Barriers to Access to Dental Treatment for People with Physical Disabilities in a Brazilian Metropolis

Abstract

Objective: To evaluate the barriers for accessing dental care for people with physical disabilities. Material and Methods: A cross-sectional study with 191 caregivers of individuals with physical disabilities attending a rehabilitation center in São Paulo, who responded to a questionnaire about information related to barriers (user, caregiver, government and professional) found in dental treatment, visit to the dentist and age of the first dental appointment. Data were collected from medical records regarding age, sex, family income and medical diagnosis of patients. Statistical analysis was performed using the MedCalc for Windows software version 12.3.0. The Chi-square test was applied for heterogeneity, with significance level of 5%. Results: The main barriers identified by caregivers (p<0.0001) were patient fear/anxiety (66.8%), patient requiring accompaniment to access treatment (87.4%), treatment costs (82.7%), lack of treatment at primary health care units (73.3%) and professionals not specialized in dental care for people with physical disabilities (67.0%). It was observed that caregivers of individuals with cerebral palsy reported greater physical barriers for accessing dental treatment compared to caregivers of other diagnoses (p=0.0307). Conclusion: Individuals with physical disabilities face financial constraints, fear of dental treatment, lack of treatment options in public services and, perhaps most importantly, lack of qualified professionals interested in treating such individuals.

Unmet Dental Treatment Needs and Barriers to Dental Care of Patients with Special Needs Attending a Dental Teaching Hospital

“…Approximately one-third of the respondents indicated that accessibility was a major challenge, specifically the distance to the clinical facilities, cost of transportation, and lack of transport. This is in keeping with the work of de Gutierrez et al, who suggested certain patients with special needs, such as those with cerebral palsy, report greater physical barriers in accessing dental care [17]. de Gutierrez, however, did not find transportation to be a major barrier to accessing dental care by patients with special needs [17].…”

“…This is in keeping with the work of de Gutierrez et al, who suggested certain patients with special needs, such as those with cerebral palsy, report greater physical barriers in accessing dental care [17]. de Gutierrez, however, did not find transportation to be a major barrier to accessing dental care by patients with special needs [17].…”

Profile of Patients with Special Needs Assisted at a Brazilian University

“…Scientific evidence shows that not all dentists are able to identify different groups with special needs, which may constitute one of the barriers to access to dental treatment. The number of universities that include the PSN discipline in their undergraduate and graduate programs is still small considering the need in Brazil [15,16,20].…”

Oral health care for people with disabilities in Brazil: Transition from the specialized dental services between 2014 and 2018

“…Professional qualification is fundamental in improving PD's oral health 30 and was pointed out by caregivers as a barrier to access care. 31 Thus, these professionals must receive continuing education to qualify and increase confidence in the specialty's practice. 32 The CEO's provision of dental care to PD is mandatory, and there is a decrease in professionals with a postgraduate degree or specialized in this user profile, already observed in Brazilian studies.…”

“…The scarcity of specialists may explain the increase in professionals without specific training to work with PDs. Professional qualification is fundamental in improving PD’s oral health 30 and was pointed out by caregivers as a barrier to access care 31 32 …”