Management of Dental Patients with Special Health Care Needs

Abstract

This best practice presents recommendations regarding the management of oral health care for dental patients with special health care needs (SHCN) rather than treatment for oral conditions. SHCN are defined as any physical, developmental, mental, sensory, behavioral, cognitive, or emotional impairment or limiting condition that requires medical management, health care intervention, and/or use of specialized services or programs. Nearly 1 in 6 US children has SHCN. The more severe their health conditions, the more likely they are to have unmet dental needs. Individuals with SHCN are at higher risk for poor oral health due to medical status, sensory issues, behavioral challenges, and significant barriers in access to and provision of dental care. Strategies for behavior guidance, sensory adaptations, and advocacy are discussed. Without timely professional preventive and therapeutic dental services, untreated oral disease has the potential to exacerbate systemic medical conditions, cause pain and dysfunction impacting overall quality of life, and increase the need for more complex dental care. This document addresses patients with developmental or acquired orofacial conditions as a special cohort of children with SHCN. Consultation and coordination of care with medical and other dental providers may be necessary for safe delivery of care and to improve long term outcomes for these patients. As children with SHCN approach adulthood, planning and coordinating their successful transition to an adult dental home ensures no disruption in the continuity of oral health care.

This document was developed through a collaborative effort of the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs to offer updated information and guidance on the management of dental patients with special health care needs.

_{KEYWORDS: DENTAL CARE FOR CHILDREN; DENTAL CARE FOR DISABLED; DISABLED CHILD; PEDIATRIC DENTISTRY}