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Oral health needs of U.S. children with developmental disorders: a population-based study
Raghad Obeidat1, Amal Noureldin2, Anneta Bitouni3
1Public Health Sciences Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX, 75246, USA. obeidatr85@gmail.com.
Insights
Children with developmental disorders/disabilities (DD) have greater oral health needs and unmet dental needs, despite increased dental visit utilization. Policy changes are crucial for affordable access and early assessment to improve oral health outcomes for these children.
Area of Science:
- Pediatric Dentistry
- Public Health
- Disability Studies
Background:
- Children with Special Health Care Needs (CSHCN) exhibit higher oral disease rates.
- Children with developmental disorders/disabilities (DD) are a subset of CSHCN with unaddressed oral health needs.
- Oral health disparities persist among vulnerable pediatric populations.
Purpose of the Study:
- To compare oral health needs (OHN) between children with and without DD.
- To identify barriers to dental care access and service utilization for children with DD.
- To examine the association between OHN and access/utilization factors in children with DD.
Main Methods:
- Cross-sectional study using the 2018 National Survey of Children's Health (NSCH).
- Sample included 30,530 noninstitutionalized children.
- Descriptive and inferential statistical analyses were performed.
Main Results:
- Children with DD (n=6501) showed higher OHN prevalence (20.3% vs. 12.2%) and unmet dental needs (3.5% vs. 1.2%) than those without DD (n=24,029).
- Despite higher dental visit utilization (86.1% vs. 76.1%), children with DD faced significant barriers.
- Poverty, lack of insurance, high disability levels, and Western US residence were associated with increased OHN in children with DD.
Conclusions:
- Children with DD have poorer oral health and greater unmet dental needs, even with increased dental service use.
- Advocacy and policy reforms are essential for affordable, accessible dental care for children with DD.
- Early assessment and intervention are critical to mitigate oral health disparities in children with DD.
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.
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