Bridging the Gap: How School-Based Dental Services Can Address Oral Health Disparities for Children In Kinship Care

Background and Purpose: Children in kinship families face disproportionate barriers to oral health care, including financial struggles, transportation barriers, and custody issues, leading to poorer health outcomes compared to children in parent-headed households. School-Based Health Centers (SBHCs) are an evidence-based strategy for reducing health disparities. However, the potential benefits of integrating dental services within SBHCs for kinship families are understudied. The purpose of the study was to explore the experiences and challenges faced by kinship families in accessing quality oral health care and assess the perceived potential of SBDS to mitigate these challenges.

Methods: This qualitative study analyzed data from nine focus groups with kinship caregivers (n=43) and stories of 97 kinship caregivers in Ohio, United States. Participants were female, and 90.7% identified as Black/African American. Data were analyzed separately using reflexive thematic analysis to identify themes, which were then integrated to address the research questions.

Results: Analysis revealed intersecting barriers to oral health care across focus groups and individual stories. Key challenges included financial struggles (e.g., lack of insurance), accessibility issues (e.g., transportation), and unique kinship-specific barriers such as legal/custody issues and unknown oral health histories. The potential benefits of SBDS included the elimination of transportation needs, reduced missed work and school, the potential for low-cost or free services, and the school environment being less intimidating for children who may have no experience or fear related to oral health care. Additionally, caregivers viewed schools as ideal partners for providing convenient, high-quality oral health care.

Conclusion: The findings demonstrate that SBDS are uniquely positioned to address many of the significant, multifaceted barriers to oral health care that children in kinship families experience. SBDS can offer accessible, affordable, quality, and kid-friendly oral health care. These results provide critical insights for practitioners, policymakers, educators, and researchers who work with kinship families. Future research directions and implications for practice are discussed.