title: Predictors of unmet dental need in children with autism spectrum disorder: results from a national sample.
abstract: OBJECTIVE
  Unmet dental need in children with autism spectrum disorder (ASD) is common. We tested hypotheses that lacking a medical home or having characteristics of more severe ASD is positively associated with having unmet dental need among children with ASD.
  
  
  METHODS
  Using data from the 2009 to 2010 National Survey of Children with Special Health Care Needs, we analyzed 2772 children 5 to 17 years old with ASD. We theorized that unmet dental need would be positively associated with not having a medical home and having characteristics of more severe ASD (eg, parent reported severe ASD, an intellectual disability, communication, or behavior difficulties). Prevalence of unmet dental need was estimated, and unadjusted and adjusted odds ratios, 95% confidence intervals, and P values were computed using survey methods for logistic regression.
  
  
  RESULTS
  Nationally, 15.1% of children with ASD had unmet dental need. Among children with ASD, those without a medical home were more apt to have unmet dental need than those with a medical home (adjusted odds ratio, 4.46; 95% confidence interval, 2.59-7.69). Children with ASD with intellectual disability or greater communication or behavioral difficulties had greater odds of unmet dental need than those with ASD without these characteristics. Parent-reported ASD severity was not associated with unmet dental need.
  
  
  CONCLUSIONS
  Children with ASD without a medical home and with characteristics suggestive of increased ASD-related difficulties were more apt to have unmet dental need. Pediatricians might use these findings to aid in identifying children with ASD who might not receive all needed dental care.
authors.affiliation: Department of Oral Health Sciences, University of Washington, Seattle, Wash. Electronic address: chrismck@uw.edu.
authors.forename: Christy M
authors.initials: CM
authors.lastname: McKinney
authors.affiliation: Department of Pediatric Dentistry, University of Washington, Seattle, Wash.
authors.forename: Travis
authors.initials: T
authors.lastname: Nelson
authors.affiliation: Department of Pediatric Dentistry, University of Washington, Seattle, Wash.
authors.forename: JoAnna M
authors.initials: JM
authors.lastname: Scott
authors.affiliation: Department of Oral Health Sciences, University of Washington, Seattle, Wash.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Heaton
authors.affiliation: Department of Health Services, University of Washington, Seattle, Wash.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Vaughn
authors.affiliation: Department of Pediatrics, University of Washington, Seattle, Wash.
authors.forename: Charlotte W
authors.initials: CW
authors.lastname: Lewis
mesh_terms: D000293:Adolescent; D000067877:Autism Spectrum Disorder; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children; D003730:Dental Care for Persons with Disabilities; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D014481:United States
keywords: austim spectrum disorder; autism; autistic disorder; dental; medical home; oral health; unmet need