PC1168: Advancing Oral Health for Medically-complex Latinx Children

Purpose/Objectives:

Introduction:
Dental decay represents the most common childhood chronic condition and can lead to missed school days, missed work, and serious health risks, particularly for children with medical complexity(1). We previously identified a local dental care gap for medically complex Latinx children, including cost, uninsurance, transportation, and interpreter services, prompting a resident CATCH grant to mitigate these barriers.

Aims:
To improve access to dental care for at least 30 Latinx children with medical complexity and provide oral health preventative education to our broader Latinx community in the Upstate of South Carolina.

Design/Methods: Methods:
We began by strengthening existing relationships (e.g. local federally qualified health center dental program) and building new partnerships, including our local dental hygiene program for initial patient exams and treatment plan building and private dentists willing to provide pro bono care. Resource specialists with PASOs, an embedded community health worker organization focused on supporting Latinx communities with education, advocacy, and leadership development, worked with a faculty pediatrician to identify eligible patients and coordinate care. We organized interpreter services to be provided either by certified bilingual (Spanish-English) medical students or through the hospital vendor interpreter services for indigenous languages. We then developed and implemented a referral algorithm for patients from our medical home to community dental providers (Figure 1). In tandem, we organized three social media community oral health education events, collated oral health handouts for children with medical complexity to be used at our clinic, and provided dental supplies to our patients.

Results:

Results:

32 patients were connected with routine and urgent dental care (Table 1). Patients range from age 3-18 years of age (median 10 years old). The top 3 medical complexities were intellectual disability (44%), seizure disorder (31%), and genetic syndrome (28%).

To date, 10 out of the 28 families (4 pairs of siblings) have completed Barriers to Care Surveys(2) (response rate = 36%). Only 22% of referred patients had a prior dental experience. While 78% of respondents felt that the healthcare system worked well for their child over the past year, 70% or more of respondents cited challenges, including missed work and lack of provider language concordance.

Our team partnered with dental hygiene students to develop three Facebook live events this Spring across three PASOs social media platforms, reaching families across the state about dental hygiene and special healthcare needs considerations. We plan to boost recorded events April 25-June 2 (viewing data available at NCE).

Conclusion/Discussion:

Discussion:
Through engagement of community partners, we have created a feasible referral algorithm to enhance access to dental care and offer education for Latinx children with medical complexity. We seek to engage in continuous quality improvement to sustain our local pediatric medical-dental collaboration that hopefully can be expanded across South Carolina.