OHRA - Children with Special Health Care Needs (CSHCN)

American Academy of Pediatrics

Course Outline > History: Determining Caries Risk

Children With Special Health Care Needs (CSHCN)

A mouth damaged from hoding medications

Damage caused by holding medications in mouth

Recommendations for Health Professionals

	Be aware of oral health problems/complications associated with medical conditions.

	Monitor impact of oral medications and therapies.

	Choose non–sugar-containing medications if given repeatedly or for chronic conditions.

	Refer early for dental care (before or by age 1 year).

	Emphasize preventive measures.

	Dental care is the most common unmet health need among children with special health care needs (CSHCN). It is important for child health professionals to address oral health issues even though other medical problems must often take priority. The potential impact of oral health problems in CSHCN is greater because of underlying vulnerabilities and the potential for significant systemic consequences, the use of medications and other treatments that can adversely affect oral health, as well as the difficulty families have accessing needed dental care. It is important that the families of CSHCN understand that oral health is a priority along with other competing problems. Child health professionals should recommend regular preventive dental care for CSHCN (fluoride, oral hygiene, healthy feeding/dietary habits). Early dental referral and collaboration with a pediatric dentist is especially important for CSHCN.

	CSHCN may experience difficulties in the dental office.
			Oral problems may be very complex or require extensive treatment.
			Medical conditions may impact dental care (eg, hemophilia).
			Child may have developmental or behavioral problems.
			Positioning in the dental chair may be difficult.
			Wheelchair access to office may be limited or unavailable.