Barriers to Utilisation of Dental Services among Children with Disabilities in a Coordinated Healthcare Programme in Mangalore, South India: A Mixed Methods Study

Authors

  • Lekshmi Radhakrishnan Suresh NITTE (Deemed-to-be University), AB Shetty Memorial Institute of Dental Sciences, Department of Paediatric and Preventive Dentistry, Mangalore, India https://orcid.org/0000-0001-6091-1867
  • Kavitha Rai NITTE (Deemed-to-be University), AB Shetty Memorial Institute of Dental Sciences, Department of Paediatric and Preventive Dentistry, Mangalore, India
  • Amitha Mahesh Hegde NITTE (Deemed-to-be University), AB Shetty Memorial Institute of Dental Sciences, Department of Paediatric and Preventive Dentistry, Mangalore, India https://orcid.org/0000-0002-2823-1076
  • Cynthia Vinitha Dsouza NITTE (Deemed-to-be University), AB Shetty Memorial Institute of Dental Sciences, Department of Paediatric and Preventive Dentistry, Mangalore, India

DOI:

https://doi.org/10.47985/dcidj.427

Keywords:

Caregiver perceptions, dental avoidance, mixed-methods study, dental education, dental health outcomes

Abstract

Purpose: Unmet oral health needs affect the quality of life of individuals, especially if they are already at a disadvantage like children with special health care needs. Strategies to mitigate these disparities in India’s diverse healthcare settings have hitherto been largely ineffective. This study aimed to assess the utilisation and barriers to the use of dental health services among children with special health care needs, against the background of a coordinated healthcare programme implemented in the A B Shetty Institute of Dental Sciences in Mangalore, India.

Method: The study was conducted over a 6-month period, from September 2018 to February 2019. A mixed-methods design was concurrently employed for data collection. Utilisation of dental services was assessed quantitatively, and the barriers to dental services utilisation were assessed qualitatively through caregiver interviews, with a sequential data integration strategy.

Results: The quantitative data revealed gross underutilisation of dental resources by children (only 16% availed of some form of dental treatment), and the prevalence of avoidance behaviour (63% showed reluctance and did not turn up for appointments). Restorative needs formed the highest unmet dental component among the children (67% required secondary dental care). In-depth interviews with the children’s caregivers revealed that the presence of cognitive barriers could have a direct effect on the time and quality of dental care delivered to their children.

Conclusion: Cognitive barriers among caregivers appear to have a profound impact on the underutilisation of dental services in their children with special healthcare needs. These barriers may be addressed within the integrated healthcare programme and the dental curricula through provisions for continued individual and community dental education, and motivational efforts that simultaneously target the caregivers and their children with special healthcare needs.

Author Biographies

Lekshmi Radhakrishnan Suresh, NITTE (Deemed-to-be University), AB Shetty Memorial Institute of Dental Sciences, Department of Paediatric and Preventive Dentistry, Mangalore, India

Dr. Lekshmi Radhakrishnan Suresh is a Doctoral research scholar in the field of Dentistry, studying dental needs and advocacy for children with special healthcare needs and their caregivers. Her research interests include Preventive Dentistry, Paediatric Dentistry, Special Care Dentistry, Behaviour management in Dentistry and Dental Education.

Kavitha Rai, NITTE (Deemed-to-be University), AB Shetty Memorial Institute of Dental Sciences, Department of Paediatric and Preventive Dentistry, Mangalore, India

Prof. (Dr.) Kavitha Rai is a Senior Professor with many years of experience in dealing with and providing dental treatment for children with special healthcare needs. Her research interests include Clinical Paediatric Dentistry, Special Care Dentistry, Autism Research, Dental implications on Medical research, Dental Academic research and Preventive Dentistry.

Amitha Mahesh Hegde, NITTE (Deemed-to-be University), AB Shetty Memorial Institute of Dental Sciences, Department of Paediatric and Preventive Dentistry, Mangalore, India

Prof. Dr. Amitha Mahesh Hegde is the Department Head of Paediatric and Preventive Dentistry at NITTE(deemed to be University) with years of teaching and research experience. Her research interests include Special Care Dentistry, Preventive Dentistry, Paediatric Dental research, Oral Epidemiology, Phytodentistry and Implications of Traditional Knowledge in Dentistry.

Cynthia Vinitha Dsouza, NITTE (Deemed-to-be University), AB Shetty Memorial Institute of Dental Sciences, Department of Paediatric and Preventive Dentistry, Mangalore, India

Cynthis Vinitha Dsousa is a Special Educator in the Department of Paediatric and Preventive Dentistry, intricately involved in the administration and management of the NSPECC programme. She is interested in healthcare advocacy for children with special healthcare needs, occupational therapy for special needs groups, disability and public health rehabilitation programmes.

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Published

2021-02-23

How to Cite

1.
Suresh LR, Rai K, Hegde AM, Dsouza CV. Barriers to Utilisation of Dental Services among Children with Disabilities in a Coordinated Healthcare Programme in Mangalore, South India: A Mixed Methods Study. DCIDJ [Internet]. 2021 Feb. 23 [cited 2024 Sep. 8];31(4):66-89. Available from: https://dcidj.uog.edu.et/index.php/up-j-dcbrid/article/view/427

Issue

Vol. 31 No. 4 (2020): Winter

Section

Original Research Articles

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