153 - Promoting Oral Health Among Youth and Young Adults with Special Health Care Needs

Poster Number: 153
Publication Number: 153.305

Rita Nathawad, Rita Nathawad, Jacksonville, FL, United States; Jasmine N. Brown, University of Florida College of Medicine, Jacksonville, FL, United States; Jeremy Yates, University of Florida College of Medicine, Jacksonville, FL, United States; Lindsey Hollingsworth, UF Health Shands Children's Hospital, Jacksonville, FL, United States

Background: Youth and young adults with special health care needs (YYASHCN) are more likely to have unmet oral health needs and are at higher risk for developing dental disease. Studies indicate that oral health counseling to prevent dental caries is critical in the medical home. Yet, pediatricians report limited knowledge and training in this area. Both YYASHCN and their caregivers report low levels of guidance for oral care specific to their condition. 

Objective: To implement an oral health screening questionnaire (OHSQ) to evaluate comfort and knowledge of oral care, and access to dental services, with subsequent provision of education and referral to dental services in a cohort of YYASHCN.   

Design/Methods: This study was conducted from January to October, 2021, in the Jacksonville Health and Transitions Services (JaxHATS) program, a primary care medical home for YYASHCN age 13 to 23 years. Quality improvement plan-do-study-act (PDSA) cycles were established to implement the OHSQ during in office and virtual chronic care visits. A random sample of 20 patient charts were reviewed to determine baseline levels of oral health discussions. Cycle 1 involved development and integration of the OHSQ into the electronic medical record for provider ease, with the goal that they administer the OHSQ to all patients presenting for chronic care. In Cycle 2, providers offered patient education and referral to dental services as needed. The OHSQ and educational materials were developed in collaboration with dentists serving YYASHCN in the community.  

Results: This work yielded significant improvement in the provision of oral health education to patients and caregivers during chronic care visits in the JaxHATS program. Baseline data revealed a 30% rate of oral health counseling. Chart review at the end of Cycle 1 revealed 100% implementation of the OHSQ. Barriers including lack of patient cooperation with oral care, biting, sensory challenges and lack of access were identified in 40% of patients. In Cycle 2, 100% of patients were provided with educational materials and referral to dental services if needed. Follow up calls to a random sample of 10 patients from Cycle 2 showed that 90% found the information provided useful and had improved comfort with oral care, 40% had also established care with a dentist since their visit. Conclusion(s): While this is a small pilot study, it demonstrates that implementation of an OHSQ and subsequent education and referral is necessary and feasible in this population. This work also highlights the need for further research and advocacy around oral health needs in YYASHCN.