College of Dentistry, University of Saskatchewan, 123-105 Wiggins Road, Saskatoon, SK, S7N5E4, Canada.
BMC Oral Health. 2022 Nov 16;22(1):497. doi: 10.1186/s12903-022-02561-z.
Individuals with developmental disabilities, including Fetal Alcohol Spectrum Disorder (FASD), often suffer from poorer oral health than the general population as they experience challenges with accessing care. However, few studies have investigated access to oral health care specific to children diagnosed with FASD. Thus, the objective of this cross-sectional study is to examine the use of oral health care services by children diagnosed with FASD in Saskatchewan, Canada, and to identify perceived barriers that affect their access to oral health care.
Parents or caregivers for children with FASD under the age of 16 were recruited through community organizations. Between July 2020 and January 2021, 189 participants completed a 64-item questionnaire that assessed sociodemographic characteristics, oral health care utilization, and perceived barriers to care.
Most children (85%) had visited the dentist within the last 24 months. 55% of children had required sedation for some treatment. 43% of caregivers experienced frustration trying to access care for their child. Common barriers were cost (63%), location (55%), the child's behaviour (78%) and caregiver anxiety (60%). 35% of caregivers believed their dentist lacked adequate knowledge of FASD. Univariate analysis reveals that income, caregiver education, residence location, and insurance status were significantly associated with reporting barriers. Multivariate logistic regression analysis reveals that caregivers who reported a high school education (OR=1.23; 95% CI 1.03 - 1.38); or public insurance (OR=1.33; 95% CI 1.24 - 1.42) or out-of-pocket payments (OR=1.37, 95% CI 1.20 - 1.46); or rural (OR=1.19, 95% CI 1.07 - 1.26) or remote (OR=1.23; 95% CI=1.12 - 1.31) residences were more likely to report difficulties accessing oral health care.
Our findings indicate that children with FASD experience various barriers to accessing oral health care. Social determinants of health were significant variables that increased likelihood of barriers. Like other vulnerable populations, cost and clinic location are notable barriers. Oral health care providers' assessment and management of children with FASD are noteworthy for future research.
患有发育障碍的个体，包括胎儿酒精谱系障碍（FASD），其口腔健康状况往往比一般人群差，因为他们在获得护理方面存在挑战。然而，很少有研究调查专门针对被诊断患有 FASD 的儿童的口腔保健服务的获取情况。因此，本横断面研究的目的是检查加拿大萨斯喀彻温省被诊断患有 FASD 的儿童使用口腔保健服务的情况，并确定影响他们获得口腔保健的感知障碍。
通过社区组织招募年龄在 16 岁以下患有 FASD 的儿童的父母或照顾者。在 2020 年 7 月至 2021 年 1 月期间，189 名参与者完成了一份包含 64 个项目的问卷，评估了社会人口统计学特征、口腔保健服务的利用情况以及获得保健服务的感知障碍。
大多数儿童（85%）在过去 24 个月内看过牙医。55%的儿童在接受某些治疗时需要镇静。43%的照顾者在试图为孩子获得护理时感到沮丧。常见的障碍包括费用（63%）、位置（55%）、孩子的行为（78%）和照顾者的焦虑（60%）。35%的照顾者认为他们的牙医对 FASD 缺乏足够的了解。单因素分析显示，收入、照顾者教育程度、居住地点和保险状况与报告障碍显著相关。多变量逻辑回归分析显示，报告具有高中教育程度的照顾者（OR=1.23；95%CI 1.03-1.38）；或公共保险（OR=1.33；95%CI 1.24-1.42）或自付费用（OR=1.37，95%CI 1.20-1.46）；或农村（OR=1.19，95%CI 1.07-1.26）或偏远地区（OR=1.23；95%CI=1.12-1.31）居住的照顾者更有可能报告在获得口腔保健方面存在困难。
我们的研究结果表明，患有 FASD 的儿童在获得口腔保健方面存在各种障碍。健康的社会决定因素是增加障碍可能性的重要变量。与其他弱势群体一样，费用和诊所位置是显著障碍。未来的研究应注意口腔保健提供者对患有 FASD 的儿童的评估和管理。
