All children with special health care needs fall into a risk category and should be referred to a dentist by 1 year of age. Any child with evidence of caries or tooth, gingival, or eruption anomalies should be immediately referred to a dentist who is comfortable caring for children with special needs.

Dental insurance coverage may be a problem for some children who have special health care needs. Most of these children qualify for Medicaid, which automatically qualifies them for comprehensive oral health services through the Early and Periodic Screening and Diagnostic and Treatment (EPSDT) program. However, some states have age minimums that do not correspond to the American Academy of Pediatrics and the American Academy of Pediatric Dentistry guidelines for referral and examination.

For a complete review of the management of oral health in the special needs population, refer to Special Care: An Oral Health Professional’s Guide to Serving Young Children with Special Health Care Needs produced by the National Maternal and Child Oral Health Research Center.