1. Better Oral Health for Kids with Special Needs Webinar June 5, 2015 Jay Balzer, DMD, MPH Consultant, ASTDD

2. General Reminders All attendees have been muted. Questions will be addressed after the speaker is finished. To ask a question, click on the icon at the top of your screen that looks like a silhouette and “raise your hand.” The host will recognize and unmute individuals with questions one at a time so questions can be asked verbally. Please respond to the polling questions at the conclusion of the webinar.

3. Better Oral Health for Kids with Special Needs Webinar June 5, 2015 Jay Balzer, DMD, MPH Consultant, ASTDD

4. Today’s Topics  Who are kids with special needs?  Eleven online resources  Preventing oral disease  Locating the right dental office  Talking to the dentist  Maintaining oral health

5. Who Are Head Start Kids with Disabilities? Office of Head Start definition: Children with an IFSP or IEP IFSP = Individual Family Service Plan IFSP focuses on the child and family and the services that a family needs to help them enhance the development of their child. IEP = Individual Education Plan IEP focuses on the educational needs of the child.

6. Some Oral Health Concerns of Kids with Disabilities  Child with poor motor control—unable to hold toothbrush  Child with cognitive/motor disability—swallows toothpaste  Child is orally “defensive”—won’t allow toothbrush in mouth  Child takes meds that are sweetened—promotes decay  Child takes meds that reduce saliva—promotes decay

7. Examples of Kids with “Special Needs”  Kids with physical but no intellectual disability—wheelchair  Kids with intellectual but no physical disability—autism  Kids with intellectual and physical disability—developmental  Kids with complex medical condition—hemophilia  Kids with learning disability—can’t pay attention due to toothache  Kids with no disability but high need for services—asthma  Kids with exceptional fear of the dentist—uncooperative  Kids with dental disability—advanced decay, constant pain

8. Oral Health Resources for Kids with Special Needs

9. Resource #1 Head Start National Center on Health Oral Health Home Page http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/oral-health

10. Resource #2 Brush Up on Oral Health Newsletters http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/ oral-health/policies-procedures/buoh.html

11. Resource #3 National Maternal and Child Oral Health Resource Center http://www.mchoralhealth.org/Topics/cshcn.html

12. Resource #4 American Academy of Pediatrics Children’s Oral Health http://www2.aap.org/commpeds/dochs/oralhealth/index.html

13. Resource #5 Association of State and Territorial Dental Directors Children with Special Health Care Needs http://www.astdd.org/children-with-special-health-care-needs

14. Resource #6 American Academy of Pediatric Dentistry http://www.aapd.org

15. Resource #7 Special Care Dentistry Association http://www.scdaonline.org

16. Resource #8 Family Voices Family to Family Networking State Contacts http://www.familyvoices.org/states Oral Health http://www.familyvoices.org/work/oral

17. Resource #9 Children’s Hospitals https://www.childrenshospitals.org/Directories/Hospital-Directory

18. Resource #10 Special Olympics—Special Smiles http://resources.specialolympics.org/Topics/ Healthy_Athletes/Disciplines/Special_Smiles.aspx

19. Resource #11 National Institute of Dental and Craniofacial Research (NIDCR) Children’s Oral Health http://www.nidcr.nih.gov/oralhealth/OralHealthInformation/ChildrensOralHealth/ Special Needs Practical Oral Care for People with Developmental Disabilities http://www.nidcr.nih.gov/oralhealth/OralHealthInformation/SpecialNeeds/

20. Preventing Oral Disease Many Opportunities  Healthy water: community water fluoridation  Healthy home: safe diet and oral care  Healthy Head Start: healthy habits and healthy food  Curriculum and program-based services in Head Start  Healthy teeth: prompt referral to treatment

21. Locating the Right Dental Office for Kids with Special Needs  The right office  The wrong office  No office at all

22. The Right Office  Physically accessible and friendly  Inquires about the child’s condition  Inquires about prior dental experience  Explains treatment plan and alternatives  Adult allowed in treatment room  Interpretation services for families

23. The Wrong Office  Accessibility barriers  Does not engage parent in discussion  Does not go slow with fearful child  Does not allow parent in treatment room  Does not explain treatment options  If unable to treat, does not refer

24. How to Find the Right Dental Office  Ask your family dentist  Ask other community dentists  Ask parents who have had success  Use online and other directories

25. Some Online Dentist Directories  Insure Kids Now (search widget)—dentists who accept Medicaid  http://www.insurekidsnow.gov  American Academy of Pediatric Dentists—dentists who treat kids  http://www.aapd.org  Special Care Dentistry Assoc—dentists who welcome special patients  http://www.scdaonline.org/?Referral  Your state dental association directory—example from Colorado  https://www.cdaonline.org/find-a-dentist/directorysearch  Special Needs Dentist Directory—example from Virginia  http://www.vdh.virginia.gov/OFHS/childandfamily/dental/dentaldirectory/Home.aspx

26. Talking to the Dentist Be Informed Some AAPD policies and guidelines that are pertinent to kids with special needs :  AAPD Policies and Guidelines: Homepage  http://www.aapd.org/policies

27. More AAPD Policies and Guidelines  Management of Patients with Special Health Care Needs  http://www.aapd.org/media/Policies_Guidelines/G_SHCN.pdf  Policy on Interim Therapeutic Restorations  http://www.aapd.org/media/Policies_Guidelines/P_ITR.pdf  Protective Stabilization for Pediatric Patients  http://www.aapd.org/media/Policies_Guidelines/G_Protective.pdf

28. More AAPD Policies and Guidelines  Ethical responsibility to treat or refer  http://www.aapd.org/media/Policies_Guidelines/P_Ethic.pdf  Transition from pediatric to adult care  http://www.aapd.org/media/Policies_Guidelines/P_Transitioni ng.pdf

29. Recipe for Maintaining Oral Health  Healthy Community  Community water fluoridation  Healthy Home  Healthy diet and home care  Healthy Schools  Healthy food, drink and play  Quality Dental Home  Used regularly

30. Thank You Contact me with questions Jay Balzer, DMD, MPH Consultant, ASTDD balzerjay@gmail.com