Wiener R C, Wiener M A
Department of Dental Practice and Rural Health, West Virginia University, Morgantown, West Virginia, USA.
Rural Remote Health. 2012;12:2069. Epub 2012 Jul 27.
Of children aged 0-17 years in the USA, an estimated 11 203 616 (15.1%; 95% CI: 14.8, 15.3) are Children with Special Health Care Needs (CSHCN). The state of West Virginia, the heart of Appalachia, has a land mass which is 97.65% rural with previously identified high overall dental need and oral health disparities. It is home to an estimated 70 609 CSHCN, or 18.5% (95% CI: 17.0, 19.9) of the state's children in 2009-2010. The purpose of this study was to determine the parent/guardian's perceived unmet dental care need of CSHCN in West Virginia.
Data from the National Survey of Children with Special Health Care Needs was used to determine prevalence. A telephone survey of 59 941 parents/guardians of CSHCN (1149 from West Virginia) for the dental interview was conducted in 2009-2010.
Nationwide, 26.7% (25.9, 27.5) of parents/guardians reported their CSHCN had dental care or orthodontia needs other than preventive care. In West Virginia, the perceived dental care or orthodontia needs other than preventive dental care need was 26.5% (22.2, 30.0). Unmet national dental care need other than preventive dental care was 5.4% (5.0, 5.9) and in West Virginia 5.0% (2.4, 7.5).
CSHCN have significant unmet dental needs. Parents/guardians in West Virginia reported similar unmet need compared with national reporting. Policies to address the health care of CSHCN should include dental needs. The clinical implications are that CSHCN have a variety of needs, including orthodontia. The benefits of orthodontic referrals should be considered in treatment planning options for CSHCN.
在美国0至17岁的儿童中，估计有11203616名（15.1%；95%置信区间：14.8, 15.3）是有特殊医疗保健需求的儿童（CSHCN）。西弗吉尼亚州位于阿巴拉契亚地区的中心，其97.65%的土地为农村地区，此前已确定该地区总体牙科需求较高且存在口腔健康差异。2009 - 2010年，该州估计有70609名CSHCN，占该州儿童总数的18.5%（95%置信区间：17.0, 19.9）。本研究的目的是确定西弗吉尼亚州有特殊医疗保健需求儿童的家长/监护人所感知到的未满足的牙科护理需求。
使用全国有特殊医疗保健需求儿童调查的数据来确定患病率。2009 - 2010年对59941名CSHCN的家长/监护人（其中1149名来自西弗吉尼亚州）进行了电话调查以进行牙科访谈。
在全国范围内，26.7%（25.9, 27.5）的家长/监护人报告他们的CSHCN除了预防性护理外还有牙科护理或正畸需求。在西弗吉尼亚州，除预防性牙科护理需求外所感知到的牙科护理或正畸需求为26.5%（22.2, 30.0）。全国范围内除预防性牙科护理外未满足的牙科护理需求为5.4%（5.0, 5.9），在西弗吉尼亚州为5.0%（2.4, 7.5）。
有特殊医疗保健需求的儿童有大量未满足的牙科需求。西弗吉尼亚州的家长/监护人报告的未满足需求与全国报告的情况相似。解决有特殊医疗保健需求儿童医疗保健问题的政策应包括牙科需求。临床意义在于有特殊医疗保健需求的儿童有多种需求，包括正畸需求。在为有特殊医疗保健需求的儿童制定治疗计划时应考虑正畸转诊的益处。
