Nelson Linda P, Getzin Anne, Graham Dionne, Zhou Jing, Wagle Elke M, McQuiston Jessie, McLaughlin Suzanne, Govind Akshay, Sadof Matthew, Huntington Noelle L
Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA, USA.
Pediatr Dent. 2011 Jan-Feb;33(1):29-36.
The purpose of this study was to conduct the first known large scale survey of parents of children with special health care needs (CSHCN) to determine their child's: oral health status; access to dental care; perceived barriers (environmental/system and nonenvironmental/family); and oral health quality of life, accounting for each child's medical diagnosis and severity of diagnosis.
A 72-item survey was sent to 3760 families of CSHCN throughout urban and rural Massachusetts.
The study yielded 1,128 completed surveys. More than 90% of the children had seen a dentist within the past year; 66% saw a pediatric dentist, and 21% needed intense behavioral interventions. Although most families had high education levels, private dental insurance, and above average incomes, 20% of CSHCN had an unmet dental need. Children with craniofacial anomalies had twice as many unmet needs and children with cystic fibrosis had fewer unmet needs. Children with cerebral palsy, autism, developmental delay, and Down syndrome had more aversions to dental treatment, more treatment complications posed by their medical conditions, and more difficulty finding a dentist willing to provide care. Children with cystic fibrosis, metabolic disorders, or hemophilia encountered fewer barriers to care.
The data paint a picture of high unmet dental needs with subpopulations of children with special health care needs who are more at risk for system barriers and internal family barriers to care based on their medical diagnoses.
本研究旨在对有特殊医疗需求儿童（CSHCN）的家长进行首次已知的大规模调查，以确定其孩子的口腔健康状况、获得牙科护理的情况、感知到的障碍（环境/系统和非环境/家庭）以及口腔健康生活质量，并考虑每个孩子的医学诊断和诊断严重程度。
向马萨诸塞州城乡地区的3760名有特殊医疗需求儿童的家庭发送了一份包含72个条目的调查问卷。
该研究共获得1128份完整的调查问卷。超过90%的儿童在过去一年中看过牙医；66%看过儿童牙医，21%需要强化行为干预。尽管大多数家庭的教育水平较高、拥有私人牙科保险且收入高于平均水平，但仍有20%的有特殊医疗需求儿童存在未满足的牙科需求。患有颅面畸形的儿童未满足的需求数量是其他儿童的两倍，而患有囊性纤维化的儿童未满足的需求较少。患有脑瘫、自闭症、发育迟缓及唐氏综合征的儿童对牙科治疗的厌恶感更强，其身体状况带来的治疗并发症更多，且更难找到愿意提供治疗的牙医。患有囊性纤维化、代谢紊乱或血友病的儿童在获得护理方面遇到的障碍较少。
数据显示，有特殊医疗需求儿童中存在大量未满足的牙科需求，基于其医学诊断，这些儿童中的一些亚群体在获得护理方面面临更多系统障碍和家庭内部障碍。
