Oral health and dental services utilization of children with learning disabilities
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OBJECTIVE: The purpose of this dissertation is to examine the oral health, caregivers’ perception of oral health, and dental services utilization among children with learning disabilities (LD). METHODS: We used the National Health And Nutrition Examination Survey 1999-2004 data to investigate the oral health and caregivers’ perception of oral health among children with LD alone, ADHD alone, and LD with ADHD. We used the National Survey of Children’s Health 2011-2012 data to examine dental services utilization and unmet dental needs among children with LD alone, non-LD CSHCN, and LD CSHCN. RESULTS: Children with LD alone have greater likelihood of having dental caries in permanent dentition compared to non-LD, non-ADHD children (OR: 1.6, 95% CI: 1.1-2.2), while the likelihood of dental caries in permanent dentition among children with combined LD and ADHD is much greater (OR: 1.9, 95%CI: 1.3-2.7). Caregivers of children with LD, ADHD, and LD with ADHD perceived their oral health to be poorer when compared to non-LD, non-ADHD (OR: 1.8, 95% CI: 1.2-2.8, OR: 1.9, 95% CI: 1.1-3.0, OR: 2.0, 95% CI: 1.3-3.1, respectively). The accuracy of caregivers’ assessments of their children’s oral health was lower among those with LD, ADHD, and LD with ADHD children. Children with ADHD alone had the least accurate caregivers’ perception (OR: 0.5, 95% CI: 0.3-0.8). Children with LD alone were less likely to have a dental visit within the past year, whether for preventive visit (OR: 0.6, 95% CI: 0.5- 0.9) or any other dental visits (OR: 0.7, 95% CI: 0.5- 0.9). While LD severity did not impact dental visit receipt, children with moderate to severe LD have higher unmet dental needs than non-LD and mild-LD (OR: 1.8, 95% CI: 1.3- 2.5). CONCLUSION: Children with learning disabilities have significant oral health needs and are at a greater risk for dental disease. Despite that, children with LD are less likely to utilize preventive and other dental services. Future interventions need to target this vulnerable population to improve their oral health and reduce these disparities.
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