spECIAL HEALTH CARE NEEDS

Dental Education in Care of Persons with Disabilities (DECOD)
Dental Education in Care of Persons with Disabilities (DECOD) is a special program of the UW School of Dentistry that treats persons with severe disabilities and prepares dental professionals to meet their special oral health needs. Includes several special clinics: pediatric, for children with disabilities; rehabilitation for those in vocational training and independent living program; geriatric, for elderly with disabilities; mobile dental service, for residents of long-term care facilities and the homebound. Training programs include short-term fellowships, extended fellowships, research training, staff training, and self-directed modules. The series of self-directed modules are for dental professionals who would like to treat patients with special needs. They include information about transfers from wheelchair to dental chair, and special dental concerns with specific conditions.

http://www.dental.washington.edu/departments/oralmed/decod/

Special Care Resources – Developmental Disabilities Practical Oral Care Series
National Institute of Dental and Craniofacial Research. Practical oral care for people with developmental disabilities: Making a difference [Dental provider’s kit]. Bethesda, MD: National Institute of Dental and Craniofacial Research, 2004.

This series of publications is designed to equip dental professionals with information on delivering quality oral health care to people with special health care needs. Strategies for care, covering topics such as mobility, neuromuscular and behavioral problems, sensory impairment, and other treatment considerations are discussed in the context of the general dentist office setting. Individual booklets offer practical guidelines on adapting standard practices for people with autism, cerebral palsy, Down syndrome, and mental retardation. A guide for caregivers has also been provided to detail the important role they play at home in maintaining good oral health. No charge for single copies. Continuing education for dental providers offered.

National Oral Health Information Clearinghouse http://www.nidcr.nih.gov/HealthInformation/SpecialCareResources/default.htm

National Institute of Dental and Craniofacial Research (NIDCR): Oral Health Information Index
The National Institute of Dental and Craniofacial Research (NIDCR) is a resource for health professionals and patients that gathers and disseminates information, including fact sheets, brochures, and information packets. The Oral Health Information Index includes bibliographic citations, abstracts, and availability information for a wide variety of print and audiovisual materials.

http://www.nidcr.nih.gov/HealthInformation/OralHealthInformationIndex/default.htm

Promoting Oral Health of Children with Neurodevelopmental Disabilities and Other Special Health Care Needs: A meeting to develop training and research agendas
Mouradian W, et al, eds. Promoting Oral Health of Children with Neurodevelopmental Disabilities and Other Special Health Care Needs. May 4-5, 2001. Seattle, WA.

This May 2001 meeting of health care professionals, educators, policy makers, researchers and parents was convened to develop training agendas related to oral health promotion for children with neurodevelopmental disabilities and other special health care needs and to consider oral health research, service, and policy needs.

Proceedings available on-line: http://depts.washington.edu/ccohr/resource/LEND_2001.pdf

Preventing Dental Diseases in Children with Disabilities
Preventing Dental Diseases in Children with Disabilities. The Arc, Johnson & Johnson Dental Care Co., the American Dental Hygienists’ Association and the Academy of Dentistry for the Handicapped. Preventing Dental Diseases in Children with Disabilities. 1990. This 10-page folder is designed for parents and other caregivers. Positioning tips, toothbrush modifications, and tips for planning dental visits are included.

Available for download or order from The Arc website (http://thearc.org): http://209.183.228.233/. (publication 10-8)

Inequalities in access: Oral health services for children and adolescents with special health care needs
National Maternal and Child Oral Health Resource Center. Inequalities in access: Oral health services for children and adolescents with special health care needs. Arlington VA: National Center for Education in Maternal and Child Health. 2000.

This fact sheet presents general information on the status of oral health services for children and adolescents with special health care needs, focusing on legal requirements, availability, and use.

http://www.mchoralhealth.org/PDFs/OHCSHCNfactsheet.pdf

Medicaid/EPSDT
Information about the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service is available online. EPSDT is Medicaid’s preventive health program for individuals under the age of 21. EPSDT services include dental services and health education.

http://www.cms.hhs.gov/medicaid/epsdt/

Title V of the Social Security Act: Maternal and Child Health Services Block Grant
US states and jurisdictions use funds allocated by Title V of the Social Security Act of 1935 for a wide range of maternal and child health programs. Programs and services vary, however the overall goal is the same, to improve the health of all mothers and children. Thirty percent of Title V funding is reserved for children with special health care needs. In some areas, this funding provides direct service (or reimbursement for service), including dental and nutrition care.

More information about Title V in general can be found online: http://mchb.hrsa.gov/programs/blockgrant/overview.htm. Links to state and regional contacts are also available: https://performance.hrsa.gov/mchb/mchreports/link/state_links.asp.

Oral development and oral conditions in young children with special health care needs
Isman B, Newton RN. Oral development and oral conditions in young children with special health care needs: A guide for medical professionals. Los Angeles CA: California Connections, 1998.

This guide describes and illustrates 11 types of oral development and oral conditions in young children with special health care needs. With each section, there is a recommendation to medical professionals for counseling of parents, referral, or treatment.

http://www.mchoralhealth.org. Available for loan; single copies available at no charge, or through the HRSA Clearinghouse, http://www.ask.hrsa.gov, Document number MCHL018

Special Smiles: A guide to good oral health for persons with special needs
Perlman SP, Friedman C, Kaufhold GH. Special Smiles: A guide to good oral health for persons with special needs. Boston, MA: Special Athletes, Special Smiles; Boston University. 1996.

This information is designed to help families and caregivers develop and maintain an oral hygiene program, including brushing, using fluoride rinses, and flossing. It has tips for adapting a toothbrush and using different body positions to make brushing easier and includes an oral hygiene evaluation checklist to be completed by the dentist. http://www.specialolympics.org/Special+Olympics+Public+Website/English/Initiatives/Healthy_Athletes/Special+Smiles/Oral_Health_Guide/default.htm

Special Olympics Special Smiles
Special Olympics Special Smiles a core component of the Special Olympics Healthy Athletes initiative. The mission of Special Smiles is to increase access to dental care for Special Olympics athletes, as well as all people with intellectual disabilities.

Dental screenings increase awareness of the state of the athletes' oral health for the athletes themselves, as well as their parents and/or caregivers. The athletes are provided with hygiene education to help ensure they are doing an adequate job of brushing and flossing, as well as nutrition education to understand how their diet affects their total health. The athletes also are provided with a list of dentists/clinics in their area who will treat patients with special needs, should they have difficulty finding a dentist. At most locations, free mouth guards are provided for athletes competing in contact or high-risk sports.

The Special Smiles website includes the Local Clinical Director’s Handbook, with information to implement Special Olympics Special Smiles events and the Training Manual for Standardized Oral Health Screening, with information to become a standardized oral health screener.

http://www.specialolympics.org/special+olympics+public+website/english/initiatives/healthy_athletes/special+smiles/default.htm

Healthy Smiles for Children with Special Needs
American Academy of Pediatric Dentistry. Healthy Smiles for children with special needs. Chicago, IL: Teletech video, 1998. 1 videotape (12:02 minutes, VHS). $9.95.

This videotape describes devices and techniques that can assist parents in helping their children with special health care needs establish an oral health care routine. Topics addressed include the basics of oral health care, the best age for a child’s first dental visit, dental sealants, and oral sensitivity. The videotape also features interviews with three parents.

American Academy of Pediatric Dentistry http://www.aapd.org

Head Start and Early Head Start
Head Start is a program with an overall goal of promoting school readiness for children from low-income families and children with special health care needs. In addition, Head Start provides social health services (including medical, dental and nutrition). Early Head Start is a similar program, started in 1994, which provides services to pregnant women with low incomes and children 0 to 3 years of age from families with low incomes. Federal law reserves 10% of enrollment slots for children with disabilities.

More information about Head Start can be found at: http://www2.acf.dhhs.gov/programs/hsb/. More information about Early Head Start can be found at: http://www.ehsnrc.org/

Critical Elements of Care
From The Center for Children with Special Needs, booklets are available for cerebral palsy, sickle cell, Duchenne muscular dystrophy, cleft lip and palate, cystic fibrosis, juvenile rheumatoid arthritis. Guidelines include anticipatory guidance for oral health and nutrition.

http://www.cshcn.org/resources/cec.cfm