What are the fears, thoughts, and barriers to oral health care for children with disabilities in Ireland? - A parents' perspective

Background Improving oral health for children with disabilities has been an ongoing public health agenda. Traditional oral health promotion has been met with varying degrees of success. The majority of interventions have... [ view full abstract ]

Background Improving oral health for children with disabilities has been an ongoing public health agenda. Traditional oral health promotion has been met with varying degrees of success. The majority of interventions have been initiated from a biomedical and top down focus with little input from the people who care for children with disabilities, and indeed who know them the best.
Aims 1) Explore the parents’ perceived needs and experiences in providing oral care for the child with disabilities. 2) Use this information to design a health promotion package.
Methods: A purposive sample of parents of 0-6 year old children with disabilities assigned to 2 Early Intervention Centres in Ireland took part in 5 focus group discussions. There were 29 participants 26 females and 3 males. Data saturation was achieved and data was recorded, transcribed. Cross-sectional thematic analysis of the whole dataset of the focus group discussions was carried out with coding on transcribed data.
Results: Some of the main themes that developed from this research highlighted dental professionals as the only healthcare worker not involved in this age group of patients. Despite a range of healthcare workers from dieticians to speech therapists to public health nurses, no healthcare worker has ever discussed the oral health of their child except dental emergencies. Parents admit that oral health is important to them but due to more immediate commitments of nutrition, communication, and mobility oral health is placed down the list of priorities. Coping strategies focus on current issues especially with more complex disabilities. Parents are concerned that they have no point of contact regarding dental queries. Most parents felt that their child would need specialist care in the future.
Conclusions: This study highlights the need for dental collaboration with the healthcare team starting with an Early Intervention team that would then be carried through to the adult services. There needs to be acknowledgement of the parent’s role in their child’s general and oral health integrating oral health into other aspects of their general care. With much diversity of disabilities healthcare professionals need to individually risk assess patients.