PAGD Keystone Explorer Fall 2019

14 www.pagd.org Quick response: Special Needs. Your definition, what may that be? What might it involve? Sadness? Happiness? Pity? Stress? Concern? Uncertainty? Compassion? What comes to mind for you? As a member of your community? As a family member or parent? As a health care provider, particularly an oral health care provider? I would like to venture a guess that one of the first things that comes to mind are children, perhaps images of young children with health care needs; or those in wheelchairs, with cancer; or on advertisements for a Children’s Hospital or Pediatric Care Facility. Or, perhaps, patients with developmental disabilities, such as those with Cerebral Palsy, Down Syndrome, or Autistic Spectrum Disorder. If your life is traveling a personal path with aging family members or parents, you may think of diagnoses such as dementia, Parkinson’s, MS, or Alzheimer’s. Reality is, these are all examples of patients with Special Health Care Needs (SHCN). I would like to provide you with an illustration: the collective group of those with SHCN as being under an umbrella, spanning on one metal spoke, the very young, to the opposite spoke, the frail elderly. From another spoke, those with mild intellectual disability, to the opposite spoke, those with severe intellectual disability. From those with a mild form of physical disability to those who are completely non-ambulatory. From mild visual impairment to complete blindness, etc. When considered as one large group, rather than individual diagnoses, those with SHCN make up the largest minority in the US. The numbers are staggering. Collectively, we are all living longer as compared to only 30–40 years ago. The estimate is that most of us in the general population will live 25–30% longer than the previous generation. The phenomenon is coined The Greying of America. We are positively benefitting from healthier lifestyles, improved health care and an increased availability to prescription medicines. Interestingly enough, those with SHCN, in particular those who were born with developmental disabilities, are benefitting even more so: living upwards of 100–150% longer as compared to only 50 years ago. It is phenomenal, wonderful, and somewhat overwhelming all at the same time. How will this impact you as an oral health care provider? I suspect, although it may not be at the forefront of your daily thoughts, you are aware that we will all be impacted by these percentages and will need to be prepared to provide care for those with SHCN in our current and future practices. You may also be aware that the current curriculum in dental schools across the US requires inclusion of training in care of individuals with SHCN. The Commission on Dental Accreditation (CODA) now includes specific wording in standard 2-25 stating: Rethinking Patients with Special Health Care Needs By Lynne Taiclet, MS, DMD