title: Factors that limit access to dental care for adults with spinal cord injury.
abstract: This study investigated dental care service utilization among adults with spinal cord injury (SCI) and identified barriers and other factors affecting utilization among this population. There were 192 subjects with SCI who participated in the oral health survey assessing dental care service utilization and they were compared with subjects from the 2004 Behavioral Risk Factors Surveillance System (BRFSS). There was no significant difference in the proportion of subjects with SCI who visited the dentist for any reason in the past year compared to the general population (65.5% vs. 68.8%, p= .350). However, subjects with SCI were less likely to go to the dentist for a dental cleaning in the past year compared to the general population (54.6% vs. 69.4%, p < .001). The three most commonly reported barriers to accessing dental care were cost (40.1%), physical barriers (22.9%), and dental fear (15.1%). Multivariate modeling showed that physical barriers and fear of dental visits were the two significant factors deterring subjects from dental visits in the past year. Physical barriers preventing access to dental facilities and dental fear are prevalent and significantly impede the delivery of dental health care to adults with SCI. Dentists should undertake necessary physical remodeling of their facilities to accommodate wheelchair users and implement appropriate strategies for the management of dental fear among patients with SCI.
authors.affiliation: Occupational Therapy Division, Department of Health Professions, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina, USA. yuen@musc.edu
authors.forename: Hon K
authors.initials: HK
authors.lastname: Yuen
authors.forename: Bethany J
authors.initials: BJ
authors.lastname: Wolf
authors.forename: Dipankar
authors.initials: D
authors.lastname: Bandyopadhyay
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Magruder
authors.forename: Anbesaw W
authors.initials: AW
authors.lastname: Selassie
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Salinas
mesh_terms: D000328:Adult; D001107:Architectural Accessibility; D001294:Attitude to Health; D040343:Behavioral Risk Factor Surveillance System; D016854:Dental Anxiety / Q000523:psychology; D003730:Dental Care for Persons with Disabilities / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data; D003777:Dental Prophylaxis / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data; D004522:Educational Status; D004651:Employment; D005260:Female; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D007347:Insurance, Dental; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D020380:Needs Assessment; D010264:Paraplegia / Q000503:physiopathology; D011782:Quadriplegia / Q000503:physiopathology; D012649:Self Concept; D012737:Sex Factors; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D014099:Toothbrushing; D014481:United States; D014910:Wheelchairs; D044465:White People