Camoin Ariane, Tardieu Corinne, Dany Lionel, Saliba-Serre Bérengère, Faulks Denise, Coz Pierre Le
Aix Marseille Université, CNRS, EFS, ADES, Marseille, France.
Aix Marseille Université, Faculte d'Odontologie, Marseille, France.
Spec Care Dentist. 2020 Jul;40(4):356-363. doi: 10.1111/scd.12482. Epub 2020 Jun 2.
Children with intellectual disabilities experience major inequality in the field of oral health, including a higher number of extracted teeth. The literature explains this difference in terms of higher levels of dental disease but does not mention the possibility of inequality in the treatment options offered these children.
The aim is to investigate whether the same treatment options are offered by practitioners to children with and without intellectual disability in equivalent clinical circumstances.
A scenario involving a clinical dental situation was developed, with one varying parameter: the patient described was a child with or without cerebral palsy.
One hundred and thirty-nine dental specialists from France and Europe were recruited. A large number of practitioners (68%) chose the same treatment for both patients, but 32% declared modifying the dental treatment planning in the case of the child with cerebral palsy. The most frequently chosen treatment for the scenario of irreversible pulpitis for the child without disability was conservative endodontic treatment (73%) whereas the most frequently chosen treatment for the child with intellectual disability was tooth extraction (54%).
These results are discussed in terms of beneficence, fear of restorative failure, lack of guidelines, practitioner experience and the implications for equity in healthcare.
智障儿童在口腔健康领域面临重大不平等，包括拔牙数量较多。文献从更高的牙病水平解释了这种差异，但未提及为这些儿童提供的治疗选择中存在不平等的可能性。
目的是调查在同等临床情况下，从业者是否为有和没有智力残疾的儿童提供相同的治疗选择。
设计了一个涉及临床牙科情况的场景，有一个可变参数：所描述的患者是有或没有脑瘫的儿童。
招募了来自法国和欧洲的139名牙科专家。大量从业者（68%）为两名患者选择了相同的治疗方法，但32%的人表示在脑瘫儿童的情况下会修改牙科治疗计划。对于无残疾儿童不可逆性牙髓炎的情况，最常选择的治疗方法是保守性牙髓治疗（73%），而对于智障儿童，最常选择的治疗方法是拔牙（54%）。
从行善、对修复失败的恐惧、缺乏指导方针、从业者经验以及对医疗保健公平性的影响等方面对这些结果进行了讨论。
