409 - The Impact of COVID-19 on Dental Care for Patients with Special Health Care Needs

Purpose: The purpose of this study is to evaluate the impact of the COVID-19 pandemic on access to dental services for pediatric patients with special healthcare needs (SHCN). The study will investigate caregiver perceptions regarding dental care for children with special healthcare needs before the COVID-19 pandemic, during the COVID-19 pandemic lockdown (March – May 2020) and after the COVID-19 lockdown.

Methods: Caregivers of special healthcare needs children aged 0-17 years at Children’s Hospital Colorado who are also concurrently patients of the Children’s Hospital Colorado Dental Center were recruited to participate in this study. A survey was distributed to caregivers willing to participate during patient appointments. The survey consisted of 24 questions regarding patient and caregiver demographics, patient medical diagnosis and severity, and perceptions about importance of receiving dental care, access to care, safety seeking care, and impact to dental treatment before, during and after the COVID-19 pandemic shutdown.

Results: The dental check-up visit was significantly more important (p = 0.021) after the pandemic shutdown than before the shutdown.
69.8% (N=37) of caregivers reported that cavities were the main concern for their child’s mouth during the pandemic shutdown, with 26.4% (N=14) indicating pain caused by a dental infection was the main concern.
64.2% of caregivers (N=34) reported that they felt their child’s dental treatment was delayed during the shutdown.
Detecting caries and cleanings were the most important aspects of the dental visit, with no significant differences between the pre- and post- shutdown periods.
Caregivers indicated that recall intervals at the 3- and 6- month periods were ideal between dental check-up visits (compared to 12 months). This was not significantly different between the pre- and post-shutdown periods.
There were no significant differences in caregiver responses regarding management of baby and adult teeth between pre- and post-shutdown periods. The majority of caregivers indicated that they wanted their child’s teeth fixed if these teeth had cavities.

Conclusions: Future studies evaluating the impact of the COVID-19 pandemic shutdown on dental care for patients with special health care needs should focus on obtaining larger sample sizes. Future studies should collect data on time elapsed between dental appointments to evaluate how visit compliance changed as a result of the pandemic. Additionally, further evaluation of the associations between the importance of the dental visit, time between dental visits and severity of medical condition is needed to understand whether there is a relationship between severity of special health care needs and perceptions on seeking dental care.