Date of Award

5-2021

Degree Type

Thesis

Degree Name

Honors Thesis

Department

Pharmacy

First Advisor

Amy Peak

Abstract

Objective:

The primary objectives of this study are to determine SCI patients' barriers to dental care, perceptions regarding dental professionals understanding of their unique needs, and feelings of SCI- related discrimination.

Methods:

An online survey was conducted through SCI social media support pages. A modified version of the Discrimination in Medical Settings Scale (DMSS) was utilized to capture perceived discrimination in dental facilities.

Results:

The majority of participants (53%) experienced at least one barrier in dental care. If patients experienced a barrier, they reported lower oral health ratings (p=0.031) and were less likely to have been to the dentist within the last year (p=0.011). Over 70% of patients believed their dentist did not understand the unique complications of SCI and over 40% felt their dentist was unaware of how common SCI medications impacted oral health. These correlated with greater instances of reporting oral health as fair/poor/very poor. Approximately 19% of participants experienced dental discrimination. Those who rated their oral health as fair/poor/very poor were 3.4 times more likely to experience dental discrimination.

Conclusions:

Dental care and outcomes in patients with SCI could be improved by decreasing accessibility barriers and educating dental health professionals about medical/dental complications unique to those with SCI, including autonomic dysreflexia, spasticity, and oral adverse effects of commonly used medications. Approximately one in five patients with SCI experience discrimination in the dental setting (DMSS score > 21). Quality of care and dental outcomes could be further improved by mindfully addressing implicit and explicit biases against disabled individuals.

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