New York State Medicaid dentistry in the 1990s.
Medicaid dental expenditure data for the 1990s are reviewed in light of current legal efforts to improve free schedules in New York State.
Biomedical subjects
Publications and source records attributed to M Swerdloff.
Medicaid dental expenditure data for the 1990s are reviewed in light of current legal efforts to improve free schedules in New York State.
Increased numbers of dental students and practitioners are necessary to provide services for children with disabilities. In many instances, the technical aspects of treatment are complicated by the interaction between the dentists, patient and the family. The stresses and strains in a family with a child with disabilities can and do impact on both the office visit and in the home setting. A review of the literature is provided in an effort to familiarize practitioners with these realities.
In an effort to encourage dental practitioners to provide needed services for children with mental retardation as they grow older, a review is provided of the ongoing difficulties faced by families and their children--including attitudes, residence, sibling and older parent dilemmas, cost of care and the realities of sexuality.
Societal attitudes and perceptions of children with mental retardation have stigmatized and stereotyped generations of youngsters. Deinstitutionalization and mainstreaming most of these children in our schools and general communities require that we recognize and reevaluate many long-held beliefs and how they serve as obstacles to implementing and ensuring needed health and social services. The background and current status of these attitudes are reviewed in an effort to 1) increase practitioner understanding of the population of youngsters with mental retardation that increasingly will be seeking the services of community dentists and 2) encourage legislative efforts and grass-root initiatives (such as the Special Olympics) to change/improve attitudes relative to children with mental retardation.
Pediatric and general dentists provide services at a time when children with (and without) mental retardation experience their first stirrings of sexuality. A review of some of the realities of sexual behavior of children with mental retardation is provided.
Despite continuing need for dental services, the use of dental services has not increased uniformly throughout the population of children. Minority group children, children in families with other than two parents present, children in lower income families and families without insurance, and children with special needs, receive reduced levels of dental services than their counterparts in the general population.
In light of the growing prevalence of children with asthma, dental practitioners should increase their awareness of the demographic characteristics of the disease and the associated use of health services. A review is provided of 1) the distribution of the disease in the pediatric and general populations, 2) the number of physician visits, 3) emergency room and hospital usage, and 4) mortality patterns.
The number of welfare cases has been halved during this latest period of financial improvement. Can children who are "no longer poor" get dental care? A review of the complex interplay between welfare, Medicaid and dental services is provided.
Providing dental services for children with mental retardation is complicated further for those youngsters with the comorbidity of attention deficit hyperactivity disorder. A general introduction into these conditions is presented in an effort to extend practitioner awareness and ability to provide needed care.
Epilepsy is the most frequent additional handicap in children with mental retardation, with a reported prevalence between 5 and 50 percent. Demographics, issues of control of epilepsy and general attitudes to the care of these youngsters are considered in an effort to increase the availability of needed dental services.
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Providing services for minority group children with mental retardation and other disabilities can challenge the abilities of any dental practitioner. The added challenge, however, is for the practitioner to recognize and understand the different cultures which can and do affect the relationships between the practitioner, the patient, the family, and the care that is provided. An introduction is provided to these complex and diverse minority group family settings which increasingly are becoming a component of our communities.
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The Americans with Disabilities Act bars discrimination in public accommodations, housing, employment and health care for people with disabilities. Efforts to "mainstream" (in housing and education) many of the individuals with mental retardation have altered the setting for dental services and place demands for services by dental practitioners in the community. These developments should be considered within the jurisdiction of this new legislation. Demographic characteristics and dental needs of children with mental retardation are reviewed to provide a background for this discussion.