Considering oral care in children with special health care needs

A study looks at the prevalence of preventive oral care and overall oral health in children who have special health care needs.

Preventive oral health services are a cornerstone of a child having good oral health. However, as with other health services, these preventive services may require extra care for children with special health care needs. A report in Pediatrics looked into the prevalence or oral health concerns as well as receiving preventive oral health care.1

The investigators used pooled data from the 2016-2018 National Survey of Children’s Health. The sample included 23,099 children with special health care needs and 75,612 children who did not have special health care needs. Caregivers were asked about toothaches, bleeding gums, delayed teeth, cavities, and fair or poor teeth conditions. Preventive dental visits, cleanings, tooth brushing as well as oral health care instructions, fluoride, and sealants were defined as preventive oral health services.

When looking at the past year, investigators found that a higher proportion of children with special health care needs than those with no special needs had received preventive dental care (84% vs 78%, P < .0001). An analysis of specific preventive services showed similar patterns. However, there were higher rates of oral health problems seen in children with special health care needs than their peers with no needs. Decayed teeth and cavities occurred in 16% of children with special health care needs and only 11% in their peers. Through an adjusted analysis, investigators found that several factors had a significant link to a decreased prevalence of receiving preventive oral services in a subset of children with special health care needs, which included lower household education, non-English language, younger or older age, and worse condition of teeth, and lack of health insurance, lack of a medical home.

The investigators concluded that although children with special health care needs receive a higher rate of preventive oral health services than their peers without those needs, they also have worse oral health status. Making sure that appropriate use of preventive oral services is important to reducing oral health problems in children with special health care needs.

Reference

1. Lebrun-Harris L, Canto M, Vodicka P, Mann M, Kinsman S. Oral health among children and youth with special health care needs. Pediatrics. July 21, 2021. Epub ahead of print. doi:10.1542/peds.2020-025700