Behavioral and Social Determinants of Oral Health in Children With Special Health Care Needs.

* Abbreviation: CYSHCN — : children and youth with special health care needs In this issue of Pediatrics , Lebrun-Harris et al1 analyzed the 2016–2018 National Survey of Children’s Health and found that children and youth with special health care needs (CYSHCN) are more likely to use preventive dental services yet are significantly more likely to have poor oral health, compared with children and youth without special health care needs. At first glance, this finding may seem to be paradoxical on the basis of the assumption that preventive dental service use is causally related to oral health. However, the greatest contributor to poor oral health in CYSHCN is not a lack of preventive dental services. For example, previous researchers have suggested that dental caries among children with autism spectrum disorders likely include a cariogenic diet, sugar-sweetened and xerostomia-causing medications, and poor oral hygiene practices.2–7 As Lebrun-Harris et al1 state, a potential reason for poor oral health among CYSHCN is sociobehavioral, which is not addressed directly through preventive dental visits. Instead, the primary objectives of preventive dental visits for children are typically diagnosis, restorative treatment … Address correspondence to Jacqueline M. Burgette, DMD, PhD, Department of Dental Public Health, School of Dental Medicine, University of Pittsburgh, 3501 Terrace St, Pittsburgh, PA 15261. E-mail: jacqueline{at}pitt.edu