Access to dental care among people with intellectual disabilities

Poor oral health often has significant impacts on quality of life – including pain, decreased communication ability or low self-esteem – all of which may reduce community inclusion, a central policy goal for people with intellectual disabilities (ID). While best practices for the provision of dental care to this population are well-documented, little is known about their access to and utilization of care. Dental coverage is vital for this population given an increased prevalence of dental problems – and their higher likelihood of having government-funded insurance that has increasingly eliminated dental coverage. Drawing on Aday and Andersen's conceptualization of access to health care, this study considers both the potential for and actual use of dental care services. Using nationally-representative data from the 2000-2002 Medical Expenditure Panel Survey, a sample of adults aged 18-64 with ID (N=495) and a comparison group without ID (N=29,661) were identified. Age-adjusted logistic regression analysis was used to assess the likelihood of access to and utilization of dental care. People with ID were 83% less likely to have dental coverage (OR=0.17***) and 45% less likely to have had a dental visit in the previous year (OR=0.55***) but were equally likely to have seen an orthodontist. Despite equal access to dental coverage, women with ID were 33% less likely than their male counterparts to have a past-year dental visit (OR=0.67*). Evidence of disparities in access to and utilization of dental care for people with ID, especially among women, suggests the need for cross-system collaboration to improve service delivery pathways.