Barriers to oral health care in children with Down syndrome.

RESEARCH QUESTION: This systematic review aimed to evaluate the barriers to accessing oral healthcare services among children with Down syndrome (DS). RESEARCH PROTOCOL: The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and registered in PROSPERO (CRD420250656328). The Population, Exposure/Environment, and Outcome framework was followed for developing the research question. LITERATURE SEARCH: A comprehensive search strategy using MeSH terms was conducted across PubMed, Google Scholar, and the Cochrane Library, PsycINFO from inception to January 2026. DATA EXTRACTION: Two independent reviewers screened the studies based on predefined eligibility criteria and extracted data on study characteristics and reported barriers. Discrepancies were resolved through mutual discussion. QUALITY APPRAISAL: The Mixed Methods Appraisal Tool (MMAT) was utilized for quality assessment of the included studies. DATA ANALYSIS AND RESULTS: A total of 1072 records were identified, of which seven studies met the inclusion criteria. A descriptive and thematic synthesis of included studies was performed. INTERPRETATIONS OF RESULTS: Children with DS face multifactorial barriers in accessing oral health care. The findings revealed several challenges to oral healthcare access, including caregiver-related factors, financial constraints, limited availability and accessibility of services, and inadequate professional expertise.