Spinal Cord Injury Veterans Access to Dental Care: Barriers and Limitations

Research Objectives: To observe whether veterans with spinal cord injury (SCI) are receiving appropriate dental care, and if not, what the barriers are.

Design: At a single center, consenting veterans completed a survey during their annual exam, inpatient stays, or outpatient visits. Analysis was primarily descriptive, but stepwise multivariable logistic regression was used to identify factors predicting dental care utilization.

Setting: Single SCI center at VA

Participants: SCI veterans at VA who consented during their annual exam,188 veterans agreed to participate

Interventions: A prospective survey study design was used to evaluate the barriers and limitations to dental care for 188 veterans with spinal cord injuries. Veterans were invited to participate in the study during their annual exams, and inpatients and outpatient visits. Signed consent was required before completing a survey.

Main Outcome Measures: Sex, age and level of injury were not related to care access, but race, insurance, and VA care eligibility were. Similar to the general population, finances were the most-reported barrier to dental care, but most veterans with SCI who receive dental care do so without having either insurance or VA eligibility for dental care. Physical barriers were reported to hinder access to dental care by < 10% of surveyed veterans.

Results: 188 veterans agreed to participate, 157 (83.51%) of whom reported having received dental care since their SCI. Most reported receiving post-SCI dental care at a non-VA clinic (63.29%), and receive care at least annually (63.29%). Some of these veterans reported that they had not always been able to receive dental care since their SCI (23.42%). Veterans who had not received dental care since their SCI reported the following barriers: lack of insurance (60.00%), money (30.00%), physical obstacles (6.67%), and “other” reasons (10.00%).

Conclusions: Providing a comprehensive list of discounted dental care options during annual exams for SCI veterans who haven't received dental care could be beneficial. Integrating dental care into preventive healthcare by ensuring annual dentist visits for SCI veterans, alongside promptly applying for Medicaid if eligible, can significantly improve access to dental services. Educating veterans about available community outreach programs and addressing accessibility issues related to power chairs and transfers into dental chairs can further enhance dental care accessibility. By making dental care a routine part of annual exams, healthcare providers can better connect veterans with community resources, Medicaid, and identify medical needs requiring dental attention. Prioritizing early intervention and preventive measures can ultimately enhance the overall health of SCI veterans.

Author(s) Disclosures: no conflicts