previously among parents of typically developing children. Efforts to improve all caregivers' oral hygiene skills are needed. For caregivers of CSHCN, oral health teaching opportunities may exist among professionals who provide ongoing medical care, special services and therapies.
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Affiliation(s)
- Maria Campanaro
- Graduate, Health Services and Maternal and Child Health, University of Washington, Seattle, WA, USA
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