Spinal cord injury Veterans access to dental care: Barriers and limitations.

CONTEXT/

OBJECTIVE

Oral hygiene is crucial for basic health by preventing systemic diseases. People with spinal cord injuries (SCI) in previous studies identified cost, physical barriers (such as chair lifts), and dental fear as barriers to dental care. Our study observes whether Veterans with SCI are receiving appropriate dental care, and if not, to identify the barriers.

DESIGN

Cross-sectional survey during their annual exam, inpatient stays, or outpatient visits.

SETTING

Clement J. Zablockie Veterans Affairs Medical Center Spinal Cord Injury/Disorders Program.

PARTICIPANTS

188 Veterans with SCI (n = 188).

RESULTS

157 (83.5%) Veterans reported having received dental care since their SCI. Most reported receiving post-SCI dental care at a non-VA clinic (63.3%) and at least annually (63.3%). Some of these Veterans reported being unable to receive dental care since their SCI (23.4%) and identified barriers: lack of insurance (60.0%), money (30.0%), physical obstacles (6.7%), and "other" reasons (10.0%). Veterans who were white (black OR 0.518, CI 0.157-1.709; other OR 0.181, CI 0.053-0.620), had dental insurance (OR 5.778, CI 1.258-26.547), and/or had VA dental care eligibility (OR 4.782, CI 1.516-15.085) were more likely to have received dental care since SCI. However, most did not report having insurance (70.9%) or VA eligibility for dental care (63.1%).

CONCLUSIONS

Sex, age and level of injury were not related to dental care access, but race, insurance, and VA care eligibility were. Similar to the general population, finances were the most-reported barrier to dental care. Prioritizing early intervention, financial aid, and preventive measures can enhance the health of Veterans with SCIs.