Improving the Oral Health of CSHCN through the Lifespan

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Improving the Oral Health of CSHCN through the
Lifespan

• A CSHCN Perspective
• Toni G. Wall, MPA
• Director
• Maine Children with Special Health Needs Program

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Maine CSHN ProgramDental Services

• Covered Services
• Cardiac Defects routine dental
• Childhood Cancer routine dental
• Cleft lip/Palate routine dental and specialty
  care

• Routine dental limited to 150/year for children
  with cardiac and cancer
• Cleanings, fluoride treatments, and x-rays.
• Children with clefts unlimited number of visits
  and services

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• Every child and adolescent deserves ready access
  to coordinated and comprehensive preventive,
  health-promoting, therapeutic and rehabilitative
  medical, mental health and dental care. Bright
  Futures Childrens Health Charter

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Challenges

• Primarily a rural state
• Minimal infrastructure for public health services
• Reliable oral health data is limited
• Access, Access, Access
• Insufficient number of dentists

• MaineCare
• If you are low-income, special needs, elderly or
  uninsured

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CSHN Program GoalBuild the capacity of
non-dental professionals to recognize and
understand oral diseases and conditions.
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ALL CYSHCN will receive coordinated, ongoing,
comprehensive care within a medical home

• Provide training using the Maine Smile Matter
  curriculum
• Collaborate with Maine Dental Association and
  Maine Chapter of AAP to establish a referral
  system
• Provide care coordination to families on dental
  issues

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All CYSHCN will have adequate private and/or
public insurance to pay for the services they
need.

• Increase routine dental care to all CSHN program
  clients
• Increase access to dental clinics
• Provide training to dentists on caring for a
  child with disabilities

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All CYSHCN will be screened early and
continuously for special health care needs

• Health prevention begins at birth provide
  anticipatory guidance at primary care visits
• Instruct parents on brushing, flossing, baby
  bottle tooth decay, fluoride etc.
• Teach parents to look for signs of decay.

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Services for CYSHCN will be organized in ways
that families and youth can use them easily

• Resources available in physicians office
• Location of dental clinics
• Funding sources
• Family Voices
• CSHN Program
• Maine Oral Health Program
• Resources for adaptive oral health devices

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Families of CYSHCN will partner in decision
making at all levels and will be satisfied with
the services they receive

• Included on Advisory Boards Maine Oral Health
  Advisory Committee
• Assist in the development and design of
  promotional materials
• Assist in training parents on prevention

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All YSHCN will receive the services necessary to
make appropriate transitions to all aspects of
adult life, including adult health care work and
independence

• Importance of oral health and prevention
• Adult health care providers understand the
  importance of oral health
• Include youth on oral health advisory boards
• Assist in locating adaptive equipment
• Raise awareness on the importance of oral health
  screenings

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Recommendations

• Start early, emphasize prevention, involve
  parents
• Integrate oral health into other service delivery
  systems ie. Primary care
• Expand knowledge base
• Build on existing partnerships and collaborations
• Use the 6 performance measures as a base