I Am A Pediatric Dentist: Why is Major Depression Among Adolescents my Concern?

The question, "why a pediatric dentist should be concerned about major depression among teenagers" is considered in light of reports from the National Institute of Mental Health. The results of these studies indicate that there is a progressive increase in the proportion of adolescents with a history of major depressive episodes; ranging from 6.4% among 12 year olds to 15% and 16% for 15-17 year olds. There are great variations by gender, race and ethnicity in the proportion of teenagers experiencing major depressive episodes and receiving needed care. In addition, there is an increased proportion of teenagers with disabilities who experience major depressive episodes. This combined impact is a reality for youngsters with disabilities as they pass through the teenage years into adulthood. Listing of symptoms of depression are provided to facilitate dental treatment planning, as well as well as assisting parents/guardians in seeking the overall needed care for their youngsters.

Special Smiles: Sports Dentistry and the Special Needs Athlete.

There is a need to expand dental services to underserved populations, such as athletes with intellectual and developmental disabilities. This review introduces dentists to this need by sharing the direction taken by the Special Smiles program of Special Olympics and addressing the need to educate special needs athletes on prevention and care of sports-related mouth injuries.

I Am a Pediatric Dentist: Why Is Substance Abuse among My Patients My Concern?

The rapidly evolving demographic base of our communities intensifies the need for an awareness which in the past seemed beyond the traditional concerns of pediatric dentists; in this case, substance abuse by teenagers. A review was carried out regarding evolving demographics, the proportion of teenagers involved with substance abuse, the rationale for the use of varying elicit substances and the associated symptoms. A series of options for action are considered given the potential for pediatric dentists to be involved in the care of teenagers using elicit substances.

Comprehending the Number of Individuals with Disabilities and the Need for Oral Health Services.

INTRODUCTION: The use of mega-large numbers and percentages to describe the one billion people with disabilities in the world is beyond the comprehension of most people. We find it difficult to personalize such information and tend to skip over the data without considering the multitude of factors that impact on individuals with disabilities and their families. STUDY DESIGN: A review of World Health Organization, U.S. Census Bureau, and Canadian and U.S. dental school accreditation agency documents were used to establish the current information on disability numbers, proportions and dental education programs. RESULTS: More meaningful details from government agencies and the health professions and their educational institutions can provide data that could be used to demonstrate the increasing number of individuals with disabilities in a more meaningful manner; as well as preparing health professionals to provide the needed care. DISCUSSION: The use of survey data for specific countries by: age, types of disabilities, race/ethnicity, family and individual economics, employment and regional distribution provides a more personalized presentation which can be used to reach legislative bodies and health providers.

A Smaller Percent of Hispanic Children Have Special Health Care Needs: Is that Possible?

The results from latest study of children with special health care needs indicate at the national and state levels that (except for Asian children) the proportion of Hispanic children with special needs is less than for other child populations. A review of a series of associated factors raises questions of the validity of these general national and state findings. The significant projected increases in the Hispanic population during the next decades points to the necessity of reconsidering the recent survey findings in light of what could be continued increases in the numbers of youngsters with special health care needs and the evolving family cultural adaptation, education and employment opportunities.

Dental Economics and the Increasing Hispanic Population in the U.S. and New York State.

The continuing dramatic increases in the U.S. Hispanic population are considered relative to the economic concerns of dental practice. Oral health needs, limited finances and health insurance, together with varying cultural orientation, are reviewed in terms of the potential for growing Hispanic political strength.

Pediatric Dentistry Specialty as Part of a Longer Continuum of Care: A Commentary.

The transition of teenagers with special needs to young adulthood is a complex period for the children and their families. This transition is especially difficult when it comes to securing needed oral health care. The teenager is forced to transfer from the services of an age defined pediatric dental specialist with training to provide care for individuals with special needs, to 1) general practitioners with limited formal training and often unwillingness to provide care and 2) at a period when most states provide limited or lack of adult dental Medicaid programs. These issues and the need to expand pediatric dental specialist involvement in the general transitional period are reviewed. "Pediatric dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs."(1) "Our system of preparing and maintaining our abilities to provide oral health services for an increasing diverse population must be brought up to date to meet the challenges posed by the treatment of young adults with disabilities."(2) "Most responding dentists (to a national study of pediatric dentists) helped adolescents with and without SHCNs (Special Health Care Needs) make the transition into adult care, but the major barrier was the availability of general dentists and specialists."(3).

New York State Dental Establishments and Dentists: 2007-2012. Economic Survey.

Every five years a series of studies is carried out by the Census Bureau which provides an opportunity to review the basic economic well-being of the many industries at the national, state and county levels. A comparison of dental economic data from the 2007 and 2012 studies for the period that encompassed the 2007-2009 "Great Recession" details the general economic difficulties faced by the dental profession during this period.

Ethics, Economics and Dentistry for Individuals with Disabilities in New York State.

The ADA Principles of Ethics and Code of Professional Conduct is an expression of the obligation occurring between the profession and society to meet the oral health needs of the public. At a time of economic concerns for the profession, suggestions are made to bring together the ethics of the profession and the need to expand services to underserved populations, including individuals with disabilities and the poor. The profession's effort to secure economic support for such an effort is possible with increased legislative awareness of the magnitude of the problem. To this end, the number of individuals with disabilities was developed for each Congressional district in New York State in an effort to challenge members of Congress to recognize the need in terms of their constituents, rather than in terms of the tens of millions with disabilities in the United States-which become "just numbers," not actual people.

Increasing Nonemployer Dental Establishments in New York State: A Component of a Changing Landscape.

The increasing numbers of nonemployer dental establishments in the counties of New York State are a component of the evolving landscape for the delivery of dental services throughout the country. Limited attention has been directed to the more than 4,000 of these facilities in the state and the more than 43,000 in the nation. Increased attention needs to be directed to nonemployer facilities as the profession comes to terms with its economic concerns, legal challenges to delivery modalities and evolving population characteristics.

Dental Practice as the Population Demographics Change in Massachusetts.

General population demographics in the United States, individual states, and counties are undergoing dramatic changes. Long-term customary populations, which provided the bulwark for many successful dental practices, are being replaced by the many minority populations (in particular, the Hispanic population), foreign-born residents, and many for whom English may not be their first language. These developments are reviewed for the Commonwealth of Massachusetts and its counties in an effort to challenge practitioners by the extent of these developments.

Access to Dental Care Depends on Appreciation of Demographics and Economics.

The evolving demographics and economics of dental practice require consideration as the profession plans forfuture changes in the dental workforce, the makeup of the population and ongoing access to care crisis. This paper is a sampling of U.S. Census Bureau reports on demographics and an appraisal of JADA and ADA News statements regarding the economics of dental practice, as well as a review of historical developments of the profession's perceptions of dental education and government support for dental care. The trends in economics and population-based changes affecting U.S. dental practice indicate a general downturn in practice busyness, stagnation of expenditures for dental services, and a continuing increase in the proportion in minorities throughout the country and the limited ability to make changes in dental economics without altering some long-held views on the delivery of dental services. Customary populations which provided the bulwark of dental practices are being replaced by minorities.The economics of dental practices will be dependent upon (a) developing cultural and structural competence in the economics of the evolving shift in population demographics, (b) implementing changes in the economics of dental education and expansion of delivery models,

Massachusetts Dental Establishments: 2007-2012 Economic Survey.

Every five years, a series of studies is carried out by the U.S. CensusBureau that provides an opportunity to review the basic economic well-being of many industries at the national, state, and county level.-A comparison of dental economic data from the 2007 and 2012 stud es for the period that encompassed the 2007-2009 "Great Recession details the general economic difficulties faced by the dental profes-ion during this period. "While much of the economy has recovered since the Great Recession, the earnings of general [dental] practitioners have not, according to the ADA. In fact, 2014's average earnings of $174,780 for all GPs follow 2013's average of $183,885 and come at the end of a nearly decade-long decline since 2005's inflation-adjusted peak of $219,378"1¹Previous presentations in the JOURNAL OF THE MAsSSCHuUSTTs DENTAL Socimetyreviewed concerns regarding national dental economics and dental practice in relation to population changes in Massachusetts.2,3 More recent information is now available for business receipts for dental establishments with employees at the state and county levels that provides an opportunity to consider economic factors and dental practices from another perspective.

Dental Economics and the Increasing Numbers of Individuals with Disabilities in New Jersey.

The dual needs of 1) providing increasing oral healthcare for individuals with special needs, and 2) improving the economics of dental practice, are explored in a review of the State of New Jersey and its counties.

Changing demographics and providing dental services for Hispanic children.

General population demographics in the United States are undergoing dramatic changes. Long-term customary populations which provided the bulwark for many successful dental practices are being replaced by the many minority populations, in particular the Hispanic population. Despite these significant general population developments, the demographic profile of the dental profession has experienced (and apparently--based on dental student populations--will continue to experience) limited changes. The economic strength of the profession may well be predicated upon its responses to these developments.

Use of oral healthcare and need to expand population that is served: a commentary.

General population demographics are undergoing dramatic changes. Long-term customary populations that provided the bulwark for successful dental practices are being replaced by the many minority populations. Despite these significant general population developments, the demographic profile of the dental profession has experienced (and, apparently, based on dental student populations, will continue to experience) limited changes. The economic strength of the profession may well be predicated upon its responses to these developments. The question remains, "Is the profession preparing for them?".

Massachusetts dental establishments in 2011: after the last recession.

Census Bureau reports for 2007 and 2011 (before and after the last recession) were used to develop data for "average" dental establishments in the counties of Massachusetts. Any changes should be considered while bearing in mind the American Dental Association (ADA) 2013 report indicating that spending for dental services has stagnated. In terms of these findings, the need for continued monitoring of dental establishment activities beyond the confines of one's own facility is emphasized.

The proportion of elderly in Pennsylvania is slipping but....

Media reports describing the anticipated increase of tens of millions of elderly residents and their attendant billions of dollar costs for health services during the next decades are difficult for any person to place in proper perspective. As a result, these estimates become "just numbers" not actual people. Census Bureau reports are used at the national, state and county levels to provide an increased meaningful picture when the 65 and older population of Pennsylvania will increase to 22.6 percent of the state population. In 2000, 12.4 percent of the U.S. population was 65 years and older (15.6 percent in Pennsylvania, 1.9 million elderly). Only in the state of Florida was the proportion greater. In 2010, the proportion of elderly in the population of Pennsylvania ranked 4th (behind Florida, West Virginia and Maine). It was tied for 3rd (behind Florida and North Dakota) with 2.5 percent of the population 85 years and over. By 2030, the projected number of elderly in Pennsylvania (22.6 percent of the state population) will rank 11th. But ... "Starting on Jan 1, (2011) our 79-million-strong baby boomer generation will be turning 65 at the rate of one elderly every eight seconds.

Ensuring oral health for older individuals with intellectual and developmental disabilities.

AIMS AND OBJECTIVES: To emphasise the oral health needs of older individuals with intellectual and developmental disabilities, the impact on the individual's general health and the role that can be played by nurses. BACKGROUND: All too often an examination and consideration of the oral health condition of this patient population by nurses/physicians is cursory at best. The increasing retention of the dentition into later years of life provides both the favourable abilities for eating, speech and self esteem, but also the potential for local and general health concerns. DESIGN: Discursive paper. METHOD: Based on the findings from dental examination of thousands of international athletes in the Special Olympic Games and clinical experiences in academic and private practice settings for care of individuals with intellectual and developmental disabilities, a discursive listing was developed for use in a preliminary examination of the oral cavity. CONCLUSION: A nurse can play a critical role in the examination, preventive services and referrals for dental care for older individuals with intellectual and developmental disabilities. RELEVANCE TO CLINICAL PRACTICE: The specific oral health needs of older individuals with intellectual and developmental disabilities should be an integral component of the preventive and general health care provided by nurses.