. 2005 Aug;95(8):1352–1359. doi: 10.2105/AJPH.2004.054858

TABLE 2—

Comparison of Ohio Consumer and Provider Perspectives on Dental Care Access Concerns for Head Start (HS) Children: 2002–2003

Access Concerns	Consumer Perspectives: HS Staff and HS Parents and Caregivers	Provider Perspectives: General Practice Dentists (GPs), Pediatric Dentists (PDs), and Safety Net Dental Clinic Dentists (SNDCs)^a
Access to dental care is a problem for low-income families 28% of HS children have untreated tooth decay^b 12% of HS 3-year-olds have early childhood caries^b	HS parents and caregivers: 11% reported their HS child could not get needed dental care during past year^c 9% reported their child had toothache during past year^c 85% reported their child had dental visit in past year; 10% never had dental visit^c	Dentists strongly or somewhat agreed that low-income families have significant difficulty obtaining dental care: 77% of GPs 86% of PDs 99% of SNDCs
Dentist factors
Most general dentists won’t see young children	HS parents and caregivers (60%) and HS staff (67%) said it is more difficult to find dentist than a doctor (physician) to care for HS children^d,e HS staff cited problems with the dentists’ inability to treat young children^d	34% of GPs reported seeing patients aged 0 through 2 years of age in the past year 91% of GPs reported seeing patients aged 3 through 5 years of age in the past year
Pediatric dentists and SNDC dentists are more likely to treat young children, HS children, and Medicaid patients^e	54% of HS parents or caregivers whose child had a dental visit reported visits to be with a PD^e	100% of PDs reported seeing patients aged 0 through 2 years of age and aged 3 through 5 years of age in the past year 65% of all SNDCs reported seeing patients aged 0 through 2 years of age in the past year 97% of all SNDCs reported seeing patients aged 3 through 5 years of age in the past year
Many general dentists who see young children are not willing to provide more than examinations or cleanings	67% of HS staff strongly or somewhat agree it is difficult to find dentists to provide fillings or extractions for their children^d	Among specific dental services, GPs reported being least willing to provide complex restorative care (46% not willing before child is aged 4 years), extractions (39%), and simple restorative care (26%) 39% of GPs reported that they will only provide examinations and cleanings for HS children
Dentists do not accept Medicaid patients aged 0 through 5 years of age, especially new patients	HS parents or caregivers and HS staff often reported dentists’ unwillingness to accept Medicaid as a hindrance to accessing care^d,e,f	22% of all GPs accept Medicaid patients aged 0 through 5 years of age, but only 7% do so without limitations 69% of all PDs do same, 29% without limitations 94% of all SNDCs do same, 81% without limitations
Head Start parent/caregiver factors
HS parents or caregivers do not know how to access dental care	HS parents and caregivers disagreed that this was a concern^e	…
HS parents or caregivers do not value dental care sufficiently	67% of HS staff somewhat or strongly agreed that parents do not value oral health care for their children^d No HS parents or caregivers considered this an impediment to their children getting care^e	For Medicaid patients, dentists strongly or somewhat agreed that parents and caregivers do not sufficiently value dental care: 79% of GPs 70% of PDs 35% of SNDCs
HS parents or caregivers find it difficult to get to dental appointments (e.g., child care, transportation, leaving work)	HS parents and caregivers (40%) and HS staff (67%) identified difficulties in getting to dental appointments as impediments to getting dental care^d,e	Dentists identified missed or late appointments as the most common problem that might limit their treatment of Medicaid patients: 95% of GPs 94% of PDs 61% of SNDCs
Head Start factors
HS staff help to get their program’s children into dental care	All interviewed HS staff reported assisting parents and caregivers to gain access to dental care for their children^d 40% of interviewed HS parents or caregivers reported receiving HS staff assistance^e	Some GPs (18%) and PDs (13%) said they were more willing to see Medicaid children if they were in HS
HS programs do not adequately prioritize oral health and dental care	73% of HS staff somewhat or strongly disagreed that there was inadequate time to make dental care a priority^d 80% of HS staff felt that their program was able to meet oral health needs of children they serve^d	…

^aMail survey of Ohio general (n = 351) and pediatric (n = 58) dentists and safety net dental clinics (n = 72), 2002–2003.9

^bOhio HS oral health screening survey, 2002–2003 (n = 2555).8

^cQuestionnaire taken by parents and caregivers of HS children participating in HS oral health screening survey (n = 2435).8

^d Telephone interview surveys of Ohio HS staff (perceptions [n = 15]; and approaches that have been effective in assuring access to dental care for EHS/HS children [n = 60]), 2002–2003.

^e Telephone interview survey of Ohio HS parents or caregivers, 2002–2003 (n = 15).

^fOnly 8% of parents and caregivers of Medicaid children who could not get needed care stated that the reason was an inability to find a dentist who accepted Medicaid.^c