Dental care needs, use and expenditures among U.S. children with and without special health care needs.
BACKGROUND
Controversy exists in the literature about whether dental care needs, use and expenditures differ between children with and without special health care needs (SHCN).


METHODS
The authors used data from the 2005 Medical Expenditure Panel Survey (MEPS) for children younger than 18 years. The MEPS questionnaire included the Children with Special Health Care Needs Screener, which defines a child as having SHCN if he or she meets at least one of five specific criteria. Using bivariate and multivariable regression analyses, the authors evaluated the effect of SHCN on unmet dental care needs, type of dental care received and average dental care expenditures.


RESULTS
Children with special health care needs (CSHCN) had an adjusted odds ratio (AOR) of 1.49 (95 percent confidence interval [CI] = 1.09-2.05) of having unmet dental care needs compared with children without SHCN, and CSHCN who met four or five screener criteria had an AOR of 2.2 (95 percent CI = 1.16-4.20). CSHCN used more dental care services and were more likely to receive only nonpreventive care. Average dental care expenditures were not statistically different between CSHCN and children without SHCN, and there was variability among CSHCN in unmet dental care needs and use.


CONCLUSIONS
Unmet dental care needs are associated independently with SHCN status and complexity (based on the number of screener criteria the child met). The CSHCN populations in MEPS varied in their ability to obtain and use needed dental care services. Practice Implications. It is important to consider the diversity of CSHCN when developing systems of dental care for this population.
Iida
Hiroko
H
Department of Epidemiology, Child Health Institute, University of Washington, Seattle, Washington. 98195-492, USA. iidah@u.washington.edu
Lewis
Charlotte
C
Zhou
Chuan
C
Novak
Louise
L
Grembowski
David
D
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children / Q000191:economics / Q000706:statistics & numerical data*; D003730:Dental Care for Persons with Disabilities / Q000191:economics / Q000706:statistics & numerical data*; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures; D006301:Health Services Needs and Demand / Q000191:economics*; D006801:Humans; D008962:Models, Theoretical; D020380:Needs Assessment; D011313:Preventive Dentistry / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States