Family Access to a Dentist Study (FADS): A multi-center randomized controlled trial

Abstract

Introduction Many low-income parent/caregivers do not understand the importance of cavity-free primary (baby) teeth and the chronic nature of dental caries (tooth decay). As a consequence, dental preventive and treatment utilization is low even when children are screened in schools and referred for care. This study aims to test a referral letter and Dental Information Guide (DIG) designed using the Common-Sense Model of Self-Regulation (CSM) framework to improve caregivers’ illness perception of dental caries and increase utilization of care by children with restorative dental needs. Methods A multi-site randomized controlled trial with caregivers of Kindergarten to 4th grade children in urban Ohio and rural Washington State will compare five arms: (1) CSM referral letter alone; (2) CSM referral letter + DIG; (3) reduced CSM referral letter alone; (4) reduced CSM referral letter + DIG; (5) standard (control) referral. At baseline, children will be screened at school to determine restorative dental needs. If in need of treatment, caregivers will be randomized to study arms and an intervention packet will be sent home. The primary outcome will be dental care based on a change in oral health status by clinical examination 7 months post-screening (ICDAS sealant codes 1 and 2; restoration codes 3–8; extraction). Enrollment commenced summer 2015 with results in summer 2016. Conclusion This study uses the CSM framework to develop and test behavioral interventions to increase dental utilization among low-income caregivers. If effective this simple intervention has broad applicability in clinical and community-based settings.

Evaluating the changes in molar incisor hypomineralization prevalence: A comparison of two cross‐sectional studies in two elementary schools in Mexico City between 2008 and 2017

“…Although the recognition of poor dental health in children is important, it is unclear how this perception is processed in the parents. Further research is required to investigate the dynamics of their coping mechanisms (Nelson et al, ). The parents' recognition of their children's oral health problems is a basic step toward the search for treatment.…”

“…Although the recognition of poor dental health in T A B L E 5 Crude and adjusted odds ratios of the mixed-effects logistic regression models of maternal perception of a child's oral health and sociodemographic, dental caries, and molar incisor hypomineralization children is important, it is unclear how this perception is processed in the parents. Further research is required to investigate the dynamics of their coping mechanisms (Nelson et al, 2015). The parents' recognition of their children's oral health problems is a basic step toward the search for treatment.…”

Do baby teeth really matter? Changing parental perception and increasing dental care utilization for young children

“…Our secondary hypothesis was that the increase in child dental care utilization would be through the primary mediating effect of changes in caregiver illness representation/perception by influencing behavioral intention, after controlling for relevant child and caregiver socio-demographic characteristics. The design and details of this study has been previously reported [26]. …”

A school‐based public health model to reduce oral health disparities

“…While these results are encouraging, there remains an important population of students who failed to access restorative care despite these services and for whom additional case management or access to school‐based and community‐based restorative dental care may be needed. Understanding how to improve the effectiveness of screening and referral programs and address barriers to accessing a dental home , are critical to addressing the substantial unmet oral health needs of low‐income children.…”

“…Studies suggests that education alone is not likely to substantially reduce caries . Various behavior change theories have been applied to oral health , but it remains unknown how to most effectively target and successfully change the drivers of oral health behaviors. Achieving a deeper understanding of this issue will be critical to reducing the overall burden of disease among vulnerable children.…”