Caregiver Burdens and Preventive Dental Care for Children with Autism Spectrum Disorder, Developmental Disability and/or Mental Health Conditions: National Survey of CSHCN, 2009–2010

Abstract

Objective The purpose of this study is to examine the burdens of caregivers on one perception of the need and receipt of preventive dental care for a subset of children with special health care needs—children with Autism Spectrum disorder, developmental disability and/or mental health conditions (CASD/DD/MHC). Methods The authors used the 2009–2010 National Survey of CSHCN. The survey included questions addressing preventive dental care and caregivers’ financial, employment, and time-related burdens. The associations of these burdens on perceptions and receipt of preventive dental care use were analyzed with bivariate Chi square analyses and multinomial logistic regressions for CASD/DD/MHC (N=16,323). Results Overall, 16.3% of CASD/DD/MHC had an unmet preventive dental care need. There were 40.0% of caregivers who reported financial burden, 20.3% who reported employment burden, and 10.8% who reported time burden. A higher percentage of caregivers with financial burden, employment burden, and time-related burden reported that their CASD/DD/MHC did not receive needed preventive dental care (14.1 %, 16.5%, 17.7% respectively) compared to caregivers without financial, employment, or time burdens (9.0%, 9.6%, 11.0% respectively). Caregivers with financial burden (adjusted multinomial odds ratio, 1.38 [95%CI: 1.02, 1.86]) and employment burden (adjusted multinomial odds ratio, 1.45 [95%CI: 1.02, 2.06]) were more likely to report that their child did not receive preventive dental care despite perceived need compared to caregivers without financial or employment burdens. Conclusions for practice Unmet needs for preventive dental care were associated with employment and financial burdens of the caregivers of CASD/DD/MHC.

Countering the poor oral health of people with intellectual and developmental disability: a scoping literature review

“…The standard DDQ has good predictive value in determining the presence or absence of caries and dental pain in children with ID. Weckwerth et al, 2016 (Brazil) [65]Cross-sectional studyTo evaluate the parents’ perception of dental caries in children with ID.Schoolchildren a ( n = 100) with ( n = 50) without ( n = 50) ID diagnoses, and their parents.Both groups had a similar prevalence of caries free children. Parents of children with ID rated impact of caries on drinking, eating and pronunciation as more important than for parents of children without ID. Wiener et al, 2016 (USA) [66]Cross-sectional studyExplore if finances, employment and time burdens are associated with perceived need for and receipt of dental care.Secondary analysis of 16,323 caregivers of children (male = 65.2%) who have CASD/DD/MHC.Unmet need for preventative dental care was associated with employment and financial burdens of caregivers. Parents with either private or public health insurance policies were more likely to self-report that their children had all their OH needs met. 2c).…”

“…Lack of access to skilled dentists working with adults with IDD was another significant factor [23]. Finances, employment and time burdens were also reported to hinder the oral care practices from these caregivers [63, 66]. The national survey by Wiener et al [66] analysed responses from caregivers of children with Autism Spectrum Disorder, Developmental Disability and Mental Health Conditions (CASD/DD/MHD) ( n = 16,323) in the USA, which reported the association between unmet needs of preventive dental care and financial burdens of the caregivers.…”

Barriers to Utilisation of Dental Services among Children with Disabilities in a Coordinated Healthcare Programme in Mangalore, South India: A Mixed Methods Study

“…Barriers that are most often cited in literature as reasons for the underutilisation of dental health services among children with special health care needs include: financial burdens, high cost of dental treatments, inadequate access to care, nonavailability of trained dentists willing to undertake their treatments, inflexibility of dentists, and fear and behaviour of the child in the dental office (Nicopoulos et al, 2007;Brickhouse et al, 2009;Lai et al, 2012;Melbye et al, 2013;Weiner et al, 2016;Aljabri et al, 2018;Krishnan et al, 2018;Rajput et al, 2019).…”

Children with Disabilities at Risk of Poor Oral Health in the Republic of Lithuania: A Retrospective Descriptive Service Evaluation

“…As far back as 2000, it was recognized that oral health for both adults and children at the lower end of the socioeconomic scale is worse than for those at the higher end (Locker, ). Further research around the oral health of children with disabilities reveals that there were higher unmet levels of need when parents experienced lower levels of education, lower levels of employment, and higher levels of poverty (Chi, McManus, & Carle, ; Weiner, Vohra, Sambamoorthi, & Madhavan, 2016). Other research indicates that where there is a mixed service provision more acute services are funded better than less acute ones, reflecting an impetus to assist those in crisis, but failing to prevent levels of disease and promote health (Adler et al, ).…”