The use of fluoride varnish and its determining factors among children with disability in Taiwan.
Fewer than 1 in 10 Taiwanese preschoolers with disabilities get fluoride varnish—BCBAs can raise the rate with simple desensitization packages.
01Research in Context
What this study did
The team looked at Taiwan’s national insurance records. They counted how many preschoolers with disabilities got fluoride varnish in one year.
Kids were under six and had diagnoses like autism, cerebral palsy, or Down syndrome. The study checked if age, income, or where they lived changed the numbers.
What they found
Only 1 in the children with disabilities received the quick tooth-coating. Rural kids and poor families were left out most.
Severe disability and very young age also lowered the odds of getting the service.
How this fits with other research
Shawler et al. (2021) asked the mothers of autistic kids why dental visits are hard. Cost and dentist refusal topped the list. Their survey widens the Taiwan picture by showing the same access gap holds for autism alone and across a wider age span.
Kammer et al. (2025) interviewed parents and dentists. They found the real culprits are scant staff training and lack of parent supports. This qualitative deep-dive explains why the Taiwan numbers are so low: it is not the kids’ behavior, it is the system.
McMullen et al. (2017) give hope. One boy with developmental delay learned to sit for dental work after prediction and desensitization. The case shows ABA tools can fix the very problem Weng et al. (2011) measured.
Why it matters
You already shape cooperation for medical visits. Use that skill set to prep kids for the dentist: priming stories, short visits, and reinforcement. Share the prep plan with dental offices so they accept, not refuse, our clients. More kids will get the varnish and keep their teeth healthy.
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02At a glance
03Original abstract
The oral health of children with disability is often not as good as that of other children. In view of improving their oral health, this study aims to explore the utilization of fluoride varnish services among children with disability in Taiwan and its relevant influencing factors. With children under the age of 5 as subjects, this study is conducted based on the database of Ministry of the Interior, Executive Yuan, ROC in 2008, coupled with information gathered between 2006 and 2008 on preventive health care and health insurance from the Bureau of Health Promotion and the National Health Research Institute, respectively. In addition to descriptive statistics and bivariate analysis, this study examined the factors determining the use of fluoride varnish with logistic regression analysis. Research revealed that fluoride varnish is used by up to 9.84% of children with disability; the use increases with age and decreases with increased level of disability, but is remarkably higher in those with catastrophic illness/injury. The probability of fluoride varnish use is lower among those living in areas of lower urbanization (levels 5-7) and higher among those whose parents have higher premium-based monthly salaries. Recommendations include (1) providing a differential pricing scheme for fluoride varnish based on the level of disability of the child, (2) promoting proactively among dentists to carry out regular fluoride varnish in rural areas and collaboration with pediatricians to provide convenient services and (3) targeting families in low socioeconomic brackets, improving knowledge of fluoride varnish.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2010.12.016