title: Oral health services within community-based organizations for young children with special health care needs.
abstract: OBJECTIVE
  To identify the types of oral health services offered by community-based organizations to young children with special health care needs (CSHCN) and the barriers and facilitators to the provision of these in a nonfluoridated community.
  
  
  METHODS
  Thirteen key informant interviews with representatives from early intervention agencies, advocacy groups, and oral health programs who provide services to CSHCN in Spokane county, Washington. We used a content analysis to thematically identify oral health services as proactive or incidental and the barriers and facilitators to their provision.
  
  
  RESULTS
  We identified four types of oral health services: screenings, parent education, preventive dental care, and dental referrals. Barriers to providing all four services included limited agency resources, restrictive administrative and system-level policies, and low demand from parents. A barrier to providing education and preventive dental care was community disagreement regarding fluoride. A barrier to providing dental referrals was the perceived lack of dentists who could treat CSHCN. Facilitators included community partnerships among the organizations and utilization of the statewide oral health program.
  
  
  CONCLUSIONS
  Oral health services for young CSHCN are limited and often delivered in response to oral health problems. Coordinated efforts between community-based organizations, health providers, and advocates are necessary to ensure the provision of comprehensive care, including preventive and restorative services, to all young CSHCN.
authors.affiliation: Department of Oral Health Sciences, University of Washington, Seattle, Washington. stefcruz@uw.edu.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Cruz
authors.affiliation: Associate Professor, Department of Oral Health Sciences, University of Washington, Seattle, Washington.
authors.forename: Donald L
authors.initials: DL
authors.lastname: Chi
authors.affiliation: Professor, Department of Health Services, University of Washington, Seattle, Washington.
authors.forename: Colleen E
authors.initials: CE
authors.lastname: Huebner
mesh_terms: D002675:Child, Preschool; D019140:Dental Care for Children / Q000458:organization & administration*; D003730:Dental Care for Persons with Disabilities / Q000458:organization & administration*; D019988:Children with Disabilities; D005260:Female; D005457:Fluoridation; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D014861:Washington
keywords: dental education; dental utilization; oral health