Unmet Dental Care Needs Among Children With Special Health Care Needs: Implications for the Medical Home

Abstract

ABSTRACT. Background. Little is known about the characteristics of children with special health care needs (CSHCN) who have unmet dental care needs.Objective. We sought to describe the magnitude of unmet needs for dental care among CSHCN and to characterize those with unmet dental care needs.Design, Setting, and Subjects. We used data from the National Survey of Children with Special Health Care Needs, which used a telephone survey to identify 750 CSHCN from each of the 50 states and the District of Columbia. Families of 38 866 CSHCN were interviewed, and the data were weighted to represent 9.32 million CSHCN nationally.Outcome. Our primary outcome of interest was unmet dental care need, defined as whether CSHCN were said to have needed dental care but were unable to obtain it. We also considered reasons why a child had an unmet dental care need and compared other categories of health care service needs and unmet needs with dental care. Bivariate and multivariate analyses were conducted to determine factors associated with unmet dental care needs.Results. Overall, 78% of CSHCN were reported as needing dental care in the past 12 months, which was second only to prescription medications in the frequency of need. Of those who reported a dental care need, an estimated 755 581 or 10.4% of CSHCN did not receive all of the dental care they needed. Relative to all other health care service categories, unmet dental care needs affected the most children. Poorer children, uninsured children, children with lapses in insurance, and children with greater limitations attributable to disability had significantly greater odds of unmet dental care needs in multivariate analyses. Children with a personal doctor or nurse were significantly less likely to have unmet dental care needs.Conclusions. Dental care is the most prevalent unmet health care need for CSHCN, affecting substantially more children than any other health care need category. Moreover, the perceived need for dental care for CSHCN exceeds the need for either preventive or specialty medical care. Given these findings, dental care should be an integral and explicitly stated part of the comprehensive coordinated services that the medical home aims to provide for CSHCN. Greater efforts to improve access to dental care for poor and more disabled CSHCN are needed. Pediatrics 2005;116:e426-e431. URL: www.pediatrics.org/cgi/doi/10.1542/peds.2005-0390; dental, access, children with special health care needs.

Preventive Oral Health Care in a School for Children with Special Health Care Needs

“…Poor oral health conditions have also been linked to low socio-economic status. Poor and nearly poor CSHCNs and those with greater limitations attributable to their disability are more likely to have unmet dental care needs [17]. The current study data support the need for all caregivers and dental professional to be concerned about the oral health of CSHCN.…”

Feasibility of a Sensory-Adapted Dental Environment for Children With Autism

“…However, despite the importance of proper oral care, dental care is the most frequently cited unmet health care need for children with special health care needs, with parents frequently reporting fair or poor condition of teeth in these children (Child and Adolescent Health Measurement Initiative, 2011;Lewis, 2009;Lewis et al, 2005). One group of children with special health care needs that may be at particular risk for poor oral health is children with ASD.…”

“…Poor oral health and the diseases that may result from it can lead to difficulties with eating, speech impediments, pain, sleep disturbances, missed days of work or school, and decreased self-esteem, causing a negative effect on people's health and quality of life (Casamassimo, 1996;Owens, Kerker, Zigler, & Horwitz, 2006; U.S. Department of Health and Human Services [HHS], 2010). However, despite the importance of oral care, disparities exist for children with special health care needs in access to and practice of oral care in the United States, with oral care being the most frequently cited unmet health care need (Child and Adolescent Health Measurement Initiative, 2011; Lewis, 2009; Lewis, Robertson, & Phelps, 2005).…”

Barriers To Dental Care for Children with Autism Spectrum Disorder- A Pilot Study

“…Limitations attributed to difficult or unmanageable behaviors hindered children from getting dental care when needed in addition to the commonly reported barriers [6,10] . This study reported that the frequency of negative behaviour in 61.3% of the patients with ASD raising concerns about their ability to access dental care.…”