AADMD Abstracts in Developmental Dentistry

AADMD ABSTRACTS IN DEVELOPMENTAL DENTISTRY
Barry Waldman, DDS, Co-editor, AADMD ABSTRACTS IN DEVELOPMENTAL HEALTHCARE DENTAL DIVISION

Boynes SG, Moore PA, Lewis CL Zovko J, Close JM Complications associated with anesthesia administration for dental treatment in a special needs clinic. Special Care Dentistry 2010;30 (1):3-7.

The goal of this study was to identify and quantify complications occurring with the administration of anesthesia for the dental treatment of patients with special needs. Anesthesia providers completed a standardized evaluation form, delineating possible complications for 202 consecutive ambulatory patients receiving anesthesia in a special needs clinic. Statistical analysis of four types of administered anesthesia showed that the overall complication rate was 23.8%. Evaluation of the data showed complications that were considered either mild (95.8%), or moderate (4.2%), while no reports of severe complications occurred. Airway obstruction and nausea/vomiting were the most frequently encountered complications. An evaluation of the results of the study showed that the majority of complications that occurred with anesthesia during care of patients with special needs were mild and did not lead to severe adverse events..

Jin EYW, Daly B. The self-reported oral health status and behaviors of adults who are deaf and blind. Special Care in Dentistry 2010;30(1):8-13.

This qualitative study explored perceived oral health, felt need, oral health knowledge and behaviors, and utilization of dental services among a community of deaf and blind adults in Toronto, Canada. Seven adults participated in depth interviews facilitated by intervenors skilled in communication with people who are deaf and blind. Subjects reported that their oral health was good, however oral health knowledge was poor and daily oral hygiene practices were minimal. Few subjects had ever received dental health education and were largely unaware of how to prevent dental disease. The presence of the subsidized sympathetic dental program and the facilitative role of intervenors promoted utilization of dental care for many of the subjects who participated in this study. The interventions need to be sensitive and appropriate for the individual's level of impairment.

Waldman HB, Perlman SP. Nuances in standards terminology and the care of individuals with special needs. J Canadian Dent Assoc 2010;76(1):33-36.

Dental school accreditation standards set the foundation for the preparation of new graduates to provide oral health services to millions of Canadian and U.S. residents with special needs. Nuances in accreditation standard terminology may (or may not) foster efforts to provide basic and clinical science experiences. Increasing numbers of individuals with special needs now reside in local communities and are dependent upon neighborhood dentists for needed care. The challenge is to ensure needed educational preparation and the elimination of the series of obstacles which impact on the delivery of care, including financial and physical barriers as well as government unresponsiveness to the oral health needs of this population.

Lewis CW. Dental care and children with special health care needs: a population- based perspective. Academic Ped 2009;9:420-426.

Dental care remains the most frequently cited unmet health care need for children with special health care needs (CSHCN). More CSHCN had unmet needs for nonpreventive than preventive dental care. CSHCN who are teens, poorer, uninsured, had insurance lapses, or are more severely affected by their condition had higher adjusted odds of unmet dental care needs. CSHCN who were both low income and severely affected had 13.4 times the adjusted odds of unmet dental care need. CSHCN are more likely to insured and to receive preventive dental care at equal or high rates than children without special health care needs. Nevertheless, CSHCN, particularly lower income and severely are affected are more likely to report unmet dental care needs compared with unaffected children.

Edelstein BL. Putting teeth in CHIP: 1997-2009 retrospective of Congressional action on children’s oral health. Academic Ped 2009;9:467-575.

When Congress reenacted the Child Health Insurance Program (CHIP) in 2009, it incorporated a range of dental provisions that had not been considered when the program was initiated in 1997. During this period the Congress received inputs on behalf of children’s oral health from multiple streams of activity; the Surgeon General’s Report, Oral Health in America, policies enacted by states, advocacy by the professions, attention by the press and actions of federal agencies. The death of 12 year old Deamonte Driver appears to have created a tipping point for action that dovetailed with Congressional need to reauthorize CHIP. Although much remains to be done, children’s oral health appears to have gained traction among members of Congress.