230 - Parent-Perceived Oral Health Status among Children with Special Health Care Needs: A Cross-Sectional Study

Publication Number: 3222.230

Amy J. Lin, Harvard School of Dental Medicine, Boston, MA, United States; Elizabeth Alpert, Harvard School of Dental Medicine, Melrose, MA, United States; Kathe Fox, Harvard Medical School, Verona, NJ, United States; Fan Bi, Harvard School of Dental Medicine, Jersey City, NJ, United States; jane barrow, Harvard School of Dental Medicine, Wayland, MA, United States; Inyang Isong, Boston Children's Hospital, Boston, MA, United States

Background: Children with special healthcare needs (SHCN) and developmental disorders (DD) experience higher oral disease burdens compared to their peers without SHCN or DD. Yet, these children are generally as likely, or even more likely, to have a dental visit. As parents play critical roles in identifying and triaging children's oral health (OH) care needs, perception of OH status and needs may influence utilization patterns.

Objective: To identify factors influencing the relationship between parental oral health (OH) perception and their child's SHCN and DD status.

Design/Methods: We examined the relationship between parents' perception of their child's OH and the child's SHCN status, specifically investigating whether dental visits or parent-reported dental problems influenced this relationship. As many nuances exist when defining SHCN, a secondary aim was to assess adjacent categorizations, such as DD. We analyzed pooled (2016-2022) data from the National Survey of Children's Health. Study population included 212,464 children, divided into 4 subgroups: children without SHCN and without DD (SHCN-/DD-), children with SHCN and without DD (SHCN+/DD-), children with DD and without SHCN (SHCN-/DD+), children with SHCN and with DD (SHCN+/DD+). The main outcome was parent-reported OH status. Exposure was SHCN/DD status. Effect modifiers included past-year dental visits and parent-reported dental problems.

Results: Children in the SCHN+/DD+ subgroup were more likely to have a dental visit than SHCN-/DD- peers (86% vs. 81%, P< 0.001), and more likely to have worse parent-perceived OH (12% vs. 2%, P< 0.001). A past-year dental visit was associated with decreased odds of worse perceived OH, compared to no dental visit for the SHCN+/DD+ subgroup (OR 1.97 (1.47, 2.65) vs. OR 3.58 (2.48, 5.17)). Results considering parent-reported dental problems varied depending on classification of SHCN and/or DD status.

Conclusion(s): Regardless of dental utilization, parents of children with either SHCN+ or DD+ classification were more likely to perceive their child's OH status as worse compared to parents of SHCN-/DD- peers. This was most pronounced for the most complex subgroup (SHCN+/DD+). The relationship between SHCN/DD status and perceived fair/poor OH is pronounced in the absence of dental care. Findings imply that disparities in OH for children with SHCN or DD may reflect challenges in care suitability and continuity, not simply access. This emphasizes the importance of establishing a dental home, which promotes coordinated, patient-centered care and continuity of services.

Table 1
Association between SHCN/DD status and parent/caregiver-perceived oral health status, stratified by dental visit.

Table 2
Association between SHCN/DD status and parent/caregiver-perceived oral health status, stratified by reported dental problems.

Figure 1
Forest plots showing adjusted logistic regression model results.