Access to Dental Care-A Survey from Dentists, People with Disabilities and Caregivers

Abstract

The literature highlights differences in the dental conditions of people with disabilities compared with the general population. The aim of this study was to provide an overview of the dental health of people with disabilities in order to understand if their needs are met and to identify their most critical issues as per dentists. A paper and a Google Form platform were used in conducting a survey in Central Italy (the Abruzzo region), by performing an analysis on different points of view as reported by people with disabilities and dentists. The results showed that only 69.2% of dentists treat persons with disabilities. Of these, 73.5% treat less than 10 patients with physical disabilities per year. However, 54% of dentists do not treat people with cognitive impairment and a poor ability to collaborate during treatment. More than 80% of respondent dentists report that people with disabilities do not have good oral hygiene. On the other hand, 49.1% of people with disabilities (or their caregivers in cases where the patient was unable to answer) report that they rarely or never go to the dental office. Moreover, when they do go, it is mainly for emergencies. Despite this, respondents are well aware of their dental problems. However, they have difficulties in communicating their dental problems to their dentist. The 50% of dentists who treat people with cognitive impairment do not include them in follow-up, while only 20% of these patients reported being regularly recalled. This illustrates the importance of the implementation of follow-up. In addition, training courses could help clinicians to reduce this gap and create barrier-free dental offices.

Keywords: disabilities; health disparities; oral health; special care; special needs.

Figure 1

(a) Results of χ² test between males and females showed no statistically significant difference in terms of treating (yes) or not treating (no) people with disabilities (p = 0.0628). (b) Evaluation of differences between physical disability (PD), collaborating (IC) and non-collaborating (INC) intellectual disabilities between those who reported treating (yes) or not treating (no) patients (p < 0.001).

Figure 2

Oral hygiene differences (yes/no) between the three groups. No statistically significant differences were shown (p = 0.23).

Figure 3

(a) The difficulty expressed by dentists to understand the needs of people with disabilities showed significant differences (p < 0.05) between the three groups. (b) It also showed the necessity of dentist to stop any treatment (yes) or not (no) (p < 0.05).

Figure 4

The graphics represent the difference between the groups in the need of special treatments: necessity of sedation use (p < 0.01) (a), wheelchair (p < 0.05) (b) or special maintenance support (p < 0.01) (c) showed a statistically significant difference between groups.