Other
Matthew D. Waite, DDS, MPH
Resident
University of Washington, Seattle, WA
University of Washington
Seattle, Missouri, United States
Bryan Williams, DDS, MSD
Seattle Children's Hospital
Anne Reeves, DDS, MPH
Seattle Children's Hospital
Barbara Sheller, DDS, MSD
Seattle Children's Hospital
Elizabeth Velan, DMD
Seattle Children's Hospital
Travis M. Nelson, DDS, MSD, MPH
Chair and Program Director
University of Washington Department of Pediatric Dentistry
University of Washington
Seattle, Washington, United States
Do Social Determinants of Health Influence Receiving Timely Dental Surgery?
Waite M., Velan E., Reeves A., Sheller B., (The University of Washington, Seattle, WA)
Research supported by the University of Washington Center for Pediatric Dentistry
Purpose: This study examined associations between social determinants of health (SDOH) and receiving 1) optimally timed dental surgery or 2) no surgery for pediatric patients with special health care needs (CSHCN).
Methods: SDOH were recorded for patients planned for treatment under general anesthesia (GA) at a pediatric hospital during 2019. Recommended surgical timeframe depended upon the patient’s medical status and dental symptoms when planned ( < 1 month, 1-3 months, 3-6 months, 6-12 months). Outcomes were: 1) surgery completed in the recommended timeframe or 2) surgery was not done within two years of planning.
Results: Surgeries were planned for 390 CHSCN: 190 (48.7%) were completed in the recommended timeframe, 119 (30.5%) were not done within two years, 20.8% were treated after the recommended timeframe but within two years. Bivariate analyses and logistic regression examined associations between patient SDOH and outcomes. SDOH associated with completing/not completing surgery were guardianship/household, and a documented social work plan for transportation, housing, food assistance or other needs. Patients receiving optimally timed surgery more frequently had: two parents/one household and/or a social work plan on record (P=.0458). SDOH for those not receiving surgery were: two parents/two households or single parents (P=.3624), and/or without a social work plan (P=.0471). SDOH of need for interpreter (P=.697), ethnicity (P=.231), and payer (P=.483) were not associated with receiving/not receiving surgery.
Conclusions: SDOH contribute to disparate health outcomes. In this group of CSCHN requiring hospital dental GA, guardianship/household status and social work supports when needed influenced receiving dental surgery in an optimal timeframe.