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Chapter 7: Special Needs
Introduction
The federal Maternal and Child Health Bureau's Division of Services for Children With Special Health Care Needs established a work
group that redefined children with special health care needs in the
following terms:


“Children with special health care needs are those who have
or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.”

This definition was adopted by the American Academy of Pediatrics in 1998. According to this definition, approximately 18% of US children and youth have a special health care need. Many of these conditions, including mental retardation, developmental disabilities, cerebral palsy, craniofacial abnormalities, and seizure disorders, can impact a child’s oral health.

By understanding the potential barriers to optimal oral health care and the consequences of poor oral health for patients with special health care needs, pediatric health professionals can identify at-risk patients early, provide anticipatory guidance, refer to appropriate dental professionals, and assist patients and families in overcoming barriers to accessing and utilizing care.


Sections
1.
Access to Care
2.
Caries Risk
3.
Other Concerns
 
Tooth Eruption
 
Malocclusion and Crowded Teeth
 
Dental Anomalies
 
Gingival Hyperplasia
 
Trauma
 
Bruxism
4.
Preventive Oral Health Practices
 
Dental Office
 
Pediatric Office Screening
5.
Examination Checklist
6.
Referrals
7.
Key Points
8.
Self-Assessment Questions
 
Upon chapter completion, participants will be able to:
 
1.
Recall that dental care is the most common unmet need among the special needs population.
 
2.
List barriers to accessing dental care.
 
3.
State reasons why children with special health care needs are at increased risk for caries.
 
4.
Complete the oral health examination checklist at all routine visits.
 
5.
Assist families in addressing oral hygiene concerns and suggest techniques for optimizing oral care in children with special needs.
 
6.
Discuss appropriate timing of referral to a pediatric dentist and list conditions that mandate early referral.
View the Chapter 7 Photo Gallery.