Identifying oral health needs of young children with special needs

Objectives: Children with special health care needs (intellectual or emotional disabilities or chronic medical conditions) are reported to be at elevated risk for dental problems. This study determined the feasibility of identifying oral health needs early, in community settings. Methods: Parent interviews and dental exams of children 2 through 4 years old occurred at an early intervention services center. The interviews, conducted by staff nurses familiar with the families, asked about dental care, professional advice, home hygiene, and dental symptoms. The exams were performed by a WHO-calibrated pediatric dental resident and included caries assessment, enamel defects identification and plaque sampling. Results: The enrollment goal of 90 families was reached ahead of schedule. Most parents reported numerous interactions with pediatric medical or education professionals monthly but less than half (42%) said they had ever received specific information about dental care or dental precautions associated with medications or disability. Nineteen children (21%) had never seen a dentist. All children who attended the study's dental exam (n=87) completed it without the need to reschedule due to behavioral interference. Exit interviews were conducted with 66 parents: 28 (42%) reported no difficulties associated with study participation and nearly all (97%) said they would participate again. The most common difficult aspect of the study noted by parents was their child's discomfort during the dental exam (44%). The most commonly noted benefit was learning their child's dental status (68%). Other benefits included receipt of oral health education, dental referrals and dental supplies. Conclusion: To date, there are no generalizable epidemiological data to describe the oral health of very young children with special needs. Early intervention service centers are a logical place to: collect these data, offer preventive dental treatments, and provide oral health education to parents and professionals who care for this high-risk group.