Provision of dental services for vulnerable groups: a scoping review on children with special health care needs

Peivand Bastani,Marco A Peres,Giampiero Rossi-Fedele,Arash Ghanbarzadegan,Mohammadtaghi Mohammadpour

doi:10.1186/s12913-021-07293-4

Abstract

BackgroundThe provision of dental services for children with special health care needs (CSHCN) needs to be considered by policymakers. This study is aimed to explore the determinant factors affecting dental and oral services provision for this vulnerable group.MethodsA review was conducted applying the 9-steps approach. Five scientific databases of PUBMED, SCOPUS, Web of Science and PROQUEST and EMBASE were searched up to 10.07.2021, applying appropriate keywords. Thematic analysis was used to analyse the extracted data, and a conceptual map was developed according to JBI manual for evidence synthesis.ResultsFrom the abstracts of the 136 articles that fulfilled the inclusion criteria, 56 articles were included. Five main themes were identified as determinants affecting the provision of dentistry services for CSHCN, including needs assessment, policy advice, oral health interventions, providers’ perception and access barriers. According to the developed conceptual map, assessing the needs of CSHCN can lead to particular policy advice. Regarding the policies, appropriate oral health interventions can be presented. These interventions, along with providers’ perception about service delivery to CSHCN and the barriers to access them, determine the provision of dentistry services for CSHCN.ConclusionsAn effective needs assessment of CSHCN and their parents/carers can lead to evidence-informed policymaking and applicable policy advice according to the needs. Then policymakers should develop interventions to improve the community’s health literacy, as well as support the seeking behaviours for appropriate services. Policymakers should also consider how to limit the barriers to accessing oral and dental health by CSHCN to decrease disparities.

Highlights

People with special health care needs (SHCN) are defined as those having long-term physical, behavioural, emotional and developmental conditions that require attention and health care [1]
15.1% of American children had special health care needs [4]. This can directly cause a financial burden for those families with children with special health care needs (CSHCN) because of their healthcare expenditures [5]
Findings show that the critical oral health need assessment of the children with special needs can be considered as a start point of the conceptual map of providing dental services

Summary

Introduction

People with special health care needs (SHCN) are defined as those having long-term physical, behavioural, emotional and developmental conditions that require attention and health care [1]. Based on the World Health Organization’s report on disability, the estimated population of Children with Special Health Care Needs (CSHCN) among 14-year-old and younger individuals with “moderate or severe disability” and “severe disability” were 93 million and 13 million, respectively as the prevalence of disability for them were 5.1 and 0.7% in 2004 [3]. This prevalence was reported by the U.S Department of Health and Human Services in 2009–2010. This study is aimed to explore the determinant factors affecting dental and oral services provision for this vulnerable group

Objectives

Results

Discussion

Conclusion