Abstract
OBJECTIVES: To determine factors associated with access to dental services of community-dwelling adults with physical disabilities in Thailand.METHODS: This cross-sectional study was conducted at the Center of Independent Living, community club for individuals with disabilities in Pathum Thani province, Thailand, in February 2018. Individual participants were interviewed by a trained interviewer using a structured questionnaire that consisted of (1) questions on demographic characteristics and (2) adapted questions that were based on the modified Penchansky and Thomas’s dimensions of access (accessibility, availability, acceptability, affordability, accommodation and awareness). Enter method of binary logistic regression analysis was used.RESULTS: We included 198 individuals with physical disabilities. Most participants had not attended dental care services in the previous 12 months (77.3%) and gave negative responses for all questions regarding the dimensions of access. Although we did not observe any statistically significant differences in age and the six dimensions of access between participants who had attended at least one dental appointment and those who had not, in multivariate analysis, we found a statistically significant association indicated that participants who had education < primary were 3.35 times more likely to had not attended at least one dental appointment (p = 0.002).CONCLUSION: Our findings have uncovered factors associated with access to dental services of community-dwelling adults with physical disabilities in Thailand. Individuals with physical disabilities are in need of oral health education programs regarding proper oral health behaviors such as regular dental services attendance, appropriate oral hygiene practices and dental care benefits.
Highlights
According to the 2012 national survey report of disability from the National Statistical Office of Thailand (NSO), (NSO, 2012) indicated that there are 1.5 million Thai individuals with disabilities, comprising an estimated 2.2% of the total Thai population
We did not observe any statistically significant differences in age and the six dimensions of access between participants who had attended at least one dental appointment and those who had not, in multivariate analysis, we found a statistically significant association indicated that participants who had education < primary were 3.35 times more likely to had not attended at least one dental appointment (p = 0.002)
Individuals with physical disabilities are in need of oral health education programs regarding proper oral health behaviors such as regular dental services attendance, appropriate oral hygiene practices and dental care benefits
Summary
According to the 2012 national survey report of disability from the National Statistical Office of Thailand (NSO), (NSO, 2012) indicated that there are 1.5 million Thai individuals with disabilities, comprising an estimated 2.2% of the total Thai population. Previous studies (Chimruang & Sermsuti-anuwat, 2012; Kothari et al, 2017; Pan et al, 2017; Rashid-Kandvani, Nicolau, & Bedos, 2015; Yuen et al, 2010) have reported that individuals with disabilities experience poorer oral health than individuals without disabilities, presenting with a greater number of dental cavities and increased risk of periodontal diseases. Good oral health is a basic human right, and disabled individuals are inclined to preserve their natural teeth for the same reasons as individuals without disabilities, including enjoyable eating, improved physical appearance, enhanced self-confidence, increased social acceptance, general well-being, and good quality of life (Dougall & Fiske, 2008; Pan et al, 2017). All individuals should have access healthcare systems and oral healthcare services of an equal quality to achieve equitable outcomes (Dougall & Fiske, 2008; Rashid-Kandvani et al, 2015)
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