Health has beenacknowledged as essential human right and oral health is a vital part ofoverall health and can be called the first line of contact to the human body.Americans are 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 considersas Children with Special Health Care Needs (CSHCN), and defines 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 numbers of children in the U.S. foster care system is increasing with an over415,000 children registered in the foster care system, over 260,000 childrenentered the foster care system in 2014, with over 238,000 children exiting thesame 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 a 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). The mean age of children in foster care was8.7 years and 75% of children in foster care lived within a foster familysetting; other settings including group homes, institution, or pre-adoptivehomes (Health& Services, 2015).
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 multiple barriers to receiving dental care (Colthirst,2008). Eventhough children in foster care having 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). Children in foster care need more dental carethan the general population, according to a study conducted in Iowa, they foundthat children in foster care have 1.29 higher odds of utilizing dental services(Chi,Momany, Kuthy, Chalmers, & Damiano, 2010).
To date,there is no published study investigated the social workers’ knowledge andperception as an encouraging involvement to increase the oral health care and knowledgefor children and their parent in foster care through preventive oral health educationand measures in the state of Florida. Since social workers have the mostcontact with foster families through home visits, social workers could 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.