Accessibility Important in Dental Home for Children with Cerebral Palsy

Background: The Dental Home is a concept advocated by the American Dental Association and American Academy of Pediatric Dentistry  aimed at increasing access and continuity of care for children and patients with special health care needs. Previous studies have documented that patients with special health care needs often have significant unmet dental health needs, and barriers to accessing dental care may be significant. Objective: The purpose of this study was to prioritize from a parental perspective, the published elements of a dental home: accessible, compassionate, family-centered, comprehensive, culturally effective, coordinated, and continuous care.  Methods: A case cohort design was used with a mail survey being sent to caregivers of patients 1-21 treated at the Nationwide Children’s Hospital Cerebral Palsy clinic. Aside from demographic information, caregivers completed a  100cm visual analog scale (VAS) answering questions that served as surrogate measures for the eight components of a dental home.  Results:  The mean age of the children included was 10.6 years.  Half of all caregivers reported a cumulative household income over the past 12 months of <$20,000.  Over 85% presented with co-morbid developmental delay, followed by 76% presenting with an associated neuromuscular defect. The highest rated quality of a dental home was; an office that makes it simple to schedule appointments (95.2/100), followed by an office that provides care to children of all ages, including exams, cleanings, restorations and extractions (95.1/100), and an office that accepts private insurance plans and Ohio Medicaid (94.9/100). Conclusion: Families of children with CP have specific elements of a dental home they prioritize over others.