Background Maintaining healthy teeth is essential for the short and long-term well-being of children. Yet, this is not the case for many children in Papua New Guinea (PNG), with its high prevalence of dental caries and periodontal disease. High rates of oral disease among children in PNG may be due, at least in part, to poor access to services of oral health and including but not limited to, the development of good oral health care techniques and routine practices. Objectives The overall aim of the current study is to address current gaps in knowledge by identifying barriers to accessing pediatric dental services for children in PNG, in an effort to support children’s oral health. Specific study objectives were to:

1. identify specific barriers to accessing paediatric dental services in PNG
2. determine whether barriers to access, differ by child age groups (1-3-year-olds and 4-6-year-olds), sex (male/female), and/or area of residence (urban/rural)
3. determine parents’ understanding of reasons to access dental care for children; and
4. to gather suggestions from families about how to improve access to paediatric dental services in PNG Methods Forty parents (aged 19 to 46 years; mean 33.15 years) of children aged 0-6 years (mean 3.75 years) living in the Morobe province of PNG, took part in the research. Parents completed a primarily quantitative survey. Parents also responded to a small number of qualitative questions. Informed, at least in part, by Levesque, Harris and Russell’s (2013) model of patient-centred access to healthcare, key areas of focus were Availability and Accommodation, Approachability, Acceptability, Affordability, and Appropriateness. Where appropriate, quantitative responses, analysed using descriptive statistics, examined parents’ experiences of accessing paediatric dental services for their children and independent samples t-tests. Qualitative questions, analysed using thematic analysis, explored parents’ awareness of reasons for accessing paediatric dental services and their suggestions for improving service access. Results The majority (95%) of parents had not accessed paediatric dental services, 82.5% never received support from health workers, and 70% could not locate a dental clinic. Expenses associated with service provision and transportation were major barriers noted by parents. Most parents reported an absence of dental service in small rural communities and they also lacked knowledge of dental service. The majority (97.5%) of parents had never accessed subsidised dental services. Families living in rural areas reported a significantly greater mean number of barriers compared to families living in urban areas. Overall barriers experienced by parents did not differ significantly by child age (p=0.18) or sex (p=0.77). Parents reported that the main reason that they would seek dental services for their child/children was because of oral disease. Suggestions by parents to improve service access included the availability of dental facilities in rural communities. Conclusions Almost all parents had not accessed dental services for their children. Barriers are prominent in rural areas. More parental education is needed about the significance of oral health and regular oral check-ups. Parents suggest that dentists should visit schools and small rural communities to conduct oral health education and provide simple dental treatment. It is clear that more needs to be done to improve dental services for children in PNG.