Special Health Care Needs
Soo Hwang, DDS
Pediatric Dental Resident
Children’s National Medical Center, Washington, D.C.
George Washington University
Potomac, Maryland, United States
Justin Unternaher, MPH(c)
Children’s National Medical Center, Washington, D.C.
Wei Li Adeline Koay, MBBS, MSc
Children’s National Medical Center, Washington, D.C.
Natella Rakhmanina, MD, PhD
Children’s National Medical Center, Washington, D.C.
Anupama Tate, DMD, MPH
Children’s National Medical Center, Washington, D.C.
Mudrika Chhabra, DMD
Program Director
Children’s National Medical Center, Washington, D.C.
Washington, District of Columbia, United States
Purpose: The aim of this quality improvement (QI) study is to identify the barriers and access to oral health care in children and adolescents between age 0 and 24 living with or at risk of Human Immunodeficiency Virus (HIV).
Methods: The questionnaire specific to oral health access and quality of life were co-developed by the Children’s National Hospital (CNH) Oral Health Department and CNH HIV Prevention and Treatment Services (HPTS) team. The surveys were distributed to patients living with or at risk of HIV and/or their caregiver during their routine visit at the CNH HPTS clinic. Among those who completed the surveys, some patients were randomly selected for personal interviews and dental clinical exams performed by a dental provider.
Results: A total of 66 surveys were completed between July of 2022 and January of 2023. Among 20% (n=13) of the total participants that report having a difficulty in finding a dentist, the barriers include insurance (35%), transportation (23%), other reasons such as time, cost, and trust (18%), inability to find a local dentist (12%), denied due to medical status (6%), and lack of appointment availability (6%).
Conclusions: Due to potential deficit in knowledge of the purpose and frequency of routine dental visits, there is a need for further dental education in this population. Health care providers can benefit from more comprehensive and collaborative protocol that can assist patients in a smooth transition into adult care. Dental screening and referral should be incorporated as a component of HIV multidisciplinary team care.