Pediatric Dental Patients are Part of a Larger Picture: Detailing Population Realities.

The traditional setting of a dental practice may offer pediatric dentists a potentially isolated picture of the general health and use of health services by youngsters in their community. Results from the latest National Health Interview Survey are reviewed to provide broad dimensions to supplement and reinforce the general and specific information usually developed regarding individual patients.

Increasing use of dental services by children, but many are unable to secure needed care.

National studies indicate that an increasing proportion of children are receiving needed oral health care. However, this increase is not uniform throughout all populations of youngsters. Overall national study findings regarding the use of dental services mask the fact that, a significant subset of low-income, minority, medically and developmentally compromised and socially vulnerable children continue to lack access to care and suffer significant and consequential dental and oral disease. In addition, these same children will face continued difficulties in securing needed care as they reach their early adult years.

Pediatric dental practice and changing population demographics: a commentary.

US. Census Bureau reports for the 2010 census detail the slowing overall growth of the number of children with specific emphasis on the increasing proportion of Hispanic children in the population. A review of these data is considered in terms of the potential impact on pediatric dental practices.

Dentistry and childhood poverty in the United States.

The proportion and numbers of children living in low income families and without health insurance continues to increase. The magnitude of these problems is considered at localized levels in terms of the impact on the use of dental services.

Well-being of Hispanic children in the United States.

The availability of general information about the economic, health and social well being of Hispanic children in the United States is essential for dental and other health practitioners. Only recently have government and private agencies moved beyond the standard presentation of information by traditional "white, black and other" groupings. The need is to develop an increased awareness of the different factors which affect children in general, and in particular Hispanic children. An overview is carried out to stimulate such an effort.

Oral and general health of Hispanic children with disabilities in the United States.

Hispanic residents are the fastest growing population of the U.S. Only recently have government agencies begun to identify the associated demographic facts and inequities which are specific to this population. In particular limited attention has been directed to Hispanic children with disabilities. Available government reports are used to provide a basic awareness of the oral and general health needs of this population of youngsters.

Dentistry for Mexicans with special needs: a commentary.

There are more than 2 million residents with disabilities in Mexico. Despite national legislation to assure individuals with disabilities needed services, including education and employment, social inclusion of these individuals is difficult since societal views exclude them from functioning as members of a community. While there are no national studies of the dental needs of individuals with disabilities in Mexico, reports of the general population indicate limited use of dental services and the need for increased restorative services. Examples of dental education accreditation standards in other countries are used as models for the improvement in the preparation of dental students to provide services for individual with special needs.

Adults with special needs and proper dental care.

The Special Olympics was founded by Eunice Kennedy Shriver in 1968 and has grown into a global movement involving 2.5 million athletes, in addition to millions of volunteers, family members, and friends. The international organization provides year-round sports training and athletic competition in a variety of Olympic-style sports for children and adults with intellectual disabilities. The year-round programs provide opportunities for participants to develop physical fitness, demonstrate courage, experience joy and participate in the sharing of gifts, skills, and friendship with their families, other Special Olympics athletes, and the community. Most important has been the opportunity to demonstrate what people with intellectual disabilities can do, rather than what they can't do.

Special Olympics, special smiles: assessing the feasibility of epidemiologic data collection.

No comprehensive national study has ever been completed on the oral health status of people with disabilities, their patterns of use of oral health services and access-to-care barriers. The authors describe the Special Olympics, Special Smiles program, conducted as part of the New Jersey Summer Special Olympics Games, and assess a pilot-tested model for collecting epidemiologic data. The results of this initial data collection are also compared with the goals of the U.S. Public Health Service, as outlined in the Healthy People 2000 publication.

Providing general dentistry for people with disabilities: a demographic review.

In the mid-1990s, approximately 54 million American people had some level of disability, including 26 million who had a severe disability. In addition, more than three-quarters of individuals with mental retardation/developmental disabilities were deinstitutionalized during the past 30 years and now reside in our communities, relying upon community practitioners for needed services. This review is provided to make dental practitioners aware of the magnitude and dimensions of the situations in which persons with special needs require their services.

Oral health status of special athletes in the San Francisco Bay Area.

A standardized oral health screening protocol was developed for assessing the oral health status of athletes participating in annual Special Olympics events at sites across the country. This paper reports on results at the San Francisco Bay Area Special Olympics event, where 385 athletes participated in the oral health screening. Trained dental screeners determined the presence or absence of edentulism, untreated decay, filled teeth, missing teeth, tooth injury, fluorosis, and gingival signs, as well as treatment urgency. The frequency of mouth cleaning, having a mouth guard, use of tobacco, and presence or absence of pain were self-reported. Overall, child athletes 9-20 years of age had more untreated decay and substantially more missing permanent teeth than 9-20-year-old children represented in the 1986-87 National Institute of Dental Research Survey of U.S. School Children. Prevalence of missing teeth among adult athletes compared favorably with data from the Third National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System Survey. Approximately one-third of child and adult athletes were determined to need dental care. Continued use of a standardized screening protocol could allow state-specific data to be available on the oral health status of this population; trends could be tracked; and needs could be identified, with strategies developed to meet those needs.

Community-based dental services for patients with special needs.

Deinstitutionalization of individuals with mental retardation and developmental disabilities has increased the demand for dental services for these patients by community practitioners. There are numerous difficulties associated with the delivery of care to this population with special needs. Nevertheless, a county-by-county review for New York State indicates that in most instances, if all dentists are willing to help, there would be a relatively small number of these patients per dental practitioner.

Low birthweight babies grow older, but there could be many problems.

An increasing number of low birthweight babies are surviving into their teen years and beyond, but with lifelong problems- including physical, intellectual and behavior difficulties. In the past, the indicators and measures used to evaluate health outcome have been selected from the perspective of the health care provider. There have been considerable skepticism as to the ability of parents to provide data about the development of their children. But practitioners often must rely upon the parent/guardian of children (particularly children with developmental and /or emotional disabilities) for significant input. This input is essential, but should be considered within the context of raising a child with special health care needs.

A quarter of a million dollars to raise a child born in 2000: and if the child is disabled....

Raising children in the year 2000 and beyond will be expensive. A review of actual costs by expense categories and a variety of family demographic characteristics provides practitioners with an appreciation of the competitive financial realities faced by many families. An added review of the costs of raising children with disabilities adds further dimension to the financial pressures placed on many families.

Children with both mental retardation and mental illnesses live in our communities and need dental care.

Children with mental retardation may also suffer from the dual condition of mental health problems. As a result of deinstitutionalization and mainstreaming of many of these youngsters, an increasing number reside in our communities and are dependent upon local dentists for services. A review of the complicating realities of these comorbidities is presented.

In 1999, the number of children (and adults) without health insurance decreased, but....

The Census Bureau announced in mid 2000 that, between 1989 and 1999, the number of children (and adults) without health insurance decreased. The continued lack of health insurance in many population groups and the limitations of Medicaid (the primary third party coverage for one-in-five children) are explored.

Children with disabilities are aging out of dental care.

Each year thousands of poor children with disabilities "age out" of dental programs that were established to meet their needs. But now they are older. Most states provide minimal if any dental services (with limited reimbursement levels) for adults within the Medicaid system. In an effort to stimulate an awareness of these difficulties, a review is provided of 1) the number of the "former" children with disabilities who are faced with the unavailability of dental services and 2) the limitations of the adult Medicaid dental program.