Oral health needs among youth with a history of foster care: A population-based study.

BACKGROUND: Children and youth in foster care are considered to have special health care needs, including oral health care needs. This study compares the self-identified oral health care needs and access to oral health care among youth who have and have not experienced foster care. METHODS: Data were drawn from the 2019 Minnesota Student Survey, a statewide survey of public school students in the 5th, 8th, 9th, and 11th grades (N = 169,484). Youth with a history of foster care (3%) were compared with youth with no history of foster care for 7 oral health indicators. RESULTS: Youth with a history of foster care reported more oral health problems and less access to oral health care than their peers with no history of foster care. Using logistic regression to control for key covariates, the odds of an oral health problem for youth with a history of foster care were 1.54 higher (95% confidence interval, 1.44 to 1.65) than for their peers. CONCLUSIONS: Youth with a history of foster care report more oral health problems than their peers. Dentists should recognize the oral health concerns of these youth in the context of their special health care needs and be prepared to render appropriate care. Future studies should explore barriers to oral health care among this vulnerable population. PRACTICAL IMPLICATIONS: Youth in foster care have self-identified oral health care needs that should be assessed by dental professionals.

Vitamin D Deficiency in a Minnesota-Based Foster Care Population: A Cross Sectional Study.

Children in foster care have complex health concerns that often interplay with their childhood experiences, environment and access to care. Studies suggest that foster care youth are at an increased risk for mental health disorders and physical disabilities. Although traditionally associated with insufficient bone development, the implications of vitamin D deficiency are broadening to encompass behavioral, neurodevelopmental, and psychological phenomena. Due to its association with diet, prenatal factors, and the prevalence of nutrition related deficiencies in foster care patients, we hypothesize that foster care patients exhibit lower levels of total 25-hydroxy vitamin D [25(OH)D] than the general pediatric population. A retrospective cross-sectional chart review of foster care patients and similar-aged non-fostered controls screened for vitamin D deficiency was conducted between January 2013 and May 2018 (n=407). Twenty-five (OH)D levels were comparable between foster care children and controls (p=0.771). A univariate analysis of risk factors within the foster care group found that higher BMI, older age, ADHD, and number of transitions was associated with decreased levels of 25(OH)D. Recognition and treatment of low 25(OH)D in foster care patients with specific risk factors may serve as an adjunct for meeting their medical and psychosocial needs.

Prevalence of vitamin D deficiency in international adoptees within the first 6 months after adoption.

BACKGROUND: Vitamin D deficiency impairs bone health and development. OBJECTIVE: To determine the prevalence of and risk factors for vitamin D deficiency in pediatric international adoptees. METHODS: A prospective cohort (N = 189) study from a single international adoption clinic was conducted. Total 25-hydroxy vitamin D [25(OH)D] level was measured at the initial clinical assessment (within 6 months of adoption). Vitamin D deficiency was defined as a 25(OH)D <20 ng/mL (<8 nmol/L) and insufficiency as 25(OH)D <30 ng/mL (<12 nmol/L). RESULTS: Vitamin D deficiency was diagnosed in 8% and insufficiency in 27% of the cohort. Lower body mass index and longer time in an institution were associated with vitamin D deficiency and insufficiency independent of age. CONCLUSIONS: Vitamin D insufficiency was common in our cohort of international adoptees. The significance of vitamin D insufficiency on bone development during the typical "catch-up" growth following international adoption needs to be determined.