Defense Date


Document Type


Degree Name

Master of Science in Dentistry



First Advisor

Dr. Elizabeth Bortell

Second Advisor

Dr. Jayakumar Jayaraman

Third Advisor

Dr. Caroline Carrico

Fourth Advisor

Dr. Conway Upshur


Purpose: The aim of this project is to evaluate the average age and primary reason for the first dental visit among patients with special health care needs as well as to examine socioeconomic factors and other barriers related to children with special health care needs accessing care.

Methods: This is a cross-sectional survey that was distributed to caregivers of children with special health care needs. Study data was collected through REDCap, a secure web-based survey application. The inclusion criteria for participating in the survey included having a child with a special health care need that presented for a recall or new patient examination. The survey was only formatted in English; any non-English speaking caregivers were excluded. The following demographics were ascertained in the survey: age and gender of the patient, level of education of the guardian, and household income.

Results: A total of 77 caregivers participated in the survey. Responses were summarized using counts and percentages. Associations with the child’s age at the first dental visit were assessed using chi-squared or Fisher’s exact tests. Only 13% of caregivers reported that their child was less than 1 by the time of their first dental visit. Most were between the ages of 1 and 3 (68%). Nearly all reported seeing a pediatric dentist for their first visit (89%) and that it was for a routine exam and cleaning (83%). Nearly half were self-referred (46%) but some reported being referred by their pediatrician (36%) or another specialist provider (10%). About one-third of guardians reported an experience where a dentist was unable to provide care for their child due to their SHCN (36%).

Conclusion: It appears that children with special health care needs (CSHCN) are establishing care with a pediatric dentist for routine care at an early age but caregivers of CSHCN are not following the recommendation to have a first dental visit by the age of twelve months set forth by the American Academy of Pediatric Dentistry. Therefore, it is important to continue to educate caregivers of CSHCN on the importance of routine care as well as support general dentists in their role of caring for patients with SHCN.


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Available for download on Friday, May 03, 2024