Barriers To Oral Health Among U.S. Children with Developmental Disorders: A Population-Based Study
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AbstractBackground Children with developmental disorders (DD) have higher rates of oral diseases and tooth decay compared to the general population. Despite that, they often face more barriers to access the needed health care, especially dental care. This study aims to describe the oral health needs (OHN), utilization of dental services, and unmet dental needs of children with developmental disorders (DD) compared to children without developmental disorders (DD); and to assess the impact of access to healthcare factors on the oral health of children with DD. Methods This cross-sectional study utilized a sample of 30,530 noninstitutionalized children from the 2018 National Survey of Childrens Health (NSCH). Descriptive and inferential statistics were used to compare and analyze healthcare barriers in children with and without OHN. Results Overall, there were 6,501 children with DD compared to 24,029 children without DD. A significantly higher proportion of children with DD relative to children without DD were found with 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 found that poverty (<100% of the Federal Poverty Level (AOR=2.27, CI: 1.463.51), being uninsured (AOR=2.12, 95% CI: 1.143.95), a great deal of disability (AOR=1.89, CI: 1.232.78), and living in the West (AOR=1.61, CI: 1.092.37) contributed to the largest odds of OHN among children with DD. Conclusion Despite the high utilization of dental services, children with DD had poor oral health and more unmet dental needs compared to children without DD. Advocacy efforts and policy changes are needed for the development of an integrated model of care that addresses health insurance, poverty and considers childrens levels of disability.
