Access to oral health care services for children with disabilities: a mixed methods systematic review.
Access
Children
Dental care
Disability
Oral health care
Journal
BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684
Informations de publication
Date de publication:
27 Aug 2024
27 Aug 2024
Historique:
received:
13
07
2024
accepted:
16
08
2024
medline:
28
8
2024
pubmed:
28
8
2024
entrez:
27
8
2024
Statut:
epublish
Résumé
Children with disabilities experience poorer oral health and frequently have complex needs. The accessibility of oral health care services for children with disabilities is crucial for promoting oral health and overall well-being. This study aimed to systematically review the literature to identify the barriers and facilitators to oral health care services for children with disabilities, and to propose priority research areas for the planning and provision of dental services to meet their needs. This was a mixed methods systematic review. Multiple databases searched included MEDLINE, Scopus, PsycINFO, EMBASE, and CINAHL. The search strategy included Medical Subject Heading (MeSH) terms related to children, disabilities, and access to oral health. Eligibility criteria focused on studies about children with disabilities, discussing the accessibility of oral health care. Using Levesque's framework for access identified barriers such as professional unwillingness, fear of the dentist, cost of treatment, and inadequate dental facilities. Facilitators of access offered insight into strategies for improving access to oral health care for children with disabilities. There is a positive benefit to using Levesque's framework of access or other established frameworks to carry out research on oral healthcare access, or implementations of dental public health interventions in order to identify gaps, enhance awareness and promote better oral health practices. The evidence suggests that including people with disabilities in co-developing service provision improves accessibility, alongside using tailored approaches and interventions which promote understanding of the importance of dental care and increases awareness for professionals, caregivers and children with disabilities. Protocol has been registered online on the PROSPERO database with an ID CRD42023433172 on June 9, 2023.
Sections du résumé
BACKGROUND
BACKGROUND
Children with disabilities experience poorer oral health and frequently have complex needs. The accessibility of oral health care services for children with disabilities is crucial for promoting oral health and overall well-being. This study aimed to systematically review the literature to identify the barriers and facilitators to oral health care services for children with disabilities, and to propose priority research areas for the planning and provision of dental services to meet their needs.
METHODS
METHODS
This was a mixed methods systematic review. Multiple databases searched included MEDLINE, Scopus, PsycINFO, EMBASE, and CINAHL. The search strategy included Medical Subject Heading (MeSH) terms related to children, disabilities, and access to oral health. Eligibility criteria focused on studies about children with disabilities, discussing the accessibility of oral health care.
RESULTS
RESULTS
Using Levesque's framework for access identified barriers such as professional unwillingness, fear of the dentist, cost of treatment, and inadequate dental facilities. Facilitators of access offered insight into strategies for improving access to oral health care for children with disabilities.
CONCLUSION
CONCLUSIONS
There is a positive benefit to using Levesque's framework of access or other established frameworks to carry out research on oral healthcare access, or implementations of dental public health interventions in order to identify gaps, enhance awareness and promote better oral health practices. The evidence suggests that including people with disabilities in co-developing service provision improves accessibility, alongside using tailored approaches and interventions which promote understanding of the importance of dental care and increases awareness for professionals, caregivers and children with disabilities.
TRIAL REGISTRATION
BACKGROUND
Protocol has been registered online on the PROSPERO database with an ID CRD42023433172 on June 9, 2023.
Identifiants
pubmed: 39192235
doi: 10.1186/s12903-024-04767-9
pii: 10.1186/s12903-024-04767-9
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1002Subventions
Organisme : The research was funded by the King Salman Center For Disability Research through Research Group no KSRG-2023-171
ID : KSRG-2023-171
Organisme : The research was funded by the King Salman Center For Disability Research through Research Group no KSRG-2023-171
ID : KSRG-2023-171
Organisme : The research was funded by the King Salman Center For Disability Research through Research Group no KSRG-2023-171
ID : KSRG-2023-171
Organisme : The research was funded by the King Salman Center For Disability Research through Research Group no KSRG-2023-171
ID : KSRG-2023-171
Informations de copyright
© 2024. The Author(s).
Références
UNICEF. Seen, Counted, Included: Using data to shed light on the well-being of children with disabilities. 2021. https://data.unicef.org/resources/children-with-disabilities-report-2021/ . Accessed 5 Nov 2023.
World Health Organization. International Classification of Functioning, Disability and Health (ICF). 2023. https://www.who.int/classifications/international-classification-of-functioning-disability-and-health Accessed 5 Nov 2023.
Allerton LA, Welch V, Emerson E. Health inequalities experienced by children and young people with intellectual disabilities: a review of literature from the United Kingdom. J Intellect Disabil. 2011;15:269–78.
pubmed: 22129526
doi: 10.1177/1744629511430772
Zhou N, Wong HM, Wen YF, McGrath C. Oral health status of children and adolescents with intellectual disabilities: a systematic review and meta-analysis. Dev Med Child Neurol. 2017;59:1019–26.
pubmed: 28627071
doi: 10.1111/dmcn.13486
Hong CL, Broadbent JM, Thomson WM, Poulton R. The Dunedin Multidisciplinary Health and Development Study: oral health findings and their implications. J Royal Soc N Z. 2020;50:35–46.
doi: 10.1080/03036758.2020.1716816
Norwood KW Jr, Slayton RL,Council on Children With D, Section on Oral H, Liptak GS, Murphy NA, et al. Oral health care for children with developmental disabilities. Pediatrics. 2013;131:614–9.
pubmed: 23439896
doi: 10.1542/peds.2012-3650
Zhou N, Wong HM, McGrath C. Oral health and associated factors among preschool children with special healthcare needs. Oral Dis. 2019;25:1221–8.
pubmed: 30725497
doi: 10.1111/odi.13057
Cermak SA, Stein Duker LI, Williams ME, Dawson ME, Lane CJ, Polido JC. Sensory adapted dental environments to enhance oral care for children with autism spectrum disorders: a randomized controlled pilot study. J Autism Dev Disord. 2015;45:2876–88.
pubmed: 25931290
pmcid: 4554774
doi: 10.1007/s10803-015-2450-5
Stein LI, Polido JC, Cermak SA. Oral care and sensory over-responsivity in children with autism spectrum disorders. Pediatr Dent. 2013;35:230–5.
pubmed: 23756306
Zhou N, Wong HM, McGrath CPJ. A multifactorial analysis of tooth-brushing barriers among mentally challenged children. J Dent Res. 2019;23:1587–94.
National Research Council. Informal caregivers in the United States: prevalence, caregiver characteristics, and ability to provide care. In: Olson S, editor. The role of human factors in home health care: Workshop summary. US: National Academies Press; 2010.
Porterfield SL, McBride TD. The effect of poverty and caregiver education on perceived need and access to health services among children with special health care needs. Am J Public Health. 2007;97:323–9.
pubmed: 17194872
pmcid: 1781389
doi: 10.2105/AJPH.2004.055921
Adyanthaya A, Sreelakshmi N, Ismail S, Raheema M. Barriers to dental care for children with special needs: general dentists’ perception in Kerala, India. J Indian Soc Pedod Prev Dent. 2017;35:216–22.
pubmed: 28762347
doi: 10.4103/JISPPD.JISPPD_152_16
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;33:29–36.
pubmed: 21406145
Aday LA, Andersen R. A framework for the study of access to medical care. Health Serv Res. 1974;9:208.
pubmed: 4436074
pmcid: 1071804
Aday LA, Andersen RM. Equity of access to medical care: a conceptual and empirical overview. Med Care. 1981;19(12):4–27.
pubmed: 11643688
doi: 10.1097/00005650-198112001-00004
Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36(1):1–10.
pubmed: 7738325
doi: 10.2307/2137284
Gelberg L, Andersen RM, Leake BD. The Behavioral Model for Vulnerable Populations: application to medical care use and outcomes for homeless people. Health Serv Res. 2000;34:1273.
pubmed: 10654830
pmcid: 1089079
Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19:127–40.
pubmed: 7206846
doi: 10.1097/00005650-198102000-00001
Levesque J-F, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12:1–9.
doi: 10.1186/1475-9276-12-18
Krishnan L, Iyer K, Madan Kumar PD. Barriers to utilisation of dental care services among children with special needs: a systematic review. Indian J Dent Res. 2020;31:486–93.
pubmed: 32769288
doi: 10.4103/ijdr.IJDR_542_18
da Rosa SV, Moysés SJ, Theis LC, Soares RC, Moysés ST, Werneck RI, et al. Barriers in access to dental services hindering the treatment of people with disabilities: a systematic review. Int J Dent. 2020;2020:1–17.
doi: 10.1155/2020/9074618
Owens J, Mistry K, Thomas AD. Access to dental services for people with learning disabilities: quality care? Br J Disabil Oral Health. 2011;12:17–27.
Stern C, Lizarondo L, Carrier J, Godfrey C, Rieger K, Salmond S, et al. Methodological guidance for the conduct of mixed methods systematic reviews. JBI Evid Implement. 2021;19:120–9.
pubmed: 34061049
doi: 10.1097/XEB.0000000000000282
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg. 2021;88:105906.
pubmed: 33789826
doi: 10.1016/j.ijsu.2021.105906
Oliver M. Understanding disability: From theory to practice. UK: Bloomsbury Publishing; 2018.
Alborz A, McNally R, Glendinning C. Access to health care for people with learning disabilities in the UK: mapping the issues and reviewing the evidence. J Health Serv Res Policy. 2005;10:173–82.
pubmed: 16053595
pmcid: 2020839
doi: 10.1258/1355819054338997
ResearchSoft. T. Endnote 9. Stamford, CT: The Thomson Corporation; 2005. http://endnote.com/ . Accessed 5 Nov 2023
Harrison R, Jones B, Gardner P, Lawton R. Quality assessment with diverse studies (QuADS): an appraisal tool for methodological and reporting quality in systematic reviews of mixed-or multi-method studies. BMC Health Serv Res. 2021;21:1–20.
Downes MJ, Brennan ML, Williams HC, Dean RS. Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open. 2016;6:e011458.
pubmed: 27932337
pmcid: 5168618
doi: 10.1136/bmjopen-2016-011458
Joanna Briggs I. The Joanna Briggs Institute critical appraisal tools for use in JBI systematic reviews. Critical Appraisal Checklist for Cohort Studies. 2017. https://jbi.global/critical-appraisal-tools . Accessed 5 May 2024.
Lockwood C, Munn Z, Porritt K. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation. JBI Evid Implement. 2015;13:179–87.
Abduludin DMA, Rahman NA, Adnan MM, Yusuf A. Experience of caregivers caring for children with cerebral palsy in accessing oral health care services: a qualitative study. Arch Orofac Sci. 2019;14(2):133–46.
doi: 10.21315/aos2019.14.2.381
Schultz ST, Shenkin JD, Horowitz AM. Parental perceptions of unmet dental need and cost barriers to care for developmentally disabled children. Pediatr Dent. 2001;23:321–5.
pubmed: 11572490
Al Agili DE, Roseman J, Pass MA, Thornton JB, Chavers LS. Access to dental care in Alabama for children with special needs: parents’ perspectives. J Am Dent Assoc. 1939;2004(135):490–5.
Allison PJ, Hennequin M, Faulks D. Dental care access among individuals with Down syndrome in France. Spec Care Dentist. 2000;20:28–34.
pubmed: 11203873
doi: 10.1111/j.1754-4505.2000.tb00007.x
Barry S, O’Sullivan EA, Toumba KJ. Barriers to dental care for children with autism spectrum disorder. Eur Arch Paediatr Dent. 2014;15:127–34.
pubmed: 23943360
doi: 10.1007/s40368-013-0075-y
Du RY, Yiu CKY, King NM. Oral health behaviors of preschool children with autism spectrum disorders and their barriers to dental care. J Autism Dev Disord. 2019;49:453–9.
pubmed: 30136115
doi: 10.1007/s10803-018-3708-5
Junnarkar VS, Tong HJ, Hanna KMB, Aishworiya R, Duggal M. Qualitative study on barriers and coping strategies for dental care in autistic children: parents’ perspective. Int J Paediatr Dent. 2023;33:203–15.
pubmed: 36271894
doi: 10.1111/ipd.13035
Liu N, Drake M, Kruger E, Tennant M. Determining the barriers to access dental services for people with a disability: a qualitative study. Asia Pac J Health Manag. 2022;17(1):72–83.
Como DH, Florindez-Cox LI, Stein Duker LI, Cermak SA. Oral health barriers for African American caregivers of autistic children. Int J Environ Res Public Health. 2022;19(24):17067.
pubmed: 36554947
pmcid: 9779821
doi: 10.3390/ijerph192417067
de Souza MLP, de Lima PDL, Herkrath FJ. Utilization of dental services by children with autism spectrum conditions: the role of primary health care. Spec Care Dent. 2023;44(1):175–83.
doi: 10.1111/scd.12837
Sabbarwal B, Puranik MP, Uma SR. Oral health status and barriers to utilization of services among down syndrome children in Bengaluru City: a cross-sectional, comparative study. J Indian Assoc Public Health Dent. 2018;16:4–10.
doi: 10.4103/jiaphd.jiaphd_138_17
Hu K, Da Silva K. Access to oral health care for children with fetal alcohol spectrum disorder: a cross-sectional study. BMC Oral Health. 2022;22:497.
pubmed: 36384583
pmcid: 9670607
doi: 10.1186/s12903-022-02561-z
AlHammad KAS, Hesham AM, Zakria M, Alghazi M, Jobeir A, AlDhalaan RM, et al. Challenges of autism spectrum disorders families towards oral health care in Kingdom of Saudi Arabia. Pesqui Bras Odontopediatria Clin Integr. 2020;20:e5178.
doi: 10.1590/pboci.2020.046
Alshihri AA, Al-Askar MH, Aldossary MS. Barriers to professional dental care among children with autism spectrum disorder. J Autism Dev Disord. 2021;51:2988–94.
pubmed: 33089446
doi: 10.1007/s10803-020-04759-y
Bhaskar BV, Janakiram C, Joseph J. Access to dental care among differently-abled children in Kochi. J Indian Assoc Public Health Dent. 2016;14:29–34.
doi: 10.4103/2319-5932.178723
Brickhouse TH, Farrington FH, Best AM, Ellsworth CW. Barriers to dental care for children in Virginia with autism spectrum disorders. J Dent Child. 2009;76:188–93.
De Jongh AD, Van Houtem C, Van Der Schoof M, Resida G, Broers D. Oral health status, treatment needs, and obstacles to dental care among noninstitutionalized children with severe mental disabilities in The Netherlands. Spec Care Dentist. 2008;28:111–5.
pubmed: 18489659
doi: 10.1111/j.1754-4505.2008.00022.x
Gerreth K, Borysewicz-Lewicka M. Access barriers to dental health care in children with disability. A questionnaire study of parents. J Appl Res Intellect Disabil. 2016;29:139–45.
pubmed: 25754132
doi: 10.1111/jar.12164
Holt S, Parry JA. Parent-reported experience of using a real-time text messaging service for dental appointments for children and young people with autism spectrum conditions: a pilot study. Spec Care Dentist. 2019;39:84–8.
pubmed: 30592319
doi: 10.1111/scd.12347
Krishnan L, Iyer K, Kumar PDM. Barriers in dental care delivery for children with special needs in Chennai, India: A mixed method research. Disabil CBR Incl Dev. 2018;29:68–82.
doi: 10.5463/dcid.v29i4.739
Lai B, Milano M, Roberts MW, Hooper SR. Unmet dental needs and barriers to dental care among children with autism spectrum disorders. J Autism Dev Disord. 2012;42:1294–303.
pubmed: 21909827
doi: 10.1007/s10803-011-1362-2
Mansoor D, Al Halabi M, Khamis AH, Kowash M. Oral health challenges facing Dubai children with Autism Spectrum Disorder at home and in accessing oral health care. Eur J Paediatr Dent. 2018;19:127–33.
pubmed: 29790776
Parry JA, Newton T, Linehan C, Ryan C. Dental visits for autistic children: a qualitative focus group study of parental perceptions. JDR Clin Transl Res. 2023;8:36–47.
doi: 10.1177/23800844211049404
Puthiyapurayil J, Anupam Kumar TV, Syriac G, R M, Kt R, Najmunnisa. Parental perception of oral health related quality of life and barriers to access dental care among children with intellectual needs in Kottayam, Central Kerala‐A cross sectional study. Spec Care Dentist. 2022;42:177–86.
pubmed: 34614254
doi: 10.1111/scd.12658
Rajput S, Kumar A, Puranik MP, Sowmya KR, Chinam N. Oral health perceptions, behaviors, and barriers among differently abled and healthy children. Spec Care Dentist. 2021;41:358–66.
pubmed: 33547693
doi: 10.1111/scd.12573
Shyama M, Al-Mutawa SA, Honkala E, Honkala S. Parental perceptions of dental visits and access to dental care among disabled schoolchildren in Kuwait. Odontostomatol Trop Trop Dent J. 2015;38:34–42.
Stein LI, Polido JC, Najera SOL, Cermak SA. Oral care experiences and challenges in children with autism spectrum disorders. Pediatr Dent. 2012;34:387–91.
pubmed: 23211914
Al Habashneh R, Al-Jundi S, Khader Y, Nofel N. Oral health status and reasons for not attending dental care among 12-to 16-year-old children with Down syndrome in special needs centres in Jordan. Int J Dent Hyg. 2012;10:259–64.
pubmed: 22335361
doi: 10.1111/j.1601-5037.2012.00545.x
Chi DL, Momany ET, Kuthy RA, Chalmers JM, Damiano PC. Preventive dental utilization for Medicaid-enrolled children in Iowa identified with intellectual and/or developmental disability. J Public Health Dent. 2010;70:35–44.
pubmed: 19694935
pmcid: 3592375
doi: 10.1111/j.1752-7325.2009.00141.x
Kachwinya SM, Kemoli AM, Owino R, Okullo I, Bermudez J, Seminario AL. Oral health status and barriers to oral healthcare among children with cerebral palsy attending a health care center in Kampala, Uganda. BMC Oral Health. 2022;22(1):656.
pubmed: 36585679
pmcid: 9801524
doi: 10.1186/s12903-022-02677-2
Zhou N, Wong HM, McGrath C. Dental visit experience and dental care barriers among Hong Kong preschool children with special education needs. Int J Paediatr Dent. 2021;31:699–707.
pubmed: 33314353
doi: 10.1111/ipd.12770
Al-Shehri SAM. Access to dental care for persons with disabilities in Saudi Arabia (Caregivers’ perspective). J Disabil Oral Health. 2012;13:51.
Fenning RM, Steinberg-Epstein R, Butter EM, Chan J, McKinnon-Bermingham K, Hammersmith KJ, et al. Access to dental visits and correlates of preventive dental care in children with autism spectrum disorder. J Autism Dev Disord. 2020;50:3739–47.
pubmed: 32112232
doi: 10.1007/s10803-020-04420-8
Zahran SS, Bhadila GY, Alasiri SA, Alkhashrami AA, Alaki SM. Access to dental care for children with special health care needs: a cross-sectional community survey within Jeddah. Saudi Arabia J Clin Pediatr Dentistry. 2023;47(1):50–7.
Zickafoose JS, Smith KV, Dye C. Children with special health care needs in CHIP: access, use, and child and family outcomes. Acad Pediatr. 2015;15:S85–92.
pubmed: 25906964
doi: 10.1016/j.acap.2015.02.001
Dao LP, Zwetchkenbaum S, Inglehart MR. General dentists and special needs patients: does dental education matter? J Dent Educ. 2005;69:1107–15.
pubmed: 16204676
doi: 10.1002/j.0022-0337.2005.69.10.tb04011.x
DeLucia LM, Davis EL. Dental students’ attitudes toward the care of individuals with intellectual disabilities: relationship between instruction and experience. J Dent Educ. 2009;73:445–53.
pubmed: 19339431
doi: 10.1002/j.0022-0337.2009.73.4.tb04715.x
Chávez EM, Subar PE, Miles J, Wong A, LaBarre EE, Glassman P. Perceptions of predoctoral dental education and practice patterns in special care dentistry. J Dent Educ. 2011;75:726–32.
pubmed: 21642517
doi: 10.1002/j.0022-0337.2011.75.6.tb05099.x
Alumran A, Almulhim L, Almolhim B, Bakodah S, Aldossary H, Alrayes SA. Are dental care providers in Saudi Arabia prepared to treat patients with special needs? J Multidiscip Healthc. 2019;12:281–90.
pubmed: 31118654
pmcid: 6498433
doi: 10.2147/JMDH.S201155
Casamassimo PS, Seale NS, Ruehs K. General dentists’ perceptions of educational and treatment issues affecting access to care for children with special health care needs. J Dent Educ. 2004;68:23–8.
pubmed: 14761169
doi: 10.1002/j.0022-0337.2004.68.1.tb03730.x
Liu H-Y, Chen J-R, Hsiao S-Y, Huang S-T. Caregivers’ oral health knowledge, attitude and behavior toward their children with disabilities. J Dent Sci. 2017;12:388–95.
pubmed: 30895080
pmcid: 6395374
doi: 10.1016/j.jds.2017.05.003