Health has beenacknowledged as essential human right and oral health is a vital part of generalhealth and can be called the first line of contact to the human body.
Americansare enjoying the growing levels of oral health. However, oral health increasesand dental care services are not being practiced evenly across all population. Someminorities, low income elderly people, poor children and children in fostercare do not have adequate access to dental care (Drainoni et al., 2006; Leck & Randall, 2017;Northridge et al., 2017).Theunaffordable cost of dental treatment is the main barrier which hinders peoplefrom using the services, especially with the absence of dental care coverage inmedical insurance or when there is a low reimbursement rates for dentalprofessionals from insurance companies (Garla, Satish, & Divya, 2014).
Generally, the high cost of health care service is due to the rising need forhealth facilities, evolving technology of health care, lacking incentives, lookingfor higher quality treatment and general inflation (Garla et al., 2014; Glavind et al., 1992).Accordingto the American Academy of Pediatrics (AAP) all children in foster care consideras Children with Special Health Care Needs (CSHCN), and define them as”children who have or are at increased risk for a chronic physical,developmental, behavioral, or emotional condition and who also require healthand related services of a type or amount beyond that required by childrengenerally” (McPhersonet al., 1998). CSHCN requiresspecific procedures, comprehensive oral health knowledge for treatment andadditional measures compared to what considered routine treatment for other children(AmericanAcademy of Pediatric Dentistry, 2015).Furthermore,the average age of children in foster care was 8.7 years, and the numbers of childrenin the U.
S. foster care system is increasing with an over 415,000 children registeredin the foster care system, and over 260,000 children entered the foster caresystem in 2014, with over 238,000 children exiting the same year (Health& Services, 2015). Infact, children and adolescents in foster care have significant mental and oral healthissues (Szilagyi,Rosen, Rubin, & Zlotnik, 2015). Moreover, those children have greater incidenceof developmental syndromes, disorders of the teeth and jaw, attention scarcity,conduct and disruptive disorders, and adjustment disorders (Baumrucker,Fernandes-Alcantara, Stoltzfus, & Fernandez, 2012). However,dental cavity is the most common chronic childhood disease and affecting amajority of children in foster care who did not utilize any sort of dental caredue to lack of access (M.Melbye, Huebner, Chi, Hinderberger, & Milgrom, 2013; Negro, 2016). Inadequate access to oral health care anduntreated dental issues may lead to harm to the child, especially pain, complicateddental problem and decreased overall health (Negro,2016).
Furthermore,the literature on children in foster care and their oral health condition islimited, but the available data shows that children in foster care have untreateddental cavities and face several barriers to receive preventive dental care (Colthirst,2008). Eventhough children in foster care have insurance coverage, they are unlikely toaccess dental care. Barriers to dental care included limited number of dentistsparticipated in Medicaid program, children moving from foster home to fosterhome, insufficient oral health knowledge and lack of resources to the socialworkers (M. L.
Melbye, Chi, Milgrom, Huebner, & Grembowski, 2014). Also, children in foster care need more comprehensivedental care than the general population, according to study conducted in Iowa,they found that children in foster care have 1.29 higher odds of utilizingdental services compared to children not in foster care, which indicate thehigh demand for dental care for children in foster care (Chi,Momany, Kuthy, Chalmers, & Damiano, 2010).Up tothe present time, there is no published study evaluated the dental knowledgeand oral health training obtained by social workers at different foster care agenciesin state of Florida, as a potential involvement to enhance the oral health carefor children and their parent in foster care.
Moreover, social workers have themost contact with foster families through home visits, therefore they can participatein oral health improvement for children in foster care by early diagnosis,providing resources and delivering oral health education and prevention tofoster parents during home visits and during foster parent training.