Dental Home Concept

Good to know

  


 

 

 The Dental Home Concept

 

 

 

 

 

Medical care of children of all ages is best managed when there is an established
relationship between a practitioner
who is familiar with the child and
the child’s family
(American Academy of Pediatrics, 1992).

 

This also applies to dental care -
AND to special oral care

 

 

 

Dental care is the most prevalent unmet health care need among children with special health care needs (CSHCN) (*, **).

Children with greater limitations attributable to disability have significantly greater odds of unmet dental care needs (**).
Children with a personal doctor or nurse are significantly less likely to have unmet dental care needs (*).

(*) Newacheck, 2000
(**) Lewis et al, 2005

 

IDEAL CHARACTERISTICS AND PRACTICAL ADVANTAGES OF A DENTAL HOME

as described by Nowak AJ and Casamassimo PS, JADA 2002
 

Accessible

- care provided in child’s community
- dentist – familiar with community needs and resources

 

Family-centered

 - low parent & child anxiety

 

Continuous

- same primary care providers from infancy through adolescence
- appropriate recall intervals
- coordination for complex dental care (e.g. trauma)
- connection between dental team and  medical providers - interdisciplinarity

 

Comprehensive

- care/advice available 24/7

- dentist – familiar with community needs and resources

 

Coordinated

- information and records are centralized
(e.g. link with speech therapy for clefts)

 

Compassionate

 - relationship between child and dentist, family and dentist; familiarity reduces anxiety

 

Culturally competent

- cultural background recognized, valued, respected

 

 

 

Can Dental Home influence
Caries Risk in children with Special Health Care Needs?

 

 

Caries Risk can be assessed by evaluating a series of factors that may influence the child’s vulnerability to decay.  
These factors can be biological, social (family background and literacy), behavioural, clinical etc.

The ratio between risk factors and protective factors, corroborated with clinical findings, gives an image of the caries risk category (low/ moderate/ high) a child fits in.

Professional forums like American Dental Association (ADA) and American Academy of Pediatric Dentistry (AAPD) elaborated dedicated forms in the attempt to make Caries Risk Assessment easier for every day practice.
 

 For example:

Caries-risk Assessment Form for 0-5 Years Old
( as given by the American Academy of Pediatric Dentistry: The Reference Manual of Pediatric Dentistry, pg. 221)

 

Corroborating elements from Caries Risk Assessment forms as recommended by ADA and AAPD:  

 

Dental management of children with SOCN through a Dental Home may contribute to lowering Caries Risk

 

 

(How) Does the Dental Home Concept impact on the Quality of Life (QoL)?

* Nowac AJ, Casamassimo PS: The dental home. A primary care oral health concept. JADA 2002 January, 133: 93-98
** Vinereanu et al. Dental behaviour of mentally challenged Romanian children. 9th Congress EAPD, Dubrovnik, 2008   

 

The Dental Home concept emerged in the US.

Conditions for creating national frameworks for Dental Home vary between countries and require a lot of work, time and public health authority involvement. This can be particularly difficult in countries where 95% or more of the dental care is based on private care, even for children (such as Romania).

BUT raising awareness among parents and dental practitioners regarding the benefits of a Dental Home can be a good step forward in implementing the concept on a smaller – even individual – level, and that can make a big, increasing, welcome difference.  

 

CONCLUSION

 

  Dental home for children with SOCN
has to be
a philosophy
embraced by the
dental practice.