Parental Perspectives on Barriers to Pediatric Oral Health Care: Associations with Children's And Families' Characteristics.

Purpose: The purpose of this study was to identify barriers to oral health services experienced by children and evaluate variation across demographic and socioeconomic population groups.

Methods: The data were collected from 1,745 parents/legal guardians who responded to a web-based survey regarding their children's access to health services in 2019. Descriptive statistics and binary and multinomial logistic models were used to examine barriers to needed dental care and factors contributing to differential experiences with those barriers.

Results: A quarter of children of responding parents experienced at least one barrier to oral health care, most commonly cost-related barriers. Child-guardian relationship type, having a pre-existing health condition, and dental insurance type increased the risk of encountering certain barriers two-to four-fold. Children with a diagnosed emotional, developmental, or behavioral condition (odds ratio [OR] equals 1.77, dental anxiety; OR equals 4.09, unavailability of needed services) and those with a Hispanic parent/guardian (OR equals 2.44, lack of insurance; OR equals 3.03, insurance not paying for needed services) were more likely to encounter various barriers than other children. The number of siblings, parent/guardian's age, education level, and oral health literacy were also associated with different barriers. The likelihood of encountering multiple barriers was over three times higher for children with a pre-existing health condition (OR equals 3.56; 95 percent confidence interval equals 2.30 to 5.50).

Conclusions: This study highlighted the significance of cost-related barriers to oral health care and suggested disparities in access among children with disparate personal and family backgrounds.