Transcript Improving the Dental Health of CYSHCN Through the Lifespan

Dental Care for
Children and Youth
with Special Health
Care Needs
AAPD Conference
Children and Adults with Special Health
Care Needs
November 17-18, 2006, Chicago
Betsy Anderson, Family Voices
FAMILY
OICES
V
• National Network of Families & Friends
http://www.familyvoices.org
• Family to Family Health Information
Centers (35!)
• Meetings and Workshops
• Research and Data
• Networking and Partnerships
Bright Futures Materials:
Complements the Bright Futures Guidelines for Health
Supervision of Infants, Children and Adolescents
The Family Pocket Guide is a quick reference that contains:
How to choose and work with your health care provider
What to expect as your child grows
What will happen at health visits from birth to age 21
Color-coded by age
Various tip sheets in the appendix for all ages
Dental Health
Issues for
Children
www.brightfuturesforfamilies.org
Dental Health Issues for Children
Thoughtsfor families
 Dentalhealth is more than teeth– it also includes
mouth, face,nutrition, speech, chewing, swallow
ing, appearance, well being, and confidence.
 Ideas about dentalhealth and what can be
done may be different from when
you were
growing up. New dental procedures
such as
sealants, cosmetic treatments,and painmanagement havebeen added andimproved.
 Experiences and beliefs about dental
care
vary from countryto country.
 Cost and coverage can bebarriers togood dentalcare
High costs of care
Lack of information about how to get services covered
Families with coveragemay face red tape and delays
in determining
what is covered,pre-approvals, andco-pays.

Providers may be hard to find, especially for those with Medicaid or certain
dental plans.
 Family-centered careexists in some, but not all,
dental practices. Needed is:
Understandingof families’ roles in day to day care
and special situations
Informationespecially forfamiliesand children
Support for children and families
 Communication and coordination among child
health providers- dentists, pediatricians,and other
caregivers– is needed.
 Dental care is not typically part of regular health
insurance, conveying a confusing message.
________________________________________________________________________________________
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Free: 1-888-835-5669  E-mail: [email protected]  Internet: http://www.familyvoices.org
Dental Health
Issues for Children
with Special
Healthcare Needs
Dental Health Issues for
Children
withSpecial Health Care Needs
Thoughts
forfamilies
All of the issues mentioned
on the previous page
may
also a
pplyfor children with special needs.
hese issues
T
may be “heightened.”
Additionalon
ccernsmay include:
 Need for ccessibility,
a
modification, accommodation. Dental
and offices
practices
should comply
with Americans
’ with Disabilities Act standards
.
 Staff attitudes and comfort caring for children with special needs
 Staff training to addr
ess information, support, and specific treatments for
children with special needs.
 Medications
a child is taking
may cause increases in cavities and plaque.
 Appropriate recommendations for anesthesia
. Some children may need
anesthesia for
treatments and
procedures that
othersdo not
. In other cases,
children with special needs may be inappropriately anesthetized.
 Consideration that
osts
c for treatment, equipment and will
supplies
likely be
in
addition to other health care costs families face.
 Under ma
naged care, some procedures may be denied, thus requiring
families to appeal in order for children to receive needed services.
 Families will needcoordinat
to
e dental appointments and care with other
health care
services
and therapies
childrenreceive
.
 Communication and coordination with children’s other health care
professionals in order to provide quality,
-centered
family care.
 Children and families
benefit from
dentalhealth professionals
whoact as
advocates for children’s
dentaland other health
care and services
!
Note that for some
children with special needs, there are no special
dentalhealth issues!
Our thanks to Bright Futures at Georgetown University for graphics
Supported byG97MCO 4453from theMaternal and Child Health Bureau, Division of Child, Adolescent and Family Health
Health Resources and Services Ad
ministration,Department of Health and Human Services
Family Roles and Partnerships:
Families are their children’s
first and best advocates,
providing and overseeing
their children’s health and
development.
Family Roles and Partnerships:
 Obstacles
• Initially - no where to go but up – families
were not seen as partners or providers
 Successes
• Roles for families at many levels
• MCHB and other champions!
• Concept of family-centered, communitybased, coordinated, culturally competent care
• Concepts now selling points
• Partnerships at many levels
Care and Services
Raising children is
important, hard
work –
24 hours a day.
Care and Services:
 Obstacles
• Few services, giant gaps in service
• Lack of parent presence
• From limited care to fragmented care
• Care in specialty settings – primary care
not comfortable or confident in their roles
 Successes
• Innovation, technology, techniques
• Success in education (IDEA) prompted changes
• Each specialty “bloomed”
• Family roles have become more diverse
• Family roles are recognized and supported
Information and Data
Children’s health happens
in many settings –
home, school, community.
Families are the links between
caregivers and settings.
Information and Data:
 Obstacles
• limited to non-existent
• not family friendly
• not matched to family roles
Information and Data:
 Successes
• Tremendous progress
• Internet dissemination
• Oral Health Data
- Nat’l Survey CSHCN (2001)
- Nat’l Survey of Children’s Health (2003)
- Family Voices: provision of oral health info
has doubled, 2005-2006
• MCHB Performance Measures
National and State Measures
Financing
Your child’s health care
providers want to help
you raise healthy children.
Children’s regular
health and dental visits
are excellent times to
get this help.
Financing:
 Obstacles
• Early on - seldom mentioned
• Soon after and ongoing - major health
and economic consequence for the entire country
 Successes
• Katie Beckett waivers (1982); children assisted
by technology
• SCHIP (1997 – being reauthorized ‘07)
• Increase in understanding of issues
• Increase in advocates
Recommendations & Resources
There are lots of
right and good
ways to raise
healthy children.
Maternal and Child Health Bureau
6 Critical Indicators of Progress
•
•
•
•
•
•
Medical Home
Insurance Coverage
Screening
Organization of Services
Family Roles
Transition to Adulthood
Promoting the Oral Health of CSHCN
• In Support of the National Agenda
Important Initiatives Advancing the
Agenda
• National Maternal and Child
Oral Health Resource Center
• ASTDD – State forums and plans
• Children’s Dental Health Project
• AAP – PROHD Project
• And others!
Family-Centered Care
 Recommendations
• Be intentional – extend FCC to
oral health practitioners
• Recognize families as primary care
providers and models for their children
• Involve families in program, policy, and
practice areas – work with families to
define roles
Care and Services
 Recommendations
• Create “virtual teams” to bring
together those involved in a child’s care
• Emphasize health and wellness for
CSHCN
• Build on Dental/Medical Homes and
Bright Futures
• Quality Care - define & discuss with
families
Information and Data:
 Recommendations
• Participate in and help shape
national, state and local initiatives
• Provide more specific and accessible
data on
– insured/uninsured
– co-pays
– out-of-pocket expenses for families
Financing:
 Recommendations
• Express and define financing needs
that partners can support
• Put teeth and gums back into the
child! Integrate health and dental
health
• Work broadly for good health for all
FAMILY
OICES
V
 Resources & Initiatives
• Family-to-Family Health Information
Centers
• FV topical call on oral health (June ’07)
• Work w/partners to identify best oral
health info for families (spring ’07)
• Family Voices Health and Wellness
Survey (current)
http://go.tufts.edu/familymatters
 Finally
• Build a community of champions for
dental health
Be advocates! Be out there! Be visible!
• Recent APHA Conference
If you find your life’s passion,
you’ll never work again.
Health promotion works!
Families matter!
Raising healthy children is everybody’s business!