Barriers to Access to Dental Treatment for People with Physical Disabilities in a Brazilian Metropolis

Objective: To evaluate the barriers for accessing dental care for people with physical disabilities. Material and Methods: A cross-sectional study with 191 caregivers of individuals with physical disabilities attending a rehabilitation center in Sao Paulo, who responded to a questionnaire about information related to barriers (user, caregiver, government and professional) found in dental treatment, visit to the dentist and age of the first dental appointment. Data were collected from medical records regarding age, sex, family income and medical diagnosis of patients. Statistical analysis was performed using the MedCalc for Windows software version 12.3.0. The Chi-square test was applied for heterogeneity, with significance level of 5%. Results: The main barriers identified by caregivers (p<0.0001) were patient fear/anxiety (66.8%), patient requiring accompaniment to access treatment (87.4%), treatment costs (82.7%), lack of treatment at primary health care units (73.3%) and professionals not specialized in dental care for people with physical disabilities (67.0%). It was observed that caregivers of individuals with cerebral palsy reported greater physical barriers for accessing dental treatment compared to caregivers of other diagnoses (p=0.0307). Conclusion: Individuals with physical disabilities face financial constraints, fear of dental treatment, lack of treatment options in public services and, perhaps most importantly, lack of qualified professionals interested in treating such individuals.

[1]  S. Friedman,et al.  Oral Health Care for Children With Developmental Disabilities , 2018, Pediatric Clinical Practice Guidelines & Policies.

[2]  A. C. Massoni,et al.  Training, Practices and Difficulties of Dentists in the Care of Children and Adolescents with Special Needs in the Primary Health Care , 2017 .

[3]  Policy on Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies. , 2016, Pediatric dentistry.

[4]  I. Vozza,et al.  Preventive strategies in oral health for special needs patients. , 2015, Annali di stomatologia.

[5]  Julie. Williams,et al.  Barriers to dental care access for patients with special needs in an affluent metropolitan community. , 2015, Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry.

[6]  Maria Vieira de Lima Saintrain,et al.  Access to dental public services by disabled persons , 2015, BMC oral health.

[7]  Santosh V. Patil,et al.  Comparison of oral health status between children with cerebral palsy and normal children in India: A case–control study , 2015, Journal of Indian Society of Periodontology.

[8]  A. Cavalcanti,et al.  Dental Caries and Periodontal Disease in Brazilian Children and Adolescents with Cerebral Palsy , 2014, International journal of environmental research and public health.

[9]  L. Metsch,et al.  Addressing the oral healthcare needs of special needs children: pediatric nurses' self-perceived effectiveness. , 2014, Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry.

[10]  R. Ravangard,et al.  Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method , 2013, Iranian Red Crescent medical journal.

[11]  A. Dougall,et al.  The value of education in special care dentistry as a means of reducing inequalities in oral health. , 2012, European journal of dental education : official journal of the Association for Dental Education in Europe.

[12]  A. M. R. Cardoso,et al.  Access to Oral Health Care for Children with Motor Disability: Caregivers’ Perspectives , 2012 .

[13]  Robson da Fonseca Neves,et al.  [Accessibility for people with disabilities or permanent mobility restrictions to the Unified Health System]. , 2012, Ciencia & saude coletiva.

[14]  N. King,et al.  Oral health in preschool children with cerebral palsy: a case-control community-based study. , 2010, International journal of paediatric dentistry.

[15]  R. Guaré,et al.  Caries prevalence in patients with cerebral palsy and the burden of caring for them. , 2010, Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry.

[16]  G. Slade,et al.  Access to dental care among adults with physical and intellectual disabilities: residence factors. , 2009, Australian dental journal.

[17]  Branca Maria de Oliveira,et al.  PERFIL EPIDEMIOLÓGICO DOS PORTADORES DE NECESSIDADES ESPECIAIS ATENDIDOS EM UMA CLÍNICA ODONTOLÓGICA Epidemiological profile of people with special needs assisted at a dental clinic , 2008 .

[18]  Adroaldo Mesquita da Costa República Federativa do Brasil - Denominação oficial do país , 1969 .