Review article
Access to dental services for children with intellectual and developmental disabilities – A scoping review

https://doi.org/10.1016/j.ridd.2017.12.022Get rights and content

Highlights

  • The scoping review provided a map of published empirical research on access to dental services for children with IDD in the last 17 years.

  • Key issues were identified according to the conceptual access framework.

  • The issues were themed under dimensions of Accessibility, Availability, Affordability, Accommodation, Acceptability, and Appropriate.

  • There is a need to conduct research into the extent of understanding of disability legislation and policies among dental service providers.

Abstract

Background

Children with Intellectual and Developmental Disabilities (IDD) face considerable challenges in participating in dental services. These challenges include resource constraints and inadequate skills of health service providers to work with this population.

Aim

The aim was to scope published studies that addressed access to dental services for children with IDD in order to determine the extent to which various barriers have been researched, using an access framework derived from the literature. Access was defined to include the six dimensions of accessibility, availability, affordability, accommodation, acceptability, and appropriateness.

Method

Arksey and O'Malley's scoping review framework was used. Relevant databases (e.g., Medline) were searched for all empirical studies conducted from January 2000 to February 2017 that met inclusion criteria. Data were extracted along the six dimensions of the access framework.

Results

Sixteen international studies were identified which indicated common key barriers to dental service use: the difficulties of physical inaccessibility, lack of access to information among carers, lack of knowledge of disability issues, and low experience and skills in caring for children with IDD among dental practitioners.

Conclusions

Key recommendations made were exploring dental practitioners' understanding of disability legislation and developing training for practitioners to expand on issues specific to IDD.

Section snippets

What this paper adds?

This paper, to our knowledge, is a first review of published empirical research data on access to dental services for children with IDD in the last 17 years. Authors of international studies from 11 countries (US, Australia, The Netherlands, Canada, France, Poland, Jordan, Kuwait, Saudi Arabia, Brazil, India) identified physical inaccessibility, lack of access to information, insufficient insurance cover among carers, and dental practitioner lack of knowledge of disability issues, and little

Research design

Guided by Arksey and O'Malley (2005), the stages of the scoping review were: (1) identifying the research question; (2) searching for relevant studies; (3) selecting studies based on pre-defined inclusion criteria; (4) extracting data; and (5) collating, summarising, and reporting the results.

Results

A total of 600 articles were identified through database searching, with 420 remaining after deletion of duplicates. Two reviewers (RUC, NH) independently screened the title and abstract of all 420 articles against the inclusion and exclusion criteria, resulting in 354 being excluded and 66 full text articles accessed for further assessment. Sixteen articles met the inclusion criteria. Disagreements between reviewers were resolved following discussions, and regular consultation was sought from

Discussion

The findings indicate that, internationally, there has been limited exploration of access to dental services for children with IDD. Of particular note was that most research was focussed on the perceptions and attitudes of carers towards dental services, with only one study addressing the perceptions of dental practitioners (de Jongh et al., 2008). More so, only one study was of an intervention (Meurs et al., 2010). Although many access barriers were identified in this review, notably absent

Conclusion

Since the research in the area of access to dental services for children with IDD is notably limited, more investigations are required to understand the influence of the six dimensions of access on the oral health of children with IDD. Addressing the service-user and service-provider perceived social and environmental factors is imperative for provision of effective and equitable services for children with IDD.

Conflicts of interest

None

Acknowledgment

First author is supported by Australian Government Training Scholarship. Authors would like to thank Ms. Ange Johns-Hayden, Senior Research Advisor, La Trobe University for her expert advice on the literature search process.

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