Oral and dental health utilization among patients with special health care needs: a qualitative study in Iran

Abstract Background Patients with special health care needs (SHCN) are considered a vulnerable group due to their complex physical and mental conditions, which often limit their utilization of oral and dental health services (ODHS). So, this study examines the utilization of ODHS among patients with...

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Main Authors: Zahra Zare, Mohammad Amin Bahrami, Foad Iranmanesh, Zahra Kavosi
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06392-6
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author Zahra Zare
Mohammad Amin Bahrami
Foad Iranmanesh
Zahra Kavosi
author_facet Zahra Zare
Mohammad Amin Bahrami
Foad Iranmanesh
Zahra Kavosi
author_sort Zahra Zare
collection DOAJ
description Abstract Background Patients with special health care needs (SHCN) are considered a vulnerable group due to their complex physical and mental conditions, which often limit their utilization of oral and dental health services (ODHS). So, this study examines the utilization of ODHS among patients with SHCN in Iran. Methods This qualitative study was conducted in Iran from September 2024 until January 2025. Informants were selected using purposive and snowball sampling. A semi structured interview guide was used to explore the perspectives of three groups: service providers, policymakers, and families of patients with SHCN. Data were analyzed using thematic analysis with MAXQDA 10. Results Data from seventeen semi-structured interviews were thematically analyzed. Four overarching themes were identified: governance and policy landscape, professional competence and service readiness, sociocultural and familial dynamics, and care delivery processes. These themes encompassed both systemic and individual-level factors that either enabled or barred the utilization of ODHS among patients with SHCN. Informants emphasized that financial factors, clinical guidelines, insurance coverage, preventive healthcare systems, systematic approaches, and integrated information systems were major governance and policy-level factors. Within the second theme, training, motivations and attitudes, screening/specialized centers, and infrastructures and equipment were seen as significant measures to service provision. Sociocultural and familial dynamics-related subthemes included parents’ and caregivers’ knowledge and awareness, socioeconomic status, attitudes and stigma. In care delivery processes, geographic access and procedures and waiting lists emerged as key subthemes. Each of these factors could act as either a barrier or an enabler depending on how they are addressed in practice. Conclusion The findings of this study underscore the complex and multifactorial nature of factors influencing the utilization of ODHS among patients with SHCN. According to the results, both systemic and individual-level barriers and enablers play significant roles in shaping access to and utilization of ODHS. Addressing these challenges requires comprehensive, targeted policies that not only focus on improving the availability and accessibility of ODHS but also foster an environment that supports the continuous training of providers, enhances awareness among patients and their families, and ensures sufficient financial and infrastructural support.
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spelling doaj-art-e02c1667167d42fe803dd5a7972999252025-08-20T04:01:35ZengBMCBMC Oral Health1472-68312025-07-0125111210.1186/s12903-025-06392-6Oral and dental health utilization among patients with special health care needs: a qualitative study in IranZahra Zare0Mohammad Amin Bahrami1Foad Iranmanesh2Zahra Kavosi3Student Research Committee, Department of Health Care Management, School of Management and Medical Informatics, Shiraz University of Medical ScienceEnd of Life Care, Health Services Programs, Clinical System Support and Improvement, Department for Health and Wellbeing, South Australia GovernmentDepartment of Endodontics, Dental School, Rafsanjan University of Medical SciencesHealth Human Resources Research Center, Department of Health Care Management, School of Management and Medical Informatics, Shiraz University of Medical ScienceAbstract Background Patients with special health care needs (SHCN) are considered a vulnerable group due to their complex physical and mental conditions, which often limit their utilization of oral and dental health services (ODHS). So, this study examines the utilization of ODHS among patients with SHCN in Iran. Methods This qualitative study was conducted in Iran from September 2024 until January 2025. Informants were selected using purposive and snowball sampling. A semi structured interview guide was used to explore the perspectives of three groups: service providers, policymakers, and families of patients with SHCN. Data were analyzed using thematic analysis with MAXQDA 10. Results Data from seventeen semi-structured interviews were thematically analyzed. Four overarching themes were identified: governance and policy landscape, professional competence and service readiness, sociocultural and familial dynamics, and care delivery processes. These themes encompassed both systemic and individual-level factors that either enabled or barred the utilization of ODHS among patients with SHCN. Informants emphasized that financial factors, clinical guidelines, insurance coverage, preventive healthcare systems, systematic approaches, and integrated information systems were major governance and policy-level factors. Within the second theme, training, motivations and attitudes, screening/specialized centers, and infrastructures and equipment were seen as significant measures to service provision. Sociocultural and familial dynamics-related subthemes included parents’ and caregivers’ knowledge and awareness, socioeconomic status, attitudes and stigma. In care delivery processes, geographic access and procedures and waiting lists emerged as key subthemes. Each of these factors could act as either a barrier or an enabler depending on how they are addressed in practice. Conclusion The findings of this study underscore the complex and multifactorial nature of factors influencing the utilization of ODHS among patients with SHCN. According to the results, both systemic and individual-level barriers and enablers play significant roles in shaping access to and utilization of ODHS. Addressing these challenges requires comprehensive, targeted policies that not only focus on improving the availability and accessibility of ODHS but also foster an environment that supports the continuous training of providers, enhances awareness among patients and their families, and ensures sufficient financial and infrastructural support.https://doi.org/10.1186/s12903-025-06392-6Oral and dental healthSpecial health care needsDentistryQualitative studyIran
spellingShingle Zahra Zare
Mohammad Amin Bahrami
Foad Iranmanesh
Zahra Kavosi
Oral and dental health utilization among patients with special health care needs: a qualitative study in Iran
BMC Oral Health
Oral and dental health
Special health care needs
Dentistry
Qualitative study
Iran
title Oral and dental health utilization among patients with special health care needs: a qualitative study in Iran
title_full Oral and dental health utilization among patients with special health care needs: a qualitative study in Iran
title_fullStr Oral and dental health utilization among patients with special health care needs: a qualitative study in Iran
title_full_unstemmed Oral and dental health utilization among patients with special health care needs: a qualitative study in Iran
title_short Oral and dental health utilization among patients with special health care needs: a qualitative study in Iran
title_sort oral and dental health utilization among patients with special health care needs a qualitative study in iran
topic Oral and dental health
Special health care needs
Dentistry
Qualitative study
Iran
url https://doi.org/10.1186/s12903-025-06392-6
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