UNMET PREVENTIVE DENTAL CARE NEEDS AMONG CHILDREN WITH SPECIAL HEALTHCARE NEEDS RESIDING IN THE MOUNTAIN STATES REGION

Abstract: Background: The Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (MCHB) have defined the Children with special health care needs (CSHCN) as “...those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally”. These conditions include low birth weight, metabolic disorders, extreme poverty, child abuse, and air pollution. 1 The NS-CSHCN 2009-2010 is the second largest survey of the health and health care experiences of the special children population along with the state-level comparisons. Objective: To report the magnitude of unmet preventive dental care needs and factors associated among Children with Special Health Care Needs residing in the mountain states. The Mountain States region includes Arizona, Colorado, Montana, New Mexico, Nevada, Texas, Utah and Wyoming Methods: We used the National Survey of Children with Special Health Care Needs (NS-CSHCN) 2009-2010.As a part of telephone survey, 40242 families were interviewed and 372,698 children between 0 and 17 years were screened. In this study, the primary outcome of interest was unmet preventive dental care needs, defined as whether CSHCN were said to have needed preventive dental care but were unable to obtain it. We analyzed the association between predictors and unmet preventive dental care needs using chi-square test and multiple logistic regression. Results: Overall, 89.6 % of CSHCN residing in Mountain States region were reported as having a need for preventive dental care in the past 12 months. Of those CSHCN who needed preventive dental care, 9.8 % did not receive all of the care they needed. After adjusting for gender, non-English language interview and, mother’s education level, the results suggested that uninsured CSHCN had 6 times greater odds of having unmet preventive dental care needs as compared to CSHCN with both insurance (public and private); 26.4% of the parents reported that the cost was unaffordable; 18% reported “no insurance” and 7.6% answered lack transport facilities as causes of unmet preventive dental care needs. Conclusion: Uninsured children, poorer children, children from Hispanic families and children with greater limitations attributable to disability residing in Mountain States region had significantly greater odds of unmet preventive dental care needs. Children with a personal doctor or nurse were significantly less likely to have unmet dental care needs. ABBREVIATIONS: CSHCN, children with special health care needs; FPL, federal poverty level; area; MCHB, Maternal and Child Health Bureau. Purpose (a): To report the magnitude of unmet preventive dental care needs and factors associated among Children with Special Health Care Needs residing in the mountain states. The Mountain States region includes Arizona, Colorado, Montana, New Mexico, Nevada, Texas, Utah and Wyoming. Methods (b): We used the National Survey of Children with Special Health Care Needs (NS-CSHCN) 2009-2010.As a part of telephone survey, 40242 families were interviewed and 372,698 children between 0 and 17 years were screened. In this study, the primary outcome of interest was unmet preventive dental care needs, defined as whether CSHCN were said to have needed preventive dental care but were unable to obtain it. We analyzed the association between predictors and unmet preventive dental care needs using chi-square test and multiple logistic regression. Results (c): Overall, 90.4 % of CSHCN residing in Mountain States region were reported as having a need for preventive dental care in the past 12 months. Of those CSHCN who needed preventive dental care, 9.8 % did not receive all of the care they needed in the region as compared to 8.9% in the nation. After adjusting for gender, non-English language interview and, mother’s education level, the results suggested that uninsured CSHCN had 5 times greater odds of having unmet preventive dental care needs as compared to CSHCN with both insurance (public and private); 26.4% of the parents reported that the cost was unaffordable; 18% reported “no insurance” and 7.6% answered lack transport facilities as causes of unmet preventive dental care needs. Conclusions (d): Uninsured children, poorer children, children from Hispanic families and children with greater limitations attributable to disability residing in Mountain States region had significantly greater odds of unmet preventive dental care needs. Children with a personal doctor or nurse were significantly less likely to have unmet dental care needs.