{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:53:45Z","timestamp":1790927625932,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004320","name":"Shiraz University of Medical Sciences","doi-asserted-by":"publisher","award":["1401.082"],"award-info":[{"award-number":["1401.082"]}],"id":[{"id":"10.13039\/501100004320","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Individuals with special health care needs (SHCN) often encounter significant challenges in accessing oral and dental health services (ODHS), a problem that is even more pronounced in developing countries. This study aimed to identify the factors associated ODHS utilization among individuals with SHCN in Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross\u2010sectional study included 380 participants with SHCN, aged\n                      <jats:bold>\u2265<\/jats:bold>\n                      \u20095 years, residing in various districts of Shiraz in 2024. Data were collected through convenience sampling in rehabilitation centers, special education schools, and disability foundations. A researcher\u2010developed questionnaire was used for data collection based on existing surveys on oral health service utilization. Data analysis involved descriptive statistics (means, standard deviations, frequencies, and percentages), along with univariate and multivariate logistic regression using SPSS software.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Oral health problems were highly prevalent among the participants: 90% reported a history of toothache, and 72.4% had undergone at least one tooth extraction due to dental caries or abscess. Furthermore, 57.1% reported brushing their teeth before bedtime. Nearly one\u2010quarter of the participants (24.7%) had the highest level of dental care needs, while 67.1% reported unmet dental care needs, with treatment cost identified as the most commonly reported barrier (52.4%). Overall, only 33.7% had utilized oral and dental health services during the previous year. Multivariable logistic regression analysis indicated that place of residence, father's employment status, and maternal income were significant predictors of oral and dental health service utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ODHS utilization among individuals with SHCN was low, and unmet dental care needs were common. Financial barriers, particularly treatment costs, were frequently reported, and several socioeconomic factors were significantly associated with service utilization. These findings highlight the need for policies and planning aimed at reducing barriers to dental care access in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73022","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T10:06:25Z","timestamp":1787133985000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated With Oral and Dental Health Utilization Among Individuals With Special Health Care Needs in Iran: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6778-8267","authenticated-orcid":false,"given":"Zahra","family":"Zare","sequence":"first","affiliation":[{"name":"Student Research Committee, School of Health Management and Information Science Shiraz University of Medical Science Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7220-776X","authenticated-orcid":false,"given":"Foad","family":"Iranmanesh","sequence":"additional","affiliation":[{"name":"Department of Endodontics School of Dentistry, Rafsanjan University of Medical Sciences Rafsanjan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2276-7440","authenticated-orcid":false,"given":"Mohammad Amin","family":"Bahrami","sequence":"additional","affiliation":[{"name":"Health Human Resources Research Center, School of Health Management and Information science Shiraz University of Medical Science Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4127-0838","authenticated-orcid":false,"given":"Fatemeh","family":"Shirazi","sequence":"additional","affiliation":[{"name":"Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8662-7987","authenticated-orcid":false,"given":"Zahra","family":"Kavosi","sequence":"additional","affiliation":[{"name":"Health Human Resources Research Center, School of Health Management and Information science Shiraz University of Medical Science Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Reference Manual of Pediatric Dentistry","author":"American Academy of Pediatric Dentistry","year":"2020"},{"key":"e_1_2_13_3_1","unstructured":"Disability: World Health Organization; 7 March 2023. access date: 2025.6.2 https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/disability-and-health."},{"key":"e_1_2_13_4_1","unstructured":"The State of Children with Disabilities and Special Health Care Needs: The ANNIE E. Casey foundation; July 14 (2024) access date: 2025.6.2 https:\/\/www.aecf.org\/blog\/the-state-of-children-with-disabilities-and-special-health-care-needs."},{"key":"e_1_2_13_5_1","volume-title":"Iran Statistical Yearbook","author":"Statistical Center of Iran","year":"2012"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13047"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-056150D"},{"issue":"7","key":"e_1_2_13_8_1","first-page":"775","article-title":"Medical Complexity of Children With Special Healthcare Needs and Healthcare Experiences","volume":"11","author":"Yun H. J.","year":"2024","journal-title":"Children (Basel)"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/0976-3147.112770"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/froh.2022.971223"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina55100676"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11195557"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-024-04734-4"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1922\/CDH_00173ASIRI09"},{"key":"e_1_2_13_15_1","volume-title":"Oral Health Workforce in the Coming Decade: Workshop Summary","author":"The U.S","year":"2009"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S291255"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-020-01354-6"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2021.04.022"},{"issue":"12","key":"e_1_2_13_19_1","article-title":"Oral Health Care for Individuals With Special Needs: Practices and Challenges Among General Practitioners in Saudi Arabia","volume":"16","author":"Alhaidar S.","year":"2024","journal-title":"Cureus"},{"issue":"7624","key":"e_1_2_13_20_1","first-page":"806","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (Strobe) Statement: Guidelines for Reporting Observational Studies","volume":"335","author":"Elm E.","year":"2007","journal-title":"PLoS Medicine"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.2307\/2137284"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1108\/IJHRH-11-2021-0202"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czy096"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina55120783"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10005-2419"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-025700"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.17796\/1053-4625-45.4.4"},{"key":"e_1_2_13_28_1","doi-asserted-by":"crossref","DOI":"10.4034\/PBOCI.2019.191.127","article-title":"Oral Health Status and Treatment Needs for Children With Special Needs: A Cross\u2010Sectional Study","volume":"19","author":"Alkhabuli J. O.","year":"2019","journal-title":"Pesquisa Brasileira em Odontopediatria e Cl\u00ednica Integrada"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12191955"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-021-01423-4"},{"issue":"3","key":"e_1_2_13_31_1","first-page":"160","article-title":"Exploring Barriers to Oral Health Care Experienced by Individuals Living With Autism Spectrum Disorder","volume":"55","author":"Bernath B.","year":"2021","journal-title":"Canadian Journal of Dental Hygiene"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10214811"},{"issue":"1","key":"e_1_2_13_33_1","first-page":"05","article-title":"Use of Dental Care Services and Related Factors in Students With Special Health Care Needs in a Rehabilitation and Education Center","volume":"15","author":"da Silva J\u00fanior I. F.","year":"2018","journal-title":"Revista Sul\u2010Brasileira de Odontologia"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.63995\/PUCI6114"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-13237-2"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/jar.13225"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-07293-4"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sdentj.2022.08.008"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-025-13236-0"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare8020086"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-025-06392-6"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/3035463"},{"issue":"2","key":"e_1_2_13_43_1","first-page":"230","article-title":"Factors That Limit Access to Dental Care for Person With Disabilities","volume":"66","author":"Ishaque M. Y.","year":"2016","journal-title":"Pakistan Armed Forces Medical Journal"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192416633"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.3390\/dj10080155"},{"issue":"8","key":"e_1_2_13_46_1","article-title":"Decomposition Analysis of Socioeconomic Inequalities in Utilization of Oral Health Services: A Population\u2010Based Study in Urban and Rural Households of Ahvaz","volume":"38","author":"Feizi A.","year":"2024","journal-title":"Medical Journal of The Islamic Republic of Iran"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.4103\/1735-3327.374806"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-023-02736-2"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.73022","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.73022","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.73022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:08:34Z","timestamp":1790924914000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.73022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":47,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/hsr2.73022"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.73022","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2025-11-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73022"}}