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Serving Special Populations Medical and Dental Homes Children with Special Health Care Needs. Washington Oral Health Regional Forum August 1, 2008. Washington State Medical Home Project Katherine TeKolste, MD - Co-Director. Partners: DOH, CSCHN Program Dept. Pediatric Dentistry
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Washington Oral Health Regional Forum
August 1, 2008
Washington State Medical Home Project Katherine TeKolste, MD - Co-Director
DOH, CSCHN Program
Dept. Pediatric Dentistry
MHLN Teams – 21 Community-based teams
Division of Genetics and Developmental Medicine, UW
Family Voices of Washington
Parent to Parent Program
Washington Family to Family Network
Medical Assistance AdministrationWashington State Medical Home ProjectUniversity of Washington - CHDD
Families, physicians and office staff working together to:
Originated in context of CSHCN. Evolved to include all children and adults…
Endorsed by the AAP, AAFP, ACP, AOA
Oral disease is the single most common chronic childhood disease
Age at First Dental Visit
*Average cumulative dental expenditure per child according to age at first dental visit
Savage MF et al. Pediatrics. 2004.
In surveys of the special needs population, parents and families identify dental care as the most common unmet health care need for their children.
CYSHCN - Higher risk for oral health problems
‘Dental care should be an integral and explicitly stated part of the comprehensive coordinated services that the medical home aims to provide for CSHCN.’
Lewis C et al. Pediatrics. 2005.
Nat’l Maternal and Child Oral Health Resource Center
“The dental home is the ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care delivered in a comprehensive, continuously accessible, coordinated, and family-centered way. Establishment of a dental home begins no later than 12 months of age and includes referral to dental specialists when appropriate.”
American Academy of Pediatric Dentistry
Oral health professionals helping families:
AAPD Guideline on Management of Dental Patients with SHCN
These themes are echoed in key informant interview (WA) and survey (UT)
(Nat’l Maternal and Child Oral Health Fact Sheet)
(assuming all are general dentists)
From The Maternal and Child Oral Health Resource Center
Special Care: Dental Office Considerations Checklist
Special Care: Getting to Know Me
Special Care: Family Satisfaction Questionnaire
As a community, move for change – improving dental outcomes for young children and CSHCN is a priority; effective prevention will leverage significant cost savings and alleviate unneeded suffering…
‘Considerable work remains to define the health team composition (including dental professionals) and technology requirements, develop the optimal medical home [and dental home] curricula and performance measures, and evaluate the effectiveness and cost of coordinated services as well as their financing and methods of provider compensation.’
Kenney MK et al. Parental perceptions of dental/oral health among children with and without special health care needs. Ambulatory Pediatrics. In press.