Top

BMC Oral Health

Published in:

Open Access 01-12-2023 | Care | Research

Disparity in access for people with disabilities to outpatient dental care services: a retrospective cohort study

Authors: Bo-Young Park, Han-A Cho, Hosung Shin

Published in: BMC Oral Health | Issue 1/2023

Abstract

Background

People with disabilities face difficulties in oral health management and gaining access to dental care. The availability of a regular source of dental care (RSDC) is an important factor that influences the access to health services and care management. The purpose of this study was to determine the effect of the availability of RSDC on the number of annual dental visits and dental expenses per visit among people with disabilities.

Methods

Data of 7,896,251 patients with dental problems in South Korea were analyzed using the 2002–2018 National Health Insurance claims data. A generalized estimating equation was applied to analyze the repeated-measurement data, and the interaction effect between RSDC and the disability severity was evaluated.

Results

The number of annual dental visits was higher among people with (2.62) than among those without (2.23) disabilities. Despite their increased dental needs, both annual dental visits and dental expenses per visit were low among older individuals (p < 0.001). The proportion and frequency of annual dental visits was lower among women than among men with disabilities. RSDC had differential effects on the severity of disability. Compared to people without disabilities, RSDC increased the number of annual dental visits (p = 0.067) and the dental expenses per visit (p < 0.05) among those with severe disabilities, but the effect on the number of annual dental visits was not significant among those with mild disabilities (p = 0.698).

Conclusions

Our results suggest a need for a special dental care system for people with disabilities, to ensure an RSDC, particularly for women and for older people with disabilities.

Hansen C, Curl C, Geddis-Regan A. Barriers to the provision of oral health care for people with disabilities. BDJ In Pract. 2021;34:30–4. https://doi.org/10.1038/s41404-021-0675-x.CrossRef

Maltais J, Morin D, Tassé MJ. Healthcare services utilization among people with intellectual disability and comparison with the general population. J Appl Res Intellect Disabil. 2020;33:552–64. https://doi.org/10.1111/jar.12698.CrossRefPubMed

Rouleau T, Harrington A, Brennan M, Hammond F, Hirsch M, Nussbaum M, et al. Receipt of dental care and barriers encountered by persons with disabilities. Spec Care Dentist. 2011;31:63–7. https://doi.org/10.1111/j.1754-4505.2011.00178.x.CrossRefPubMed

Lee JY, Lim KC, Kim SY, Paik HR, Kim YJ, Jin BH. Oral health status of the disabled compared with that of the non-disabled in Korea: a propensity score matching analysis. PLoS One. 2019;14:e0208246. https://doi.org/10.1371/journal.pone.0208246.CrossRefPubMedPubMedCentral

Health Promotion Administration, Huang ST. National survey of oral health status for people with disabilities and oral hygiene education promotion in Taiwan. HPA Website. 2006. http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=200811210006&parentid=200811100002. Accessed 2 Aug 2022.

Petrovic BB, Peric TO, Markovic DLJ, Bajkin BB, Petrovic D, Blagojevic DB, et al. Unmet oral health needs among persons with intellectual disability. Res Dev Disabil. 2016;59:370–7. https://doi.org/10.1016/j.ridd.2016.09.020.CrossRefPubMed

Costa IM, Maciel SM, Cavalcanti AL. Access to dental services and reasons of demand for service for elderly patients in Campina Grande – PB. Odontol Clín-Cient. 2008;7:331–3.

Gambhir RS, Brar P, Singh G, Sofat A, Kakar H. Utilization of dental care: an Indian outlook. J Nat Sci Biol Med. 2013;4:292–7. https://doi.org/10.4103/0976-9668.116972.CrossRefPubMedPubMedCentral

Aday LA, Andersen R. A framework for the study of access to medical care. Health Serv Res. 1974;9:208–20.PubMedPubMedCentral

10.

Grembowski D, Spiekerman C, Milgrom P. Racial and ethnic differences in a regular source of dental care and the oral health, behaviors, beliefs and services of low-income mothers. Community Dent Health. 2009;26:69–76.PubMedPubMedCentral

11.

Skaret E, Milgrom P, Raadal M, Grembowski D. Factors influencing whether low-income mothers have a usual source of dental care. ASDC J Dent Child. 2001;68(136–9):142.PubMed

12.

Patrick DL, Lee RS, Nucci M, Grembowski D, Jolles CZ, Milgrom P. Reducing oral health disparities: a focus on social and cultural determinants. BMC Oral Health. 2006;6 Suppl 1(Suppl 1):4. https://doi.org/10.1186/1472-6831-6-S1-S4.CrossRef

13.

Mofidi M, Rozier RG, King RS. Problems with access to dental care for Medicaid-insured children: what caregivers think. Am J Public Health. 2002;92:53–8. https://doi.org/10.2105/ajph.92.1.53.CrossRefPubMedPubMedCentral

14.

Grembowski D, Spiekerman C, Milgrom P. Disparities in regular source of dental care among mothers of medicaid-enrolled preschool children. J Health Care Poor Underserved. 2007;18:789–813. https://doi.org/10.1353/hpu.2007.0096.CrossRefPubMedPubMedCentral

15.

Kim JH, Cho HJ. Effects of having regular source of care on preventive services and disease control. Korean J Fam Med. 2007;28:278–85.

16.

Park SH, Kim HJ, Jeong JY, Hong MJ, Kim NY. Comparative analysis of accessibility for dental care utilization of people with disabilities. Korean Public Heal Res. 2021;47:33–45.

17.

MacarevichCondessa A, Pilotto LM, Celeste RK, Hilgert JB. Use of dental services by disability status in Brazil in 2013. Community Dent Oral Epidemiol. 2021;49:471–7. https://doi.org/10.1111/cdoe.12623.CrossRef

18.

Havercamp SM, Scott HM. National health surveillance of adults with disabilities, adults with intellectual and developmental disabilities, and adults with no disabilities. Disabil Health J. 2015;8:165–72. https://doi.org/10.1016/j.dhjo.2014.11.002.CrossRefPubMed

19.

CheolSeong S, Kim YY, Khang YH, Heon Park J, Kang HJ, Lee H, et al. Data resource profile: the National Health Information database of the National Health Insurance Service in South Korea. Int J Epidemiol. 2017;46:799–800. https://doi.org/10.1093/ije/dyw253.CrossRef

20.

Lopez Silva CP, Singh A, Calache H, Derbi HA, Borromeo GL. Association between disability status and dental attendance in Australia-A population-based study. Community Dent Oral Epidemiol. 2021;49:33–9. https://doi.org/10.1111/cdoe.12571.CrossRefPubMed

21.

Ballinger GA. Using generalized estimating equations for longitudinal data analysis. Organ Res Methods. 2004;7:127–50. https://doi.org/10.1177/1094428104263672.CrossRef

22.

Shin HS, Cho HA. Spatial barriers and the bypassing of nearby dental clinics for dental services: A secondary data analysis in Korea. BMJ Open. 2019;9:e024116. https://doi.org/10.1136/bmjopen-2018-024116.CrossRefPubMedPubMedCentral

23.

Zeger SL, Liang KY, Albert PS. Models for longitudinal data: A generalized estimating equation approach. Biometrics. 1988;44:1049–60.CrossRefPubMed

24.

Bunn AG. A dendrochronology program library in R (dplR). Dendrochronologia. 2008;26:115–24. https://doi.org/10.1016/j.dendro.2008.01.002.CrossRef

25.

Ishaque MY, Rahim S, Hussain MH. Factors that limit access to dental care for person with disabilities. Pak Armed Forces Med J. 2016;66:230–4.

26.

Lin PY, Wang KW, Tu YK, Chen HM, Chi LY, Lin CP. Dental service use among patients with specific disabilities: A nationwide population-based study. J Formos Med Assoc. 2016;115:867–75. https://doi.org/10.1016/j.jfma.2015.09.007.CrossRefPubMed

27.

Sakellariou D, Rotarou ES. Access to healthcare for men and women with disabilities in the UK: Secondary analysis of cross-sectional data. BMJ Open. 2017;7:e016614. https://doi.org/10.1136/bmjopen-2017-016614.CrossRefPubMedPubMedCentral

28.

Moodley J, Graham L. The importance of intersectionality in disability and gender studies. Agenda. 2015;29:24–33. https://doi.org/10.1080/10130950.2015.1041802.CrossRef

29.

Choi KH, Kim M, Choi YJ, Cho YM, Kim MS, Jeong EH, et al. Current status of unmet health care needs in the disabled in Korea. Korea Open Access J. 2021;41:160–76.

30.

Jang SN, Kawachi I. Care inequality: Care received according to gender, marital status, and socioeconomic status among Korean older adults with disability. Int J Equity Health. 2019;18:105. https://doi.org/10.1186/s12939-019-1008-0.CrossRefPubMedPubMedCentral

31.

Katz SJ, Kabeto M, Langa KM. Gender disparities in the receipt of home care for elderly people with disability in the United States. JAMA. 2000;284:3022–7. https://doi.org/10.1001/jama.284.23.3022.CrossRefPubMed

32.

Manski RJ, Hyde JS, Chen H, Moeller JF. Differences among older adults in the types of dental services used in the United States. Inquiry. 2016;53:0046958016652523. https://doi.org/10.1177/0046958016652523.CrossRefPubMedPubMedCentral

33.

Kang HK. A study on the relationship between physical activity, mental health, oral health and quality of life according to chewing difficulty. Korean Soc Oral Health Sci. 2019;7:1–8.CrossRef

34.

Liu HY, Chen JH, Hsu KJ, Yao CT, Chen PH, Hsiao SY, et al. Decreased tongue pressure associated with aging, chewing and swallowing difficulties of community-dwelling older adults in Taiwan. J Pers Med. 2021;11:1–15. https://doi.org/10.3390/jpm11070653.CrossRef

35.

Johansson AK, Johansson A, Unell L, Ekbäck G, Ordell S, Carlsson GE. Self-reported dry mouth in 50- to 80-year-old swedes: Longitudinal and cross-sectional population studies. J Oral Rehabil. 2020;47:246–54. https://doi.org/10.1111/joor.12878.CrossRefPubMed

36.

Cho HA, Shin HS. Dental care utilization patterns by the status of ADL and IADL in the elderly. J Korean Acad Oral Health. 2015;39:102–9. https://doi.org/10.11149/jkaoh.2015.39.2.102.CrossRef

37.

Jung ES, Ahn GS. Relationship between demographic and socioeconomic characteristics of the Korean elderly and unmet dental care needs. Korean Society of Dental Hygiene. 2018;18:911–31. https://doi.org/10.13065/jksdh.20180078.CrossRef

38.

Kaye EK, Valencia A, Baba N, Spiro A 3rd, Dietrich T, Garcia RI. Tooth loss and periodontal disease predict poor cognitive function in older men. J Am Geriatr Soc. 2010;58:713–8. https://doi.org/10.1111/j.1532-5415.2010.02788.x.CrossRefPubMedPubMedCentral

39.

Shin HS, Shin MS, Ahn YB, Choi BY, Nam JH, Kim HD. Periodontitis is associated with cognitive impairment in elderly Koreans: Results from the Yangpyeong cohort study. J Am Geriatr Soc. 2016;64:162–7. https://doi.org/10.1111/jgs.13781.CrossRefPubMed

40.

Taniguchi-Tabata A, Ekuni D, Mizutani S, Yamane-Takeuchi M, Kataoka K, Azuma T, et al. Associations between dental knowledge, source of dental knowledge and Oral Health behavior in Japanese university students: A cross-sectional study. PLOS ONE. 2017;12:e0179298. https://doi.org/10.1371/journal.pone.0179298.CrossRefPubMedPubMedCentral

41.

Langevin SM, Michaud DS, Eliot M, Peters ES, McClean MD, Kelsey KT. Regular dental visits are associated with earlier stage at diagnosis for oral and pharyngeal cancer. Cancer Causes Control. 2012;23:1821–9. https://doi.org/10.1007/s10552-012-0061-4.CrossRefPubMedPubMedCentral

42.

Spalthoff S, Holtmann H, Krüskemper G, Zimmerer R, Handschel J, Gellrich NC, et al. Regular dental visits: Influence on health-related quality of life in 1,607 patients with oral squamous cell carcinoma. Int J Dent. 2017;2017:9638345. https://doi.org/10.1155/2017/9638345.CrossRefPubMedPubMedCentral

43.

Iwasaki M, Usui M, Ariyoshi W, Nakashima K, Nagai-Yoshioka Y, Inoue M, et al. Interruption of regular dental visits during the COVID-19 pandemic due to concerns regarding dental visits was associated with periodontitis in Japanese office workers. J Periodont Res. 2021;56:1091–8. https://doi.org/10.1111/jre.12923.CrossRef

44.

Tomioka K, Kurumatani N, Saeki K. Regular dental visits may prevent severe functional disability: A community-based prospective study. Arch Gerontol Geriatr. 2020;88:104019. https://doi.org/10.1016/j.archger.2020.104019.CrossRefPubMed

45.

AL-Shehri SA. Access to dental care for persons with disabilities in Saudi Arabia (Caregivers’ perspective). J Disabil Oral Health. 2012;13:51. https://doi.org/10.4483/JDOH_006AL-shehri11.CrossRef

46.

Edwards DM, Merry AJ. Disability part 2: access to dental services for disabled people. A questionnaire survey of dental practices in Merseyside. Br Dent J. 2002;193:253–5. https://doi.org/10.1038/sj.bdj.4801538.CrossRefPubMed

47.

D’Addazio G, Santilli M, Sinjari B, Xhajanka E, Rexhepi I, Mangifesta R, et al. Access to dental care- a survey from dentists, people with disabilities and caregivers. Int J Environ Res Public Health. 2021;18:1556. https://doi.org/10.3390/ijerph18041556.CrossRefPubMedPubMedCentral

48.

Olivier R, Thibault D, Stéphane V, Aline D, Camille I, Jean V, et al. Oral care in facilities for disabled people: interest of teledentistry. Dent Oral Maxillofac Res. 2019;5:1–4. https://doi.org/10.15761/DOMR.1000303.CrossRef

49.

Sinjari B, Rexhepi I, Santilli M, D′Addazio G, Chiacchiaretta P, Di Carlo P, et al. The impact of COVID-19 related lockdown on dental practice in central Italy- outcomes of a survey. Int J Environ Res Public Health. 2020;17:5780. https://doi.org/10.3390/ijerph17165780.CrossRefPubMedPubMedCentral

50.

Aquilanti L, Santarelli A, Mascitti M, Procaccini M, Rappelli G. Dental care access and the elderly: what is the role of teledentistry? A systematic review. Int J Environ Res Public Health. 2020;17:9053. https://doi.org/10.3390/ijerph17239053.CrossRefPubMedPubMedCentral

Title: Disparity in access for people with disabilities to outpatient dental care services: a retrospective cohort study
Authors: Bo-Young Park
Han-A Cho
Hosung Shin
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Care
Published in: BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-023-02948-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Disparity in access for people with disabilities to outpatient dental care services: a retrospective cohort study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2023

A population-based study to assess two convolutional neural networks for dental age estimation

Oral healthcare seeking behavior of Malaysian adults in urban and rural areas: findings from the National Health and Morbidity Survey 2019

The combined effect of pit and fissure sealant application and oral health education on oral health status of children aged 6–9 years: a 12-month follow-up study in Northeast China

Identification of a novel PTH1R variant in a family with primary failure of eruption

Three-dimensional relationships between condylar volume and dentoskeletal characteristics in Class II hyperdivergent female adults

Influence of buccal and palatal bone thickness on post-surgical marginal bone changes around implants placed in posterior maxilla: a multi-centre prospective study