Augmentation of predoctoral education: a solution to ending the disparity in oral health care for children with special health care needs
Curtis, Arielle Brooke
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Children with special health care needs (CSHCN) continue to be one ofthe most underserved populations in the United States when it comes to dental health care. The inclusion of CSHCN in the American oral health disparity, directed the U.S Surgeon General to challenge the current dental education system to include instruction on caring for individuals with special needs. Years later, the Commission on Dental Accreditation instated a mandate for graduating dentists to be competent in the oral health needs of patients with special health care needs. Yet, several studies have indicated that dental professionals still are not confident treating CSHCN, largely as a result of a lack of training in this area during their predoctoral experience. This paper aims to demonstrate that lack of experience in treating CSHCN during dental school is prohibitive of care in practice. This will be addressed by illuminating didactic learning, clinical experience, service learning and continuing education as feasible means of instilling the confidence necessary for dentists to treat CSHCN. This study reviewed a large collection of the current literature on the oral health disparity for children with special health care needs and the role of dental education in that disparity. The data showed that the greatest barriers to general dentists' willingness to care for children with special health care needs were the patients' behavior, level of disability, and level of training. Furthermore in a retrospective evaluation of their predoctoral education, practitioners of general dentistry were adamant that the instruction and training they received did not prepare them well to treat patients with special health care needs. In evaluating current didactic training, most students report that they spend less than five hours learning about CSHCN in a curriculum that uses lectures and case studies to cover the material. Recently, the implementation of a virtual patient model into the predoctoral classroom has proven effective at many schools. The clinical experience students receive is shown to be more varied, with more than half of graduating dental students reporting that they never treated a patient with special health care needs in the clinic. However, students who had a favorable experience in the clinic working with this patient population are more likely to continue to care for SHCN patients in practice. Likewise, students who had community oriented experiences as part of a service learning initiative, were more likely to continue to treat and show compassion for patients with special health care needs in their practices. [TRUNCATED]
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