Perceived Unmet Dental Needs: CSHCN in States with Appalachian Counties

Objectives: Although Appalachian children without special needs exhibit high rates of dental disease, surveillance oral health data concerning Children with Special Health Care Needs (CSHCN) in states containing Appalachian counties is limited   A national survey of parents/guardians of CSHCN was conducted in 2001 and again in 2005-2006.  The purpose of this study was to compare prevalences of parent/guardian reported perceived unmet dental need among CSHCN in 2005-2006 with the 2001 epidemiological data in states containing Appalachian counties. 

Methods: Data were analyzed for 10,434 Appalachian CSHCN from the 2005-2006 and 7,637 children in 2001 utilizing the National Survey of Children with Special Health Care Needs.  Parents/guardians were asked if their child needed dental care within the previous year.  Of those who reported a dental need, the question, “Did [child] receive all the dental care that he/she needed?” was posed.  Prevalences of perceived unmet dental needs were assessed utilizing multivariate data analysis.

Results: Nationally, 10.4% (95% CI: 9.6, 11.1) of parents/guardians reported CSHCN had unmet dental need in 2001.  In 2005-2006, the percentage was 2.6% (95% CI: 2.3, 2.8).  In states containing Appalachian counties, 8.47% (95% CI: 8.05, 8.89) of parents/guardians reported CSHCN had unmet dental need in 2001.  In 2005-2006, the percentage was 2.2% (95% CI: 1.7, 2.5).  The results indicate a significant decrease in parent/guardian perceived unmet dental need in 2005-2006.

Conclusions: CSHCN comprise a group with a potential for greater dental needs and risks.  Overall, there has been a significant national parent/guardian change in perception of unmet dental need for CSHCN and a similar significant change in perception in states containing Appalachian counties between 2001 and 2005-2006.  Further research is needed to determine the correspondence with actual clinical assessment of treatment needs.