Oral Health Needs and Barriers to Care in Children with Learning Difficulties

@#Introduction: Children with learning difficulties (LD) have poorer oral health compared to those without LD due to barriers in maintaining oral care. However, the scarcity of data for this population in Malaysia has left a huge gap in understanding their problems and how to overcome those barriers. Therefore, this study was conducted to evaluate the unmet dental needs and barriers to care perceived by the guardians of children with learning difficulties (CWLD) attending the Special Education Integrated Programmes of a mainstream primary school, in comparison to children without learning difficulties. Methods: This cross-sectional study surveyed the guardians of CWLD (case) and those without LD (control), aged 6-12 years old. A total of 225 questionnaires were distributed to the guardians with a response rate of 40.4% (N=91). Unmet dental needs and barriers in both groups were analysed using the chi-square test. Barriers with significant Chi-square results were further tested with logistic regression to investigate possible confounders. Results: Unmet dental needs of 23.1% of CWLD were found. Most of the guardians agreed that regular dental check-ups were the most needed dental treatment (27.1%) compared to other treatments. The child’s behaviour and the unwillingness of the dentists to treat were among the significant barriers to dental care within the CWLD group. Conclusion: Despite regular dental visits, guardians of CWLD perceived that their children had the most unmet dental needs compared to other children without LD, with significant barriers in terms of accessing professional dental services.

Autism Spectrum Disorder: Patients’ Oral Health Behaviors and Barriers in Oral Care from Parents’ Perspectives

@#To assess the oral health behaviors of children with Autism Spectrum Disorder (ASD) and explore attitudes and barriers in providing oral care by their parents. A cross-sectional, mixed method study design, which comprised of quantitative and qualitative sections was conducted. The quantitative part assessed the oral health behavior through a parent-proxy report questionnaire whilst the qualitative part assessed parents’ overall perspective on maintenance of oral health in children with ASD through an in-depth interview using semi-structured questions. All children below the age of 16 who have been clinically diagnosed with ASD and registered at the Pediatric Dental Clinic were included. The sample consisted of twenty children with ASD. Most of the sample were male and between 5-8 years old. Majority had good oral health behaviors but some exhibited self-injurious behaviors that may affect oral health. Severe characteristics of ASD, co-morbid conditions and incompetent health professionals were reported as barriers in oral care by parents of these children. Despite having good oral health behaviors, several barriers and challenges were expressed by these parents with ASD when providing home oral care or bringing them for dental appointment. Continuous support for parents with ASD child by dental professionals is essential to help overcome the real challenges and barriers in providing oral care among these parents.

Oral Health Behaviours and Preventive Dental Care Experiences Among Patients with Special Health Care Needs at Special Care Dentistry Clinic, University of Malaya

@#To assess the oral health behaviour and preventive dental care experiences of patients with special health care needs (SHCN) who attended the Special Care Dental (SCD) Clinic at University of Malaya. Data were collected from 31 patients using a self-administered questionnaire which consisted of questions pertaining to their oral health behaviours and experiences on receiving preventive dental care (PDC). For patients who were unable to answer due to existing health conditions, parents or primary caregivers were approached as proxy. Descriptive analysis was conducted and reported based on percentages to identify the oral health behaviour and PDC of the individuals. Majority brushed their teeth at least once a day (84%), used fluoridated toothpaste (87%) and oral hygiene aids (58%). However, almost half of them (48%) required assistance from parents or caregivers during tooth brushing and consumed sugary snacks in between meals (58%). About 80% had received PDC where the type of care received was mainly oral hygiene advice (77%). Slightly more than 80% preferred the one-to-one demonstration method during PDC. Most gave positive evaluation on their PDC experience especially on items pertaining to the dentist’s attitude. Whilst most of the SHCN patients in this study had positive perception on the PDC that they received and practised good brushing behaviour, their dietary habits need to be improved. Thus, regular preventive dental visit amongst SHCN patients is important for appropriate and comprehensive dental care in maintaining oral health..