McKinney Christy M, Nelson Travis, Scott JoAnna M, Heaton Lisa J, Vaughn Matthew G, Lewis Charlotte W
Department of Oral Health Sciences, University of Washington, Seattle, Wash.
Department of Pediatric Dentistry, University of Washington, Seattle, Wash.
Acad Pediatr. 2014 Nov-Dec;14(6):624-31. doi: 10.1016/j.acap.2014.06.023. Epub 2014 Oct 30.
Unmet dental need in children with autism spectrum disorder (ASD) is common. We tested hypotheses that lacking a medical home or having characteristics of more severe ASD is positively associated with having unmet dental need among children with ASD.
Using data from the 2009 to 2010 National Survey of Children with Special Health Care Needs, we analyzed 2772 children 5 to 17 years old with ASD. We theorized that unmet dental need would be positively associated with not having a medical home and having characteristics of more severe ASD (eg, parent reported severe ASD, an intellectual disability, communication, or behavior difficulties). Prevalence of unmet dental need was estimated, and unadjusted and adjusted odds ratios, 95% confidence intervals, and P values were computed using survey methods for logistic regression.
Nationally, 15.1% of children with ASD had unmet dental need. Among children with ASD, those without a medical home were more apt to have unmet dental need than those with a medical home (adjusted odds ratio, 4.46; 95% confidence interval, 2.59-7.69). Children with ASD with intellectual disability or greater communication or behavioral difficulties had greater odds of unmet dental need than those with ASD without these characteristics. Parent-reported ASD severity was not associated with unmet dental need.
Children with ASD without a medical home and with characteristics suggestive of increased ASD-related difficulties were more apt to have unmet dental need. Pediatricians might use these findings to aid in identifying children with ASD who might not receive all needed dental care.
自闭症谱系障碍(ASD)儿童中未满足的牙科需求很常见。我们检验了以下假设:缺乏医疗之家或具有更严重ASD特征与ASD儿童未满足的牙科需求呈正相关。
利用2009年至2010年全国特殊医疗需求儿童调查的数据,我们分析了2772名5至17岁的ASD儿童。我们推测,未满足的牙科需求与没有医疗之家以及具有更严重ASD特征(例如,家长报告为严重ASD、智力残疾、沟通或行为困难)呈正相关。估计未满足牙科需求的患病率,并使用逻辑回归的调查方法计算未调整和调整后的优势比、95%置信区间和P值。
在全国范围内,15.1%的ASD儿童有未满足的牙科需求。在ASD儿童中,没有医疗之家的儿童比有医疗之家的儿童更有可能有未满足的牙科需求(调整后的优势比为4.46;95%置信区间为2.59 - 7.69)。与没有这些特征的ASD儿童相比,有智力残疾或更大沟通或行为困难的ASD儿童有未满足牙科需求的几率更高。家长报告的ASD严重程度与未满足的牙科需求无关。
没有医疗之家且具有提示ASD相关困难增加特征的ASD儿童更有可能有未满足的牙科需求。儿科医生可以利用这些发现来帮助识别可能无法获得所有所需牙科护理的ASD儿童。