Access to preventive dental care by Midwest children with special health care needs

Approximately 14% of all children in the United States have special health care needs. Children with special health care needs (CSHCN) are often at greater risk for dental problems. Previous studies have identified dental care as a primary unmet health care need among this group. Little is known about the impact of rural residence on the level of unmet oral health care needs among CSHCN. Therefore, CSHCN in rural areas may face a greater risk for oral health neglect. We analyzed data from the 2005-2006 National Survey of CSHCN by using a sample of 39364 CSHCN aged 2 to 17 years. Independent random samples were taken in all 50 states and the District of Columbia by a national telephone survey. A multilevel stepwise logistic regression analysis was conducted to analyze the level of unmet oral healthcare needs. The average age for the selected subpopulation was 11.56 years (SD=3.7). Ninety percent (90%) of respondents (n=6951 of 7700) needed preventive dental care including checkups, but only 40% of respondents (n=176 of 435) actually received care. The multilevel stepwise logistic regression result indicated three variables were the main barriers to access: children refused to go (p-value=0.0144), age (p-value=0.0355), inside or outside metropolitan statistical area (MSA) (p-value=0.0141). There was no significant difference among the states in the Midwest. Primary barriers for Midwest CSHCN differ from the national level. Health policy to improve access should address these regional concerns along with national needs.