Agarwal Bhaskar, Srivastava Shitij, Shekhar Abhinav, Arora Kshitij, Singh Mayank, Kumar Lakshya
Department of Prosthodontics, King George's Medical University, Lucknow, Uttar Pradesh, India.
Department of Prosthodontics, Sardar Patel PGI of Medical and Dental Sciences, Lucknow, Uttar Pradesh, India.
Natl J Maxillofac Surg. 2024 May-Aug;15(2):188-198. doi: 10.4103/njms.njms_206_22. Epub 2024 Jul 24.
Quite often, it is seen that the number of special care individual in the dental OPD/clinics is quite low, as compared to their population. This can be due to specific barriers that restrict them in availing dental treatment. Our aim was to identify different barriers to dental care of persons with special needs through a systematic review and to quantify them. A systematic review was carried out according to PRISMA guidelines. PubMed data was searched with predefined keywords leading to retrieval of 576 records. Full length studies published in English language from 2010 onwards with mention of proportion of persons citing a barrier to dental care were included. Three studies published in peer reviewed journals from other data sources were also identified while retrieving the full length texts. Out of a total of 576 PubMed and three additional records, a total of 22 studies were included in the systematic review. Cost, communication, physical facilities, fear/uncooperativeness, unawareness, distant location/inaccessibility, unwilling dentist, transportation, and difficulty in getting appointment were identified as nine major barriers. Pooled proportions for different barriers ranged from 22.75% (Accessibility; 95%CI = 19.96-25.54) to 44.35% (Communication; 95% CI = 32.63-56.07A). There was a high heterogeneity across different studies for both fixed effects and random effects models. Communication, physical facilities, and unawareness were identified as the three most common barriers showing minimum heterogeneity in random effects model.
通常可以看到，与特殊护理人群的数量相比，牙科门诊/诊所中特殊护理个体的数量相当少。这可能是由于特定障碍限制了他们获得牙科治疗。我们的目的是通过系统评价确定特殊需求人群牙科护理的不同障碍并对其进行量化。根据PRISMA指南进行了系统评价。使用预定义关键词搜索PubMed数据，检索到576条记录。纳入2010年以后发表的、提及指出牙科护理障碍的人群比例的英文全文研究。在检索全文时，还从其他数据源确定了三项发表在同行评审期刊上的研究。在总共576条PubMed记录和另外三条记录中，共有22项研究纳入系统评价。成本、沟通、物理设施、恐惧/不合作、意识缺乏、地理位置偏远/难以到达、牙医不愿意、交通以及预约困难被确定为九个主要障碍。不同障碍的合并比例从22.75%（可达性；95%置信区间=19.96-25.54）到44.35%（沟通；95%置信区间=32.63-56.07A）不等。固定效应模型和随机效应模型在不同研究中均存在高度异质性。沟通、物理设施和意识缺乏被确定为随机效应模型中显示最低异质性的三个最常见障碍。
