ABSTRACT
Many patients with special healthcare needs present to medical, dental, and other health visits with behavioral, emotional, postural, and psychological issues. According to the American Academy of Developmental Medicine and Dentistry (AADMD) guidelines from 2017: "Clinical dental treatment is the most exacting and demanding medical procedure that persons with special needs undergo on a regular basis throughout their lifetime." Moreover, dental treatment is basically surgical in nature, usually requiring controlled placement of sharpened instruments in intimate proximity to the face, airway, and highly vascularized and innervated oral tissues. When medically necessary healthcare must be provided and the patient's inability to accept or cooperate will compromise the quality of care the clinician will be able to deliver, interventions may be indicated and implemented.
Subject(s)
Dental Care for Disabled , Health Services Accessibility , Humans , United StatesABSTRACT
Clinical dental treatment is the most exacting and demanding medical procedure that persons with special needs undergo on a regular basis throughout their lifetime. Dental treatment is surgical in nature, usually requiring controlled placement of sharpened instrumentation in intimate proximity to the face, airway, and highly vascularized and inner aged oral tissues. Although approximately 90% of patients with special needs can and should be mainstreamed through any general dental practice, without significant behavioral guidance, techniques, or medical immobilization/protective stabilization, there has been a drastic shift toward pharmacologic management of these patients using various forms of sedation and general anesthesia.
Subject(s)
Anesthesia, General , Restraint, Physical , Aged , HumansABSTRACT
People with disabilities develop the same health problems that affect the general population. Some may be more susceptible to developing chronic conditions because of the influence of behavioral risk factors such as increased physical inactivity. In addition, people with disabilities are more likely to be overweight or obese and to smoke. People with disabilities are at a greater risk of being a victim of violence than those without disabilities. The oral health of many people with disabilities is poor, and access to dental care is limited.
Subject(s)
Disabled Persons , Oral Health , Chronic Disease , Health Services Accessibility , HumansABSTRACT
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.
Subject(s)
Depressive Disorder, Major/diagnosis , Pediatric Dentistry , Adolescent , Humans , Physician's RoleABSTRACT
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.
Subject(s)
Athletic Injuries/prevention & control , Dentists , Health Education , Mouth/injuries , Professional Role , Athletes , Disabled Persons , Humans , SportsABSTRACT
A recent series of reports in Health Affairs reviewed the disparities in securing needed oral health services in the U.S. Despite an extensive oversight of the many issues involved, no direct mention is made of the particular conditions of the largest minority population in the U.S. unable to access dental care-the tens of millions of individuals with special health care needs. A review is provided of the particular barriers and conditions faced by this increasing population in its efforts to secure needed services.
Subject(s)
Dental Care for Disabled , Health Services Accessibility , Racial Groups , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , United StatesABSTRACT
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.
Subject(s)
Alcoholism/epidemiology , Dentist-Patient Relations , Dentists/psychology , Illicit Drugs , Prescription Drug Misuse/statistics & numerical data , Smoking/epidemiology , Substance-Related Disorders/epidemiology , Substance-Related Disorders/prevention & control , Adolescent , Alcoholism/prevention & control , Cross-Sectional Studies , Humans , Prescription Drug Misuse/prevention & control , Smoking Prevention , United StatesABSTRACT
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.
Subject(s)
Dental Health Services , Disabled Persons/statistics & numerical data , Health Services Needs and Demand , Canada , Censuses , Humans , United StatesABSTRACT
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.
Subject(s)
Dental Care for Children , Disabled Children/statistics & numerical data , Health Services Needs and Demand , Hispanic or Latino/statistics & numerical data , Adolescent , Child , Child, Preschool , Health Surveys , Humans , Infant , Infant, Newborn , United States/epidemiologyABSTRACT
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.
Subject(s)
Economics, Dental , Hispanic or Latino/statistics & numerical data , Humans , New York , United StatesSubject(s)
Dental Care/economics , Forecasting , Health Expenditures/trends , Demography , Health Services Research , Humans , United StatesABSTRACT
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).
Subject(s)
Continuity of Patient Care , Pediatric Dentistry , Transition to Adult Care , Adolescent , Child , Dental Care for Disabled , Female , General Practice, Dental , Healthcare Disparities , Humans , Male , Medicaid , United States , Young AdultABSTRACT
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.
Subject(s)
Dental Care for Disabled/ethics , Economics, Dental , Ethics, Dental , Health Services Accessibility/ethics , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Dental Care for Disabled/economics , Financing, Organized , Health Expenditures , Health Services Accessibility/economics , Health Services Needs and Demand/economics , Health Services Needs and Demand/ethics , Humans , Medicaid/economics , Medically Underserved Area , Middle Aged , New York , Population Dynamics , Poverty , United States , Young AdultABSTRACT
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.
Subject(s)
Dental Care/statistics & numerical data , Population Dynamics , Practice Management, Dental/statistics & numerical data , Adolescent , Adult , Black or African American/statistics & numerical data , Aged , Asian/statistics & numerical data , Black People/statistics & numerical data , Child , Child, Preschool , Disabled Persons/statistics & numerical data , Emigrants and Immigrants/statistics & numerical data , Ethnicity/statistics & numerical data , Hispanic or Latino/statistics & numerical data , Humans , Language , Massachusetts , Mexican Americans/statistics & numerical data , Middle Aged , Minority Groups/statistics & numerical data , United States , White People/statistics & numerical data , Young AdultABSTRACT
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.
Subject(s)
Dentists/statistics & numerical data , Economics, Dental/statistics & numerical data , Professional Practice/statistics & numerical data , Dentists/economics , Economic Recession/statistics & numerical data , Economics/statistics & numerical data , Financial Management/economics , Financial Management/statistics & numerical data , Humans , New York , Practice Management, Dental/economics , Practice Management, Dental/statistics & numerical data , Professional Practice/economics , Professional Practice Location/economics , Professional Practice Location/statistics & numerical data , United StatesABSTRACT
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.
Subject(s)
Dental Offices/organization & administration , Dentistry/organization & administration , Employment , New York , Salaries and Fringe BenefitsABSTRACT
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.