Oral health needs of U.S. children with developmental disorders: a population-based study.
Access to health care
Barriers to dental care
Children with developmental disorders
Developmental disabilities
Oral health
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
29 04 2022
29 04 2022
Historique:
received:
01
09
2021
accepted:
11
04
2022
entrez:
29
4
2022
pubmed:
30
4
2022
medline:
4
5
2022
Statut:
epublish
Résumé
Children with Special Health Care Needs (CSHCN) have higher rates of oral diseases and tooth decay compared with the general population. Children with developmental disorders/ disabilities (DD) are a subset of CSHCN whose oral health has not been specifically addressed. Therefore, this study had two objectives: to describe the oral health needs (OHN) of children with DD compared with children without DD; and to assess barriers to access to care, utilization of dental services, and their association with oral health needs for children with DD. This cross-sectional study utilized a sample of 30,530 noninstitutionalized children from the 2018 National Survey of Children's Health (NSCH). Analysis was conducted using descriptive and inferential statistics. The analysis identified 6501 children with DD and 24,029 children without DD. Children with DD had significantly higher prevalence of OHN (20.3% vs. 12.2%, respectively), unmet dental needs (3.5% vs 1.2%), and utilization of any dental visits (86.1% vs 76.1%), (P-value < . 001). The adjusted logistic model identified four factors that contributed to the higher odds of OHN among children with DD: poverty (< 100% of the Federal Poverty Level (AOR = 2.27, CI: 1.46-3.51), being uninsured (AOR = 2.12, 95% CI: 1.14-3.95), a high level of disability (AOR = 1.89, CI: 1.23-2.78), and living in the western United States (AOR = 1.61, CI: 1.09-2.37. Despite higher utilization of dental services, children with DD had poorer oral health and more unmet dental needs than children without DD. Advocacy efforts and policy changes are needed to develop affordable access that assesses, as early as possible, children with DD whose conditions impact their ability a great deal so that their potential OHN may be alleviated more effectively.
Sections du résumé
BACKGROUND
Children with Special Health Care Needs (CSHCN) have higher rates of oral diseases and tooth decay compared with the general population. Children with developmental disorders/ disabilities (DD) are a subset of CSHCN whose oral health has not been specifically addressed. Therefore, this study had two objectives: to describe the oral health needs (OHN) of children with DD compared with children without DD; and to assess barriers to access to care, utilization of dental services, and their association with oral health needs for children with DD.
METHODS
This cross-sectional study utilized a sample of 30,530 noninstitutionalized children from the 2018 National Survey of Children's Health (NSCH). Analysis was conducted using descriptive and inferential statistics.
RESULTS
The analysis identified 6501 children with DD and 24,029 children without DD. Children with DD had significantly higher prevalence of OHN (20.3% vs. 12.2%, respectively), unmet dental needs (3.5% vs 1.2%), and utilization of any dental visits (86.1% vs 76.1%), (P-value < . 001). The adjusted logistic model identified four factors that contributed to the higher odds of OHN among children with DD: poverty (< 100% of the Federal Poverty Level (AOR = 2.27, CI: 1.46-3.51), being uninsured (AOR = 2.12, 95% CI: 1.14-3.95), a high level of disability (AOR = 1.89, CI: 1.23-2.78), and living in the western United States (AOR = 1.61, CI: 1.09-2.37.
CONCLUSION
Despite higher utilization of dental services, children with DD had poorer oral health and more unmet dental needs than children without DD. Advocacy efforts and policy changes are needed to develop affordable access that assesses, as early as possible, children with DD whose conditions impact their ability a great deal so that their potential OHN may be alleviated more effectively.
Identifiants
pubmed: 35488224
doi: 10.1186/s12889-022-13237-2
pii: 10.1186/s12889-022-13237-2
pmc: PMC9055681
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
861Informations de copyright
© 2022. The Author(s).
Références
McPherson M, Arango P, Fox H, Lauver C, McManus M, Newacheck PW, et al. A new definition of children with special health care needs. Pediatrics. 1998;102(1):137–9.
doi: 10.1542/peds.102.1.137
pubmed: 9714637
Frank M, Keels MA, Quinonez R, Roberts M, Divaris K. Dental Caries Risk Varies Among Subgroups of Children with Special Health Care Needs. Pediatr Dent. 2019;41(5):378–84.
pubmed: 31648669
Nelson LP, Getzin A, Graham D, Zhou J, Wagle EM, McQuiston J, et al. Unmet dental needs and barriers to care for children with significant special health care needs. Pediatr Dent. 2011;33(1):29–36.
pubmed: 21406145
Iida H, Lewis C, Zhou C, Novak L, Grembowski D. Dental care needs, use and expenditures among U.S. children with and without special health care needs. J Am Dent Assoc. 2010;141(1):79–88.
doi: 10.14219/jada.archive.2010.0025
pubmed: 20045826
Committee on Monitoring Access to Personal Health Care Services. Access to health care in America. National Academy Press; 1993.
Norwood KW Jr, Slayton RL. Oral health care for children with developmental disabilities. Pediatrics. 2013;131(3):614–9.
doi: 10.1542/peds.2012-3650
pubmed: 23439896
Lewis CW. Dental care and children with special health care needs: a population-based perspective. Acad Pediatr. 2009;9(6):420–6.
doi: 10.1016/j.acap.2009.09.005
pubmed: 19945077
pmcid: 2787477
Sarkar M, Earley ER, Asti L, Chisolm DJ. Differences in Health Care Needs, Health Care Utilization, and Health Care Outcomes Among Children With Special Health Care Needs in Ohio: A Comparative Analysis Between Medicaid and Private Insurance. J Public Health Manag Pract. 2017;23(1):e1–9.
doi: 10.1097/PHH.0000000000000403
pubmed: 27870721
Craig MH, Scott JM, Slayton RL, Walker AL, Chi DL. Preventive dental care use for children with special health care needs in Washington’s Access to Baby and Child Dentistry program. J Am Dent Assoc. 2019;150(1):42–8.
doi: 10.1016/j.adaj.2018.08.026
pubmed: 30528747
Sannicandro T, Parish SL, Son E, Powell RM. Health care changes for children with special health care needs, 2005–2011. Matern Child Health J. 2017;21(3):524–30.
doi: 10.1007/s10995-016-2136-4
pubmed: 27469109
Paschal AM, Wilroy JD, Hawley SR. Unmet needs for dental care in children with special health care needs. Prev Med Rep. 2016;3:62–7.
doi: 10.1016/j.pmedr.2015.11.013
pubmed: 26844190
Fisher K. Is there anything to smile about? A review of oral care for individuals with intellectual and developmental disabilities. Nurs Res Pract. 2012;2012.
Centers for Disease Control and Prevention C. Facts About Developmental Disabilities 2019 [Available from: https://www.cdc.gov/ncbddd/developmentaldisabilities/facts.html .
Chi DL, McManus BM, Carle AC. Caregiver burden and preventive dental care use for US children with special health care needs: a stratified analysis based on functional limitation. Matern Child Health J. 2014;18(4):882–90.
doi: 10.1007/s10995-013-1314-x
pubmed: 23793537
pmcid: 3815970
Chi DL. Oral Health for US Children with Special Health Care Needs. Pediatr Clin North Am. 2018;65(5):981–93.
doi: 10.1016/j.pcl.2018.05.007
pubmed: 30213358
Cheak-Zamora NC, Thullen M. Disparities in Quality and Access to Care for Children with Developmental Disabilities and Multiple Health Conditions. Matern Child Health J. 2017;21(1):36–44.
doi: 10.1007/s10995-016-2091-0
pubmed: 27423238
Ummer-Christian R, Iacono T, Grills N, Pradhan A, Hughes N, Gussy M. Access to dental services for children with intellectual and developmental disabilities–A scoping review. Res Dev Disabil. 2018;74:1–13.
doi: 10.1016/j.ridd.2017.12.022
pubmed: 29355670
Owens J, Dyer T, Mistry K. People with learning disabilities and specialist services. Br Dent J. 2010;208(5):203.
doi: 10.1038/sj.bdj.2010.204
pubmed: 20228748
Dougall A, Fiske J. Access to special care dentistry, part 1. Access Br Dent J. 2008;204(11):605.
doi: 10.1038/sj.bdj.2008.457
pubmed: 18552796
Zablotsky B, Black LI, Maenner MJ, Schieve LA, Danielson ML, Bitsko RH, Blumberg SJ, Kogan MD, Boyle CA. Prevalence and trends of developmental disabilities among children in the United States: 2009–2017. Pediatrics. 2019;144(4).
Data Resource Center (DRC). About the National Survey of Children’s Health. Available from: https://www.childhealthdata.org/learn-about-the-nsch .
Lipkin PH, Macias MM. Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics. 2020;145(1).
American Academy of Pediatrics. Council on children with disabilities, section on developmental behavioral pediatrics, Bright Futures Steering Committee, Medical Home Initiatives For Children With Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics. 2006;118(1):405–20.
The United States Office of Management and Budget. 2010 Standards for Delineating Metropolitan and Micropolitan Statistical Areas; Notice; 2010. Available from: https://www.govinfo.gov/content/pkg/FR-2010-06-28/pdf/2010-15605.pdf .
U.S. Department of Commerce Economics and Statistics Administration U.S. Census Bureau. Census Regions and Divisions of the United States; 2010. Available from: https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf .
Jaber MA. Dental caries experience, oral health status and treatment needs of dental patients with autism. J Appl Oral Sci. 2011;19(3):212–7.
doi: 10.1590/S1678-77572011000300006
pubmed: 21625735
pmcid: 4234331
Moreira RN, Alcântara CEP, Mota-Veloso I, Marinho SA, Ramos-Jorge ML, Oliveira-Ferreira F. Does intellectual disability affect the development of dental caries in patients with cerebral palsy? Res Dev Disabil. 2012;33(5):1503–7.
doi: 10.1016/j.ridd.2012.03.026
pubmed: 22522208
Shyama M, Al-Mutawa SA, Morris RE, Sugathan T. Dental caries experience of disabled children and young adults. Community Dent Health. 2001;18:181–6.
pubmed: 11580096
US Department of Health and Human Services. Title V maternal and child health services block grant program. Retrieved April. 2017;7.
Skinner AC, Slifkin RT, Mayer ML. The effect of rural residence on dental unmet need for children with special health care needs. J Rural Health. 2006;22(1):36–42.
doi: 10.1111/j.1748-0361.2006.00008.x
pubmed: 16441334
Berdahl T, Hudson J, Simpson L, McCormick MC. Annual report on Children’s health care: dental and orthodontic utilization and expenditures for children, 2010–2012. Acad Pediatr. 2016;16(4):314–26.
doi: 10.1016/j.acap.2016.02.013
pubmed: 27154430
Lee JN, Scott JM, Chi DL. Oral health behaviours and dental caries in low‐income children with special healthcare needs: A prospective observational study. Int J Paediatr Dent. 2020;30(6):749–57.
McManus BM, Chi D, Carle A. State Medicaid Eligibility Criteria and Unmet Preventive Dental Care Need for CSHCN. Matern Child Health J. 2016;20(2):456–65.
doi: 10.1007/s10995-015-1843-6
pubmed: 26520157
McKinney CM, Nelson T, Scott JM, Heaton LJ, Vaughn MG, Lewis CW. Predictors of unmet dental need in children with autism spectrum disorder: results from a national sample. Acad Pediatr. 2014;14(6):624–31.
doi: 10.1016/j.acap.2014.06.023
pubmed: 25439161
pmcid: 4367192
Nasseh K, Vujicic M. Dental benefits coverage rates increased for children and young adults in 2013. Health Policy Institute Research Brief. American Dental Association. 2015.
Vujicic M, Buchmueller T, Klein R. Dental care presents the highest level of financial barriers, compared to other types of health care services. Health Aff. 2016;35(12):2176–82.
doi: 10.1377/hlthaff.2016.0800