Assessing the factors affecting the accessibility of primary dental care for people with haemophilia

Abstract

Introduction: Patients with haemophilia (PWH) often have difficulty accessing dental services.

Aim: To determine the accessibility of dental care for PWH and to examine their perceptions of how coronavirus type-2 (CoV-2) disease (COVID-19) has affected their ability to access dental treatments following the pandemic.

Methods: The questionnaire survey was conducted between July 2022 and December 2022 at haemophilia treatment centres in Hungary. Variables with statistical significance (Pearson's Chi-squared test; p < .05) were included in logistic regression analyses. Least absolute shrinkage and selection operator (LASSO) regression was used as a machine learning technique to identify the most predictive variables.

Results: Twenty-one percent of the sixty-eight participants reported that they had been refused dental treatment, mainly in primary care (86%). Dental refusal was influenced by infectious disease (OR: 4.48, CI: 1.14-17.69) and previous dental bleeding complications (OR: 4.23, CI: 1.10-16.27). There was correlation between dental visits and having a permanent dentist or receiving oral hygiene advice (OR: 9.95, CI: 2.86-34.62 and OR: 3.84, CI: 1.09-13.58). Participation in an oral hygiene consultation increased patients' satisfaction with their dental care (OR: 6.28, 95% CI: .71-55.88). Twenty-eight percent of patients had experienced difficulties since the start of the COVID-19, but 84% had visited their dentist at least once between 2021 and 2022 (p = .002). Nevertheless, 16% of respondents went for only the most necessary treatments due to pandemic.

Conclusion: Refusal of dental care was high among participants, especially in primary care. The COVID-19 pandemic has exaggerated the difficulties of PWH in accessing dental treatment.

Highlights: Patients with haemophilia (PWH) have difficulty accessing dental care, and the coronavirus type 2 (CoV-2) disease pandemic (COVID-19) has created a new barrier. The study revealed a high prevalence of dental care refusal (21%), particularly in primary care (86%). This 2022 survey found that 28% of patients experienced difficulties since the pandemic started and 16% only sought necessary treatments.

Keywords: COVID‐19; dental care; haemophilia A; haemophilia B; machine learning; surveys and questionnaires.