Access to dental care for patients with inherited bleeding and hemoglobin disorders

Abstract

To identify the main barriers to dental care access for patients with inherited bleeding (IBD) and hemoglobin disorders (HbD). Methods: Patients with IBD and HbD were invited to participate in this study between August 2019 and March 2020. Data were collected through a questionnaire consisting of socioeconomic and demographic items and questions about access to dental services and history of dental treatment. Univariate and multiple Poisson regression model was used to determine associations between professional refusal of dental care and other co-variables (p < .05). Results:The participants (29.1%) have already had professional refusal of dental care and participants with IBD (53.2%) did not feel confident with their local dentist due to their bleeding tendency. Most (64.6%) felt apprehensive about visiting the local dentist and high prevalence of refusal to provide dental care was associated with age (prevalence ratio [PR] = 1.021; 95% confidence interval [CI] = 1.010-1.032). Individuals with low bleeding risk were less likely to be denied dental care by a professional compared to those with high bleeding risk (PR = 0.536; 95%CI = 0.291-0.990). Conclusion: Professional refusal of dental care was high among patients with IBD, particularly older adults and with an increased risk of bleeding.

People with congenital bleeding disorders perspectives on why dentists refused to treat them: An exploratory qualitative study using a card sorting technique

“…12 Indeed, the relationship between patients and dentists is associated to the delivery and quality of dental care. 21 For example, the high prevalence of dental anxiety among participants reported in this study (43%), which was reported in a recent study as 64.6%, 20 is not unexpected and it further explains why the majority of participants in this study have been refused to be treated by dentists. In this study, adult participants reported that dentists' fear from uncontrolled gingival bleeding followed by dentists' beliefs that no dental treatment is needed were the reasons behind why dentists refused to treat them.…”

“…An audit conducted in the Royal Free Hospital (London, United Kingdom) found that 20% of people with CBDs have been refused to be treated by their dentists 12 . Similarly, a recent cross‐sectional study reported that 29.1% of people with CBDs have had professional refusal of dental care 20 . Furthermore, 37% of participants in this study were “ not comfortable and not comfortable at all ” regarding their dentists’ knowledge and skills of their dental management.…”

“…Furthermore, 37% of participants in this study were “ not comfortable and not comfortable at all ” regarding their dentists’ knowledge and skills of their dental management. This was supported by a recent study which reported that 53.2% of people with CBDs did not feel confident with their local dentists 20 . Other study supported this finding when it indicated that 45% of people with CBDs reported that they were not confident about their dentists’ knowledge and skills 12 .…”

“…12 Similarly, a recent cross-sectional study reported that 29.1% of people with CBDs have had professional refusal of dental care. 20 Furthermore, 37% of participants in this study were "not comfortable and not comfortable at all" regarding their dentists' knowledge and skills of their dental management. This was supported by a recent study which reported that 53.2% of people with CBDs did not feel confident with their local dentists.…”

“…This was supported by a recent study which reported that 53.2% of people with CBDs did not feel confident with their local dentists. 20 Other study supported this finding when it indicated that 45% of people with CBDs reported that they were not confident about their dentists' knowledge and skills. 12 In fact, it has been reported that 40% of dentists were unconfident when they managed people with CBDs.…”