Research Article

Barriers in Access to Dental Services Hindering the Treatment of People with Disabilities: A Systematic Review

Table 2

Characteristics of the studies.

Author/yearCountryStudy designTypeSampleSample featuresStatistical analysisTypes of servicesTypes of disabilitiesMost frequent dental procedures

Burtner et al, 1990 [70]United StatesCross-sectionalArticle362 respondentsPersons with disabilities from the Florida Department of Health and Rehabilitation, United States. Primary data.Not adjustedTreatment paid by federal government funds. Private payment through private plans or funds.Emergency treatment, examination and prophylaxis, other services.

Milnes et al, 1995 [71]CanadaCross-sectionalArticle342 respondentsManitoba dentists. Primary data.Not adjustedPrivate, social, federal, provincial, municipal, unpaid services, institutions.Asthma, autism, cancer, cardiac arrest, cerebral palsy, diabetes, hearing impaired, hemophilia, immunosuppression, leukemia, liver, mental retardation, renal, spinal cord injury, stroke, visually impaired.Examinations, oral radiographs, panoramic radiography, topical fluoride, restoration, scaling, crown and bridge, partial and total prosthesis, periodontics, endodontics, surgery, orthodontics and sealants.

Schultz et al, 2001 [72]United StatesCross-sectionalArticle12,539The data source for this study was an interview survey of the National Center for Health Statistics 1997. Secondary data.AdjustedMental retardation, cerebral palsy, attention deficit, Down syndrome, autism, developmental delay.

Edwards et al, 2002 [73]EnglandCross-sectionalArticle157 respondentsLiverpool dentists, Sefton and St Helens and Knowsley. Primary data.Not adjustedPhysical disability, learning disabilities, and mental health problems.

Al Agili et al, 2004 [74]United StatesCross-sectionalArticle714 respondentsDatabase provided by child rehabilitation services from Alabama. Secondary data.AdjustedPrivate payment through private plans or funds.Cleft lip and/or palate or other craniofacial disorders; epileptic/convulsive disorders; spina bifida; cerebral palsy.Seek emergency treatment rather than prevention due to barriers encountered.

De Jongh et al, 2008 [75]NetherlandsCross-sectionalArticle40 dentists and 126 responding caregivers.Children with disabilities in day care centres in the Netherlands. Primary data.Not adjustedMost subjects suffered from physical disabilities and complex medical problems. Based on their social aspects, language, and motor skills, all children were considered to have a severe mental disability.

Koneru and Sigal, 2009 [76]CanadaCross-sectionalArticle634 respondentsPeople with disabilities in Ontario.Not adjustedPrivate insurance, Ontario Disability Support Program, another form of government-sponsored coverage.Autism, cerebral palsy, Down syndrome, developmental delay, physical disability, psychiatric disability, brain injury.Examination, X-ray, fluoride application, cleaning, oral hygiene instruction, sealants, fillings, extraction, stainless steel crown, aesthetic crown and bridge, dentures, whitening, canal treatment, dental implants.

Nelson et al, 2011 [77]United StatesCross-sectionalArticle1128 respondentsChildren with disabilities in Massachusetts, United States.Not adjustedAutism, invasive developmental disorder, Asperger’s syndrome, cerebral palsy, musculoskeletal disorders, seizures, cystic fibrosis, developmental/neurological/behavioral/chromosomal delay, Down syndrome, speech/hearing/blind, metabolic/cardiac/renal/immune, hemophilia/sickle cell anemia/von Willebrand’s disease, craniofacial/cleft lip and palate.Checkup or just cleaning, emergency services and catering.

Pradhan et al, 2009 [78]AustraliaCross-sectionalArticle1280 respondentsAdults with disabilities living in Adelaide, South Australia. Primary data.AdjustedAutism, brain injury, cerebral palsy, intellectual disability, spina bifida and quadriplegia.Checkup, extractions, restorations, prostheses, and radiographs.

Aragão et al, 2011 [79]BrazilCross-sectionalArticle113 respondentsDisabled children from Recife, Pernambuco, Brazil. Primary data.Not adjustedPublic servicePhysical, mental, hearing

Cardoso et al, 2011 [80]BrazilCross-sectionalArticle43 respondentsCaregivers of children with motor disabilities in the city of João Pessoa, Paraíba, Brazil. Primary data.Not adjustedPrivate and public serviceCerebral palsy, hydrocephalus, myelomeningocele, Rett syndrome, Down syndrome, West syndrome.Prevention, prophylaxis, restoration, extraction, scraping, trauma, orthodontics.

Rocha et al, 2015 [5]BrazilCross-sectionalArticle89 dentists and 204 people with disabilitiesDentists and people with disabilities in Fortaleza, Ceará, Brazil. Primary data.Not adjustedPrivate and public serviceMotor impairment, hearing impairment, and visual impairment.

Bindal et al, 2015 [81]MalaysiaCross-sectionalArticle102 respondentsDentists from the cities of Kuala Lumpur, Penang, and Kuching in Malaysia. Primary data.Not adjustedPrivatePhysical disability, mental disability, sensory deficiency.Emergency, extractions, restorative treatment, prostheses, periodontal treatment.

Dantas Cardoso 2015 [82]BrazilCross-sectionalCompletion of course work100 respondentsParents or guardians of institutionalized patients in APAE/natal. Primary data.Not adjustedThe most suitable place of care was the Association of Parents and Friends of the Exceptional (APAE)Mental disability, physical disability, cerebral palsy, birth defect, Down syndrome, sensory impairment, oral communication impairment, behavioral disorder, and autism.Prophylaxis, restoration, and extraction.

Damiance, 2016 [83]BrazilCross-sectionalThesis41 respondentsPeople with multiple disabilities in the state of São Paulo, Brazil. Primary data.AdjustedPhilanthropic service, public and private serviceMultiple disability.Review, prevention, checkup, extraction.

Paulo et al, 2017 [84]BrazilCross-sectionalArticle121 respondentsResponsible for people with special needs in João Pessoa, Paraíba, Brazil. Primary data.Not adjustedPublic serviceMental impairment, cerebral palsy, other motor defects, Down syndrome, Apert syndrome, Rett syndrome, Seckel syndrome, congenital microcephaly, autism, oral communication disorder (speech), audiocommunication disorder (deaf).