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This study was undertaken to establish the caries prevalence in Head Start/Early Head Start children among the non-fluoridate community of Suffolk County, Long Island, and to elicit access-to-oral-health-care issues that are present for these children. Three hundred five parents completed questionnaire surveys about access-to-care issues at Suffolk County Head Start centers. Two hundred sixteen Suffolk County Head Start children ages 2 to 5 were screened for this study. The average DMFT (decayed, missing, filled teeth) across all children screened was 2.01. Fifty-four percent of parents reported that their children received dental care in the last two years. Twenty-four percent of children who received dental care reported having access-to-care issues. Of the parents who encountered such issues, the most prevalent one stated was, "We could not find a dentist to accept our insurance." The authors concluded that there is a heightened prevalence of early childhood caries in the Head Start/Early Head Start population of Suffolk County, Long Island. There are high levels of underutilized dental care in this population. The parents in this community have reported there are access-to-care issues present that may result in high levels of dental disease.

Objectives: This study had two objectives: (1) to investigate the socioeconomic and cultural characteristics of HIV-infected children and their families in relation to the presence of oral manifestations of AIDS and (2) to identify the most frequent oral manifestations of AIDS in the sample of children studied., Methods: The sample consisted of a total of 184 children - both boys and girls - from 0 to 13 years old. The children were receiving care at two hospitals in the city of Porto Alegre, Brazil (the Hospital de Clínicas de Porto Alegre and the Hospital São Lucas da Pontifícia Universidade Católica), and at Stony Brook University Hospital, which is in the state of New York, United States. Data were analyzed using the chisquare test, Student's t test, and analysis of variance., Results: Of the 184 patients, 117 of them (63.59%) were receiving care at the Hospital de Clínicas de Porto Alegre, 26 (14.13%) at the Hospital São Lucas, and 41 (22.28%) at Stony Brook University Hospital. In the Brazilian sample (the two hospitals in Porto Alegre) 42.66% of the children were living with their natural parents (mostly with the mother), while in the United States 56.10% of the children were living with foster families. Concerning income, 39.86% of the Brazilian families had a monthly income ranging from US$ 180 to US$ 450, and 33.57% had no income or did not provide information. With the United States sample, we were not allowed to ask about income, but all the families were classified by the social workers as having a monthly income below US$ 1 000. HIV was acquired through vertical transmission by 97.20% of the Brazilian children and by 97.56% of the children in the United States sample. Oral manifestations were more frequent in the Brazilian children (72.73%) than in the children in the United States sample (53.66%) (P = 0.01)., Conclusions: The frequency of oral manifestations in the samples in both Brazil and the United States was influenced by socioeconomic and cultural conditions, family structure and income, access to information concerning AIDS, and adherence to treatment.

Continuation of the national trend toward deinstitutionalization and community placement for persons with developmental disabilities, physical handicaps and other medical problems will mean increased demand for dentists trained to care for this segment of the population. The New York State Office of Mental Retardation and Developmental Disabilities now offers dental fellowships in developmental disabilities to help fill the learning gap.

This article discusses the role of a social worker in a dental school based program for the developmentally disabled. Developmentally disabled people constitute a heterogeneous population with problems that often prevent them from receiving appropriate dental services. A social worker in the dental care setting can help this population access dental services. Data gathered during a 2-year period support the hypothesis that patients living at home present more obstacles to dental care and require more social work intervention in obtaining dental care than patients living in residential settings.

This paper reports the results of a survey of School of Dental Medicine graduates at State University of New York at Stony Brook, regarding their willingness to treat patients with developmental disabilities in private practice. It also explored the influence of the DCDD program.