UCSF

Purpose: The aim of this mixed method study was to identify barriers for children with special health care needs (SHCN) to receiving routine preventive dental care following dental care with general anesthesia (GA).

Methods: Electronic health records were reviewed for inclusion criteria and demographic data. Caregivers of children with SHCN were contacted to participate in qualitative interviews. Interview topics explored child, family, and community level influences to accessing dental care. Qualitative analysis identified key themes of barriers and enablers to care.

Results: A total of 1,708 children received dental care with GA during the two-year study period, of which 498 (29.16%) had a diagnosis of a SHCN. The most common type of SHCN was neurodevelopmental disorders (n=142, 28.51%). The mean age at time of GA was 8.6 years. Fifty caregivers completed interviews. Identified barriers to obtaining routine dental care included child stress/anxiety, finding an accepting provider, dismissive providers, and proximity of provider/transportation to dental care. Enablers to obtaining care included effective behavior management, continuity of provider/care, positive provider attitude, and referral to an accepting provider.

Conclusion: Adequately trained and local providers with an accepting attitude are essential to enabling children with SHCN to obtain equitable access to routine preventive dental care.