Access to Dental Services for Children with Special Health Care Needs: A Pilot Study at the Dental Department of BC Children's Hospital.

Abstract

Objectives: This pilot study at the dentistry department of BC Children's Hospital (DD-BCCH) in Vancouver, British Columbia, Canada, aimed to explore issues of access to dental services for children with special health care needs (CSHCN).

Methods: Caregivers of CSHCN, who were patients of record at DD-BCCH, were recruited to participate in this study. We collected sociodemographic characteristics, insurance coverage and medical diagnosis, and information on caregivers' perceptions of enabling factors and barriers to dental services using a pretested survey instrument with 33 closed and open-ended questions. We also obtained referral source, insurance coverage and medical diagnosis from the child's dental record. We analyzed quantitative data descriptively and qualitative comments from caregivers thematically.

Results: Common medical diagnoses among this sample of CSHCN (n = 50) were: genetic disorder/syndrome, developmental delay, sensory impairments and autism. Half of the children were referred by a medical professional; most (90%) had had a dental appointment within the last year that included preventive treatment. Although most caregivers reported some available dental benefits, affordability of dental services was a concern. Lack of dentist's training or comfort treating CSHCN, because of the complexity of the child's medical condition or behavioural challenges was also a reported barrier.

Conclusions: The complexity of the child's medical status, the limited ability of dentists to provide care and financial obstacles were commonly reported barriers to care. Current efforts may best be focused on encouraging the province's health professionals, including dentists, to facilitate early referral to tertiary-level care for CSHCN whom they consider medically or behaviourally complex beyond their skill or comfort level.