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Global oral health policies and recommendations for children with special health care needs and their applicability and effectiveness during the COVID -19 pandemic: a systematic review

Evidence-Based Dentistry (2024)Cite this article

Subjects

Abstract

Aim

This systematic review aims to assess effectiveness of oral health policies, recommendations and guidelines in safeguarding oral health of children with special healthcare needs during COVID-19.

Background

This systematic review evaluated the adaptation of global oral health policies for children with special healthcare needs (SHCN) during the COVID-19 pandemic, to provide evidence-based insights to inform policymakers and healthcare providers amid the ongoing global health crisis. The study focused on assessing the effectiveness of these adaptations in ensuring equitable access to quality dental care for this vulnerable group.

Methods

A PRISMA guided online search through LILIACS, PubMed, Scopus, COCHRANE and grey literature was conducted. The search strategy incorporated a combination of subject headings (MeSH terms) and free-text terms related to “oral health,” “dental health,” “policy,” “effectiveness,” “dental practice guidelines,” “oral health policies,” and “special care needs children.” Eligibility criteria included oral health policies, recommendations and guidelines targeting individuals/children with special care needs. Both qualitative and quantitative studies published in English from 2008 to 2023 were included.

Results

Sixteen guidelines, recommendations and policies, from six authorities were identified. These documentations addressed six different areas mentioned broadly as comprehensive care, ethical considerations, preventive and therapeutic measures, equity, patient-centric treatment, and reducing disparities signaling a paradigm shift. International collaborations and standardization of guidelines indicated a unified approach. The review also emphasized on a commitment to continuous improvement through quality measurement, systematic referral management, and needs assessment. With the exception of two documents, the remaining guidelines did not address COVID-19 or provide specific adaptations for it. The lack of emphasis on individual condition was notable, as the guidelines generally took a more generalized approach toward individuals with special healthcare needs.

Conclusions

In conclusion, this review assessed the impact of COVID-19 on oral healthcare for individuals with special needs. It underscores global and local efforts for equitable access, patient-centric care, and preventive measures. The lessons learned advocate for a resilient, inclusive healthcare framework capable of meeting diverse needs.

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CRD 42023452475.

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Fig. 1: PRISMA flow diagram.
Fig. 2: Key domains.

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Data availability

The data supporting the findings of this study are available upon request.

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Funding

The author(s) received no specific funding for this work.

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Authors and Affiliations

  1. Department of Paediatric and Preventive Dentistry I.T.S Dental, College Hospital, and Research Centre, Greater Noida, Uttar Pradesh, India

    Mousumi Goswami, Bhawna Saxena, Shivya Tuli, Bakhtawar Shakil, Supriya Bhatara & Sanjesh Padha

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  1. Mousumi Goswami
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  2. Bhawna Saxena
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  3. Shivya Tuli
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  4. Bakhtawar Shakil
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Contributions

MG: analysed and resolved any difference in opinion, led the writing. MG and BS: conceived the ideas. BS: collected the data, analysed the data, led the writing. ST: collected the data, data extraction and analysis, led the writing. BS: collected the data, data extraction and analysis. SB: resolved differences and helped with data analysis. SP: resolved differences and helped with data analysis.

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Correspondence to Bhawna Saxena.

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Goswami, M., Saxena, B., Tuli, S. et al. Global oral health policies and recommendations for children with special health care needs and their applicability and effectiveness during the COVID -19 pandemic: a systematic review. Evid Based Dent (2024). https://doi.org/10.1038/s41432-024-00992-x

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