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Children's Oral Health| Volume 14, ISSUE 6, P624-631, November 01, 2014

Predictors of Unmet Dental Need in Children With Autism Spectrum Disorder: Results From a National Sample

DOI:https://doi.org/10.1016/j.acap.2014.06.023
Predictors of Unmet Dental Need in Children With Autism Spectrum Disorder: Results From a National Sample
Previous ArticleOral Health Opinions and Practices of Pediatricians: Updated Results From a National Survey
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      Abstract

      Objective

      Unmet dental need in children with autism spectrum disorder (ASD) is common. We tested hypotheses that lacking a medical home or having characteristics of more severe ASD is positively associated with having unmet dental need among children with ASD.

      Methods

      Using data from the 2009 to 2010 National Survey of Children with Special Health Care Needs, we analyzed 2772 children 5 to 17 years old with ASD. We theorized that unmet dental need would be positively associated with not having a medical home and having characteristics of more severe ASD (eg, parent reported severe ASD, an intellectual disability, communication, or behavior difficulties). Prevalence of unmet dental need was estimated, and unadjusted and adjusted odds ratios, 95% confidence intervals, and P values were computed using survey methods for logistic regression.

      Results

      Nationally, 15.1% of children with ASD had unmet dental need. Among children with ASD, those without a medical home were more apt to have unmet dental need than those with a medical home (adjusted odds ratio, 4.46; 95% confidence interval, 2.59–7.69). Children with ASD with intellectual disability or greater communication or behavioral difficulties had greater odds of unmet dental need than those with ASD without these characteristics. Parent-reported ASD severity was not associated with unmet dental need.

      Conclusions

      Children with ASD without a medical home and with characteristics suggestive of increased ASD-related difficulties were more apt to have unmet dental need. Pediatricians might use these findings to aid in identifying children with ASD who might not receive all needed dental care.

      Keywords

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      References

        • Yu S.M.
        • Bellamy H.A.
        • Kogan M.D.
        • et al.
        Factors that influence receipt of recommended preventive pediatric health and dental care.
        Pediatrics. 2002; 110: e73
        View in Article
        • Iida H.
        • Lewis C.W.
        Utility of a summative scale based on the Children with Special Health Care Needs (CSHCN) Screener to identify CSHCN with special dental care needs.
        Matern Child Health J. 2012; 16: 1164-1172
        View in Article
        • Lewis C.
        • Robertson A.S.
        • Phelps S.
        Unmet dental care needs among children with special health care needs: implications for the medical home.
        Pediatrics. 2005; 116: e426-e431
        View in Article
        • Bloom B.
        • Cohen R.A.
        • Freeman G.
        Summary health statistics for U.S. children: National Health Interview Survey, 2010.
        Vital Health Stat 10. 2011 Dec; : 1-80
        View in Article
      5. Surgeon General. Oral Health in America: A Report of the Surgeon General. United States Dept of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, Rockville, MD2000
        View in Article
        • Committee on Oral Health Access to Services
        • Institute of Medicine, National Research Council
        Improving Access to Oral Health Care for Vulnerable and Underserved Populations.
        National Academies Press, Washington, DC2011
        View in Article

      7. Centers for Disease Control and Prevention. Prevalence of the Autism Spectrum Disorders (ASDs) in Multiple Areas of the United States, 2004 and 2006: Community Report from the Autism and Developmental Disabilities Monitoring (ADDM) Network. 2006.

        View in Article
        • Centers for Disease Control and Prevention
        Prevalence of Autism Spectrum Disorders — Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008.
        MMWR Morb Mortal Wkly Rep. 2012; 61: 1-19
        View in Article
        • Blumberg S.J.
        • Bramlett M.D.
        • Kogan M.D.
        • et al.
        Changes in prevalence of parent-reported autism spectrum disorder in school-aged U.S. children: 2007 to 2011–2012.
        Natl Health Stat Report. 2013; (1 p following 11): 1-11
        View in Article
        • Kopycka-Kedzierawski D.T.
        • Auinger P.
        Dental needs and status of autistic children: results from the National Survey of Children's Health.
        Pediatr Dent. Jan-Feb 2008; 30: 54-58
        View in Article
        • Lewis C.W.
        Dental care and children with special health care needs: a population-based perspective.
        Acad Pediatr. Nov-Dec 2009; 9: 420-426
        View in Article
        • Stein L.I.
        • Polido J.C.
        • Cermak S.A.
        Oral care and sensory over-responsivity in children with autism spectrum disorders.
        Pediatr Dent. 2013; 35: 230-235
        View in Article
        • Stein L.I.
        • Polido J.C.
        • Najera S.O.
        • Cermak S.A.
        Oral care experiences and challenges in children with autism spectrum disorders.
        Pediatr Dent. 2012; 34: 387-391
        View in Article
        • Stein L.I.
        • Polido J.C.
        • Mailloux Z.
        • et al.
        Oral care and sensory sensitivities in children with autism spectrum disorders.
        Spec Care Dentist. 2011; 31: 102-110
        View in Article
        • Lai B.
        • Milano M.
        • Roberts M.W.
        • Hooper S.R.
        Unmet dental needs and barriers to dental care among children with autism spectrum disorders.
        J Autism Dev Disord. 2012; 42: 1294-1303
        View in Article
        • Brickhouse T.H.
        • Farrington F.H.
        • Best A.M.
        • Ellsworth C.W.
        Barriers to dental care for children in Virginia with autism spectrum disorders.
        J Dent Child (Chic). 2009; 76: 188-193
        View in Article
        • Nelson L.P.
        • Getzin A.
        • Graham D.
        • et al.
        Unmet dental needs and barriers to care for children with significant special health care needs.
        Pediatr Dent. 2011; 33: 29-36
        View in Article
        • Strickland B.B.
        • Jones J.R.
        • Ghandour R.M.
        • et al.
        The medical home: health care access and impact for children and youth in the United States.
        Pediatrics. 2011; 127: 604-611
        View in Article
        • Martin A.B.
        • Crawford S.
        • Probst J.C.
        • et al.
        Medical homes for children with special health care needs: a program evaluation.
        J Health Care Poor Underserved. 2007; 18: 916-930
        View in Article
        • Homer C.J.
        • Klatka K.
        • Romm D.
        • et al.
        A review of the evidence for the medical home for children with special health care needs.
        Pediatrics. 2008; 122: e922-e937
        View in Article

      21. Data Resource Center for Child & Adolescent Health. Child and Adolescent Health Measurement Initiative (CAHMI). 2009-2010 NS-CSHCN: SAS Code for Data Users: Child Health Mesasures, Indicator and Subgroups, Version 1. May 2012. Available at: www.childhealthdata.org/learn/methods#Codebooks. Accessed July 27, 2014.

        View in Article

      22. Data Resource Center for Child & Adolescent Health. Child and Adolescent Health Measurement Initiative (CAHMI). National Survey of Children with Special Healthcare Needs (2009/10 NS-CSHCN): Fast Facts. Available at: http://www.childhealthdata.org/docs/default-document-library/ns-cshcn-fast-facts-2009.pdf. Accessed July 1, 2013.

        View in Article

      23. Data Resource Center for Child & Adolescent Health. 2009/10 National Survey of Children with Special Health Care Needs (2009/10 NS-CSHCN). Sampling and Survey Administration Process. Available at: http://childhealthdata.org/docs/default-document-library/2009-nscshcn-survey-sampling-administration.pdf. Accessed November 21, 2013.

        View in Article
        • Bethell C.D.
        • Read D.
        • Stein R.E.
        • et al.
        Identifying children with special health care needs: development and evaluation of a short screening instrument.
        Ambul Pediatr. 2002; 2: 38-48
        View in Article
        • McPherson M.
        • Arango P.
        • Fox H.
        • et al.
        A new definition of children with special health care needs.
        Pediatrics. 1998; 102: 137-140
        View in Article

      26. Data Resource Center for Child & Adolescent Health. Child and Adolescent Health Measurement Initiative (CAHMI). National Survey of Children with Special Health Care Needs (NS-CSHCN), 2009-2010: Guide to Topics & Questions Asked. Available at: www.childhealthdata.org/learn/topics_questions. Accessed July 27, 2014.

        View in Article

      27. Centers for Disease Control and Prevention. Autism Spectrum Disorder (ASD). Data & Statistics. Available at: http://www.cdc.gov/ncbddd/autism/data.html. Accessed May 22, 2014.

        View in Article
        • Savage M.F.
        • Lee J.Y.
        • Kotch J.B.
        • Vann Jr., W.F.
        Early preventive dental visits: effects on subsequent utilization and costs.
        Pediatrics. 2004; 114: e418-e423
        View in Article

      29. Health and Human Services. Visits to a dentist during the past year among those aged 2 years and older. Available at: http://drc.hhs.gov/report/dqs_tables/pdf/4.pdf. Accessed May 28, 2014.

        View in Article

      30. Data Resource Center for Child & Adolescent Health. 2009–2010 National Survey of Children with Special Health Care Needs. Available at: http://www.cdc.gov/nchs/data/slaits/NS_CSHCN_Questionnaire_09_10.pdf. Accessed May 21, 2014.

        View in Article
        • CAHMI - The Child and Adolescent Health Measurement Initiative
        Measuring Medical Home for Children and Youth: Methods and Findings from the National Survey of Children with Special Health Care Needs and the National Survey of Children's Health.
        Oregon Health Sciences University, 2009
        View in Article
      32. Policy statement: organizational principles to guide and define the child health care system and/or improve the health of all children.
        Pediatrics. 2004; 113: 1545-1547
        View in Article
        • American Academy on Pediatric Dentistry Council on Clinical Affairs
        Policy on the dental home.
        Pediatr Dent. 2008; 30: 22-23
        View in Article
        • Hale K.J.
        Oral health risk assessment timing and establishment of the dental home.
        Pediatrics. 2003; 111: 1113-1116
        View in Article
        • dela Cruz G.G.
        • Rozier R.G.
        • Slade G.
        Dental screening and referral of young children by pediatric primary care providers.
        Pediatrics. 2004; 114: e642-e652
        View in Article
        • Rozier R.G.
        • Stearns S.C.
        • Pahel B.T.
        • et al.
        How a North Carolina program boosted preventive oral health services for low-income children.
        Health Aff (Millwood). 2010; 29: 2278-2285
        View in Article

      37. Pew Charitable Trusts. Reimbursing Physicians for Fluoride Varnish. Available at: http://www.pewstates.org/research/analysis/reimbursing-physicians-for-fluoride-varnish-85899377335. Accessed February 23, 2014.

        View in Article
        • Al Agili D.E.
        • Bronstein J.M.
        • Greene-McIntyre M.
        Access and utilization of dental services by Alabama Medicaid-enrolled children: a parent perspective.
        Pediatr Dent. 2005; 27: 414-421
        View in Article
        • Raposa K.A.
        Behavioral management for patients with intellectual and developmental disorders.
        Dent Clin North Am. 2009; 53: 359-373, xi
        View in Article
        • American Psychiatric Association
        Diagnostic and Statistical Manual of Mental Disorders.
        5th ed. American Psychiatric Publishing, Arlington, Va2013
        View in Article

      Article Info

      Publication History

      Accepted: June 28, 2014
      Received: March 6, 2014

      Footnotes

      The authors have no conflicts of interest to disclose.

      Identification

      DOI: https://doi.org/10.1016/j.acap.2014.06.023

      Copyright

      © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

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