Published for the British Institute of Learning Disabilities
Journal of Applied Research in Intellectual Disabilities 2016, 29, 139–145
Access Barriers to Dental Health Care in Children with Disability. A Questionnaire Study of Parents Karolina Gerreth and Maria Borysewicz-Lewicka Department of Pediatric Dentistry, Poznan University of Medical Sciences, Poznan, Poland
Accepted for publication 21 October 2014
Background A patient’s with disability everyday life is rife with many limitations such as architectural, transport, information as well as medical, psychological, legal, economic and social barriers. The aim of this study was to evaluate access to dental health care of special-care schoolchildren with intellectual disability on the basis of their parents’ opinion. Material and method A questionnaire survey was carried out among 264 parents/caregivers of children from eight special-care schools in Poznan (Poland). Closeended questions concerned children’s barriers in access to dental care and parents’ satisfaction with their children’s dental care. Results Only 31.8% parents/caregivers did not have any problems with access to dental care and the most
Introduction Numerous studies have repeatedly confirmed that the population of persons with disability still meet considerable difficulties and obstacles in access to medical and dental care despite the attempts at legal regulation (Waldman et al. 1998; Allison et al. 2000; Shenkin et al. 2001; Bonito 2002; Edwards & Merry 2002; Griffiths 2002; Al Agili et al. 2004; Gerreth & Lewicka 2004; Lewis et al. 2005; Miller 2005; Nowakowska 2005; Wozniak 2005). These barriers are not only architectural, communication and information hindrances, but also medical, psychological, legal, economic and social problems. However, it is emphasized that medical procedures performed on patients with intellectual disability are more time-consuming and require more physical and emotional involvement, both from parents and medical © 2015 John Wiley & Sons Ltd
commonly reported barrier to obtaining dental care was protracted waiting time for a visit (36.7%). Most commonly, children were treated in dental surgery conditions (90.1%). Only 42.1% respondents were satisfied with their children’s dental care. Conclusions The research revealed that there is a need to improve the access of children with disability to dental care. Hence, it seems to be beneficial to set up specialist dental surgeries in special-care schools which would improve the access of children with disability to prophylaxis as well as dental treatment. Keywords: barriers, children with disability, dental care
staff, due to hampered cooperation (Burtner et al. 1990). Patients cannot control unusual sounds or unpleasant reflexes, which, however, should be accepted. On the other hand, it is also well-known that there is a need for proper adaptation and equipment of the dental surgery which would facilitate carrying out therapeutic procedures in optimal conditions. Moreover, wheelchair users may come across difficulties in the majority of medical centres due to lack of elevators and special driveways or ramps (Griffiths 2002; Nowakowska 2005). In children with severe and profound intellectual disability dental treatment under general anaesthesia is often a method of choice but it requires access to specialized centres (Takano & Ohmori 1994; Wong et al. 1997; Szymanska & Bogucka-Gordziejko 1999; Prabhu et al. 2003). It also seems that there is no satisfactory solution for dental treatment in chronically ill, bedridden patients 10.1111/jar.12164
140 Journal of Applied Research in Intellectual Disabilities
who cannot leave their homes (Fiske & Lewis 2000; Simons 2003; Smith & Freeman 2003). The aim of this study was to evaluate access to dental health of special-care schoolchildren with intellectual disability on the basis of their parents’ opinion.
Material and Method The sociomedical study was carried out among parents/ caregivers of students, aged 6–18 years, attending eight special-care schools in Poznan (Poland). It was established that in those institutions there were 852 students under the age of 18 years with various degree of intellectual disability (mild, moderate, severe and profound). The information about the degree of child’s disability was taken from school documentation. The mean age of the students whose parents/ caregivers took part in the research was 13.1 years for the total population (SD = 3.1), in the group of children with mild intellectual disability 12.4 years (SD = 3.0), with moderate disability 13.6 years (SD = 3.1), with severe disability 13 years (SD = 2.8) and with profound disability 13.3 years (SD = 3.3). Close-ended questions of the questionnaire for parents/caregivers concerned barriers in a child’s access to dental care, the place where dental treatment is usually performed and the date of the next appointment fixed by the dentist as well as the satisfaction of parents/caregivers with earlier dental care. The questionnaire was distributed during parent– teacher meetings and filled in at home. Participation in the study was voluntary and full confidentiality of the collected data was provided to its participants. The analysis did not take into account questionnaires without child’s personal data or those where the answers to most questions were missing. The final analysis dealt with the data from 264 respondents, including parents/ caregivers of 86 students with mild intellectual disability (32.6%) – 39 girls and 47 boys, 116 with moderate disability (43.9%) – 48 girls and 68 boys, 40 with severe disability (15.2%) – 15 girls and 25 boys and 22 with profound disability (8.3%) – 10 girls and 12 boys. The results were divided into three groups depending on intellectual disability (mildly, moderately, severely and profoundly disabled) of the child. For a statistical analysis relating to the differences in answers between students with various degree of intellectual disability the chi-square test was used, but in the case of a low number of observations (
Journal of Applied Research in Intellectual Disabilities 2016, 29, 139–145
Access Barriers to Dental Health Care in Children with Disability. A Questionnaire Study of Parents Karolina Gerreth and Maria Borysewicz-Lewicka Department of Pediatric Dentistry, Poznan University of Medical Sciences, Poznan, Poland
Accepted for publication 21 October 2014
Background A patient’s with disability everyday life is rife with many limitations such as architectural, transport, information as well as medical, psychological, legal, economic and social barriers. The aim of this study was to evaluate access to dental health care of special-care schoolchildren with intellectual disability on the basis of their parents’ opinion. Material and method A questionnaire survey was carried out among 264 parents/caregivers of children from eight special-care schools in Poznan (Poland). Closeended questions concerned children’s barriers in access to dental care and parents’ satisfaction with their children’s dental care. Results Only 31.8% parents/caregivers did not have any problems with access to dental care and the most
Introduction Numerous studies have repeatedly confirmed that the population of persons with disability still meet considerable difficulties and obstacles in access to medical and dental care despite the attempts at legal regulation (Waldman et al. 1998; Allison et al. 2000; Shenkin et al. 2001; Bonito 2002; Edwards & Merry 2002; Griffiths 2002; Al Agili et al. 2004; Gerreth & Lewicka 2004; Lewis et al. 2005; Miller 2005; Nowakowska 2005; Wozniak 2005). These barriers are not only architectural, communication and information hindrances, but also medical, psychological, legal, economic and social problems. However, it is emphasized that medical procedures performed on patients with intellectual disability are more time-consuming and require more physical and emotional involvement, both from parents and medical © 2015 John Wiley & Sons Ltd
commonly reported barrier to obtaining dental care was protracted waiting time for a visit (36.7%). Most commonly, children were treated in dental surgery conditions (90.1%). Only 42.1% respondents were satisfied with their children’s dental care. Conclusions The research revealed that there is a need to improve the access of children with disability to dental care. Hence, it seems to be beneficial to set up specialist dental surgeries in special-care schools which would improve the access of children with disability to prophylaxis as well as dental treatment. Keywords: barriers, children with disability, dental care
staff, due to hampered cooperation (Burtner et al. 1990). Patients cannot control unusual sounds or unpleasant reflexes, which, however, should be accepted. On the other hand, it is also well-known that there is a need for proper adaptation and equipment of the dental surgery which would facilitate carrying out therapeutic procedures in optimal conditions. Moreover, wheelchair users may come across difficulties in the majority of medical centres due to lack of elevators and special driveways or ramps (Griffiths 2002; Nowakowska 2005). In children with severe and profound intellectual disability dental treatment under general anaesthesia is often a method of choice but it requires access to specialized centres (Takano & Ohmori 1994; Wong et al. 1997; Szymanska & Bogucka-Gordziejko 1999; Prabhu et al. 2003). It also seems that there is no satisfactory solution for dental treatment in chronically ill, bedridden patients 10.1111/jar.12164
140 Journal of Applied Research in Intellectual Disabilities
who cannot leave their homes (Fiske & Lewis 2000; Simons 2003; Smith & Freeman 2003). The aim of this study was to evaluate access to dental health of special-care schoolchildren with intellectual disability on the basis of their parents’ opinion.
Material and Method The sociomedical study was carried out among parents/ caregivers of students, aged 6–18 years, attending eight special-care schools in Poznan (Poland). It was established that in those institutions there were 852 students under the age of 18 years with various degree of intellectual disability (mild, moderate, severe and profound). The information about the degree of child’s disability was taken from school documentation. The mean age of the students whose parents/ caregivers took part in the research was 13.1 years for the total population (SD = 3.1), in the group of children with mild intellectual disability 12.4 years (SD = 3.0), with moderate disability 13.6 years (SD = 3.1), with severe disability 13 years (SD = 2.8) and with profound disability 13.3 years (SD = 3.3). Close-ended questions of the questionnaire for parents/caregivers concerned barriers in a child’s access to dental care, the place where dental treatment is usually performed and the date of the next appointment fixed by the dentist as well as the satisfaction of parents/caregivers with earlier dental care. The questionnaire was distributed during parent– teacher meetings and filled in at home. Participation in the study was voluntary and full confidentiality of the collected data was provided to its participants. The analysis did not take into account questionnaires without child’s personal data or those where the answers to most questions were missing. The final analysis dealt with the data from 264 respondents, including parents/ caregivers of 86 students with mild intellectual disability (32.6%) – 39 girls and 47 boys, 116 with moderate disability (43.9%) – 48 girls and 68 boys, 40 with severe disability (15.2%) – 15 girls and 25 boys and 22 with profound disability (8.3%) – 10 girls and 12 boys. The results were divided into three groups depending on intellectual disability (mildly, moderately, severely and profoundly disabled) of the child. For a statistical analysis relating to the differences in answers between students with various degree of intellectual disability the chi-square test was used, but in the case of a low number of observations (
