Dentists and their Willingness to Treat Adolescents with Learning Disabilities : a Survey of Accessibility in Primary Dental Care
The aim of this study is to examine primary dental care practitioners’ willingness to treat adolescents with learning disability (LD) in two contrasting areas of Northern Ireland (NI) and Scotland using Cohen’s accessibility ‘dental health professional’factors (Cohen, 1987). A non-probability sample of all primary care dentists in the more urban EHSSB [NI] and remote and rural health board of NHS Highland (Scotland) (537) in both the Salaried Dental Services (SDS) and General Dental Services (GDS), were invited to take part in the survey. The main outcome measures were demographic profile, previous undergraduate and postgraduate experience, knowledge of LD and its’ management in the clinical setting, numbers of adolescents with LD treated, attitudes towards individuals LD and willingness to treat this patient group. The data was analysed by t-tests, Analysis of Variance (ANOVA), factor analysis and pathway analysis. Three hundred SDS and GDS dentists completed the self-administered questionnaire. The valid response rate was 61%. There was no significant difference in numbers of adolescents with LD treated in the health boards examined in NI and Scotland. Willingness to treat adolescents with LD was positively associated with a social model perspective on disability. This in turn translated to the development of positive attitudes. Conversely, dentists who held a medical model of disability, were found to have more negative attitudes and were less willing to treat adolescents with LD. The acquisition of knowledge and increased level of undergraduate training in relation to LD and its’ management would appear to strengthen a social model perspective and hence promote positive attitudes and willingness to treat those adolescents with LD. Meanwhile, undergraduate training and knowledge pertaining to disability did not significantly contribute to dentists whose beliefs underpinned the medical model of disability. These findings were consistent for dentists working in two distinct health board areas of the United Kingdom and within both the SDS and GDS. Therefore area of work per se (ie rural or urban location) is not an influential factor in willingness to treat and hence unmet treatment need. This does not exclude the possibility that area of work may have a bearing on willingness to treat as a consequence of university attended for their undergraduate training. It is recommended that suggestions for undergraduate training and postgraduate education are commensurate with Government policy (DoH, 2007) on the mainstreaming of dental services for special care patients.
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