For children with special healthcare needs and their families, going to the dentist can be a stressful ordeal. According to a report published by the Iowa Bureau of Oral and Health Delivery Systems, 10% of children and youth with special health care needs (CYSHCN) did not receive their needed preventative dental care over the past year, and over 20% of CYSHCN did not receive the restorative dental care they needed. This is compared to just over 5% of children without special healthcare needs who have untreated dental problems. If left untreated, tooth decay can cause pain and infections, and eventually the loss of teeth.
The same report says that children with special healthcare needs who take medication containing sugar or who have a specialized diet may be at a higher risk for tooth decay. Because of these increased risk factors, it is important for any child with special healthcare needs to see a dentist at least twice a year.
Westown Pediatric Dentistry, which has offices in West Des Moines and Spirit Lake, Iowa, is trying to make sure patients are aware of how important proper dental health is. Diane S., a representative for the practice, said there’s not enough emphasis in the medical community on dental health.
“The mouth and the teeth are just as important. A lot of health conditions arise from lack of pure dental care and dental treatment.… Just because someone has a special need, they shouldn’t be unable to receive that care,” Diane S. said.
An article from the Delta Dental of Iowa website lists seven dental health tips for families of special needs children. The article includes tips on good dental practices at home, as well as how to find the best dental care for children with special healthcare needs.
Jill Hamilton, the author of the article and corporate communications director for Delta Dental, said it’s important for parents of CYSHCN to be proactive in finding the right dentist for their child.
“I think it’s important that the parent maybe meet with the dentist prior, especially if they do have a special needs child. They want to make sure that the child is comfortable with the dentist and that the dentist can accommodate any special needs that that child may have,” Hamilton said.
Hamilton said parents looking for dental care for their child should talk to their physicians, who may be able to provide dental recommendations best suited to the child’s individual healthcare needs, and that often times pediatric dentists can accommodate patients with special healthcare needs.
Dr. Jeffery Chaffin, the dental director for Delta Dental of Iowa, said that while clinically, dental care is the same for patients with or without special healthcare needs, the dental team needs to be aware of the individual and unique needs of children with special healthcare needs.
“Generally, there is a much slower approach to this dental care, and often focus on removing some of the distractions in the dental setting that might be an impediment to care,” Chaffin said.
Chaffin said that in extreme cases, a patient may need to be sedated to receive a diagnosis and treatment. In these cases, Hamilton said, parents should work with their insurance to make sure the sedation is covered.
“It really depends on the insurance plan the individual has. Sometimes, depending on what the need is or the situation of the patient, it may be a medical cost,” Hamilton said.
Westown Pediatric Dentistry has a dentist who is equipped to treat children with special healthcare needs both in the office and in the operating room, should sedation or general anesthesia be required.
“We do have one of our doctors here on staff that actually has OR [operating room] rights, so basically he has privileges in two local hospitals here, and so if we cannot get the child, if it’s a special needs situation and they can’t be accommodated in office there is an opportunity to have the child seen in the OR with Dr. Nick,” said Diane S.
Westown Pediatric Dentistry evaluates whether patients should be treated in the office or in the OR at their first visit.
“We go through their medical history, we talk to mom or dad or their chaperone … to discuss their needs. How capable are they of sitting in a chair for x amount of minutes or x amount of hours?” said Diane S.
She said the decision of where treatment occurs is based on having the best chance of fixing the problem so that the child doesn’t return with the same issues at their next visit.
Chaffin said that a key part of preventing dental disease is consistent dental self-care at home, but said that it may be challenging for patients with special needs to do on their own.
“Family members and other caregivers can help ensure proper brushing is completed daily,” Chaffin said.