Nonfinancial barriers such as language and psychosocial, structural, and cultural considerations may interfere with access to oral health care.18 Effective communication is essential and,for hearing impaired patients/parents, can be accomplished through a variety of methods including interpreters, written
materials, and lip-reading. Psychosocial factors associated with access for patients with SHCN include oral health beliefs,
norms of caregiver responsibility, and past dental experience of the caregiver. Structural barriers include transportation, school absence policies, discriminatory treatment, and difficulty locating providers who accept Medicaid.14 Community-based health services, with educational and social programs, may assist dentists and their patients with SHCN.21