Preventive Dental Care for Children in the United States: A National Perspective

Lewis, Carol; Johnston, Brian; Linsenmeyar, Kristi A.; Williams, Alexis; Mouradian, Wendy E.

doi:10.1542/peds.2006-1958

Cited by 61 publications

(45 citation statements)

References 16 publications

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“…6 Although early dental visits are an integral dimension of anticipatory guidance, 7 the evidence base supporting their effectiveness in preventing dental disease is weak, 8 and young children' s utilization of preventive services is low. 2,9 It is estimated that ∼90% of infants and 1-year-old children had a pediatrician visit in 2000-2005, yet only 1.5% had a dental visit in the same time frame. 10 A variety of "distal" factors are likely influences of young children' s receipt of preventive dental services, including health system and insurance coverage factors, physical environment, workforce availability, distribution, and cultural competency.…”

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confidence: 99%

“…15 Nationally representative surveys have found links between caregivers' age, health status, race, ethnicity, education, income, insurance status, and their children' s receipt of preventive dental care. 9,16,17 Without proper guidance and counseling, caregivers' dental care seeking for their children may be probleminitiated, episodic, and therefore poorly and inappropriately timed and ineffective. To make matters worse, caregivers are generally not adept at recognizing the initial signs of early childhood caries in very young children.…”

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confidence: 99%

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Influence of Caregivers and Children’s Entry Into the Dental Care System

Divaris¹,

Lee²,

Baker³

et al. 2014

Pediatrics

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OBJECTIVES: Early preventive dental visits are essential in improving children’s oral health, especially young children at high risk for dental caries. However, there is scant information on how these children enter the dental care system. Our objectives were as follows: (1) to describe how a population-based cohort of young Medicaid-enrolled children entered dental care; and (2) to investigate the influence of caregiver characteristics on their children’s dental care–seeking patterns. METHODS: We relied on Medicaid claims and interview data of caregiver–child dyads who were enrolled in the Carolina Oral Health Literacy study during 2007–2008. The analytical cohort comprised 1000 children who had no dental visits before enrollment. Additional information was collected on sociodemographic characteristics, oral health status, health literacy, dental neglect, and access to care barriers. Our analyses relied on descriptive, bivariate, and multivariate methods. RESULTS: During the 25-month median follow-up period, 39% of the children (mean baseline age: 16 months) entered the dental care system, and 13% of their first encounters were for emergency care. Caregivers’ dental neglect emerged as a significant predictor of nonentrance. Children with reported oral health problems at baseline were more likely to enter the dental care system compared with children with better oral health, but they were also more likely to require emergency care. CONCLUSIONS: Caregivers have a pivotal role in children’s oral health and care. Interventions aimed at improving children’s oral health should involve community outreach to engage caregivers in a culturally appropriate manner when their children are infants or toddlers.

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confidence: 99%

mentioning

confidence: 99%

Influence of Caregivers and Children’s Entry Into the Dental Care System

Divaris¹,

Lee²,

Baker³

et al. 2014

Pediatrics

View full text Add to dashboard Cite

show abstract

“…5 The Government Accountability Office reported low rates of access to dental care. 6 State-reported levels of dental care are also low (Early Periodic Screening, Diagnostic, and Treatment reports). 7 To date, there are no national reports describing use of dental services by using Medicaid claims data.…”

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confidence: 99%

State of Dental Care Among Medicaid-Enrolled Children in the United States

2012

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OBJECTIVE: To evaluate the prevalence of dental care visits (DCV) in 2007 in the United States among Medicaid-enrolled children from birth to age 18 and measure progress since 2002. METHODS: By using Medicaid research files and information from the Centers for Medicare & Medicaid Services 416 Early Periodic Screening, Diagnostic, and Treatment forms, we calculated the prevalence of DCV in 50 states and the District of Columbia, stratifying by age, race, type of health plan, and Children’s Health Insurance Program status. RESULTS: The prevalence of having DCV ranged from 12% depending on age, to 49% with a median value of 33% but did not exceed 50% in any state. The median percent change between 2002 and 2007 was 16%. DCV among toddlers and infants were low in all but 3 states and in most states peaked at age of school entry to >60% in some states. In most states, there were few racial differences in the prevalence of DCV. Children enrolled in Primary Care Case Management tended to have the highest DCV, the effect of Children’s Health Insurance Program enrollment on the number of DCV was generally positive. CONCLUSIONS: To our knowledge, this is the first study to evaluate the prevalence of dental care by using paid Medicaid claims. Consistent with other reports, levels of DCV were low; but when the number of DCV was stratified by age and type plan, striking patterns emerged suggesting that a combination of school programs and having a medical home may have a positive impact on dental care.

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“…10 Additional factors that are known to be associated with use of oral health services include the child's age, race, country of birth, and wellchild visit history. 11,12 Beyond these child factors, other parent (eg, education level, age, nativity) and household (eg, family structure and size, language spoken at home, area of residence) factors have been identified as important determinants of children's use of oral health services. [11][12][13][14][15] A broader, multilevel perspective could shed more light on the complex interplay of factors that influence children's (under)use of oral health services and help to inform development of new strategies that will eliminate persistent disparities.…”

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confidence: 99%

Association Between Parents' and Children's Use of Oral Health Services

et al. 2010

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OBJECTIVE: Several parental factors influence children's use of oral health services. Some localized studies have shown that children's dental use patterns correlate positively with those of their parents. The objective of this study was to investigate associations between parents' and children's oral health–seeking behaviors among a representative sample of US children. METHODS: We used the 2007 National Health Interview Survey to analyze a sample of children aged 2 to 17 years, matched with 1 parent. Using logistic regression, we examined associations between parents' and children's use of dental services and deferred dental care because of cost. RESULTS: The sample included 6107 child–parent pairs. Overall, 77% of children and 64% of parents had a dental visit in the previous 12 months. Adjusting for sociodemographic and use variables, children were more likely to have a dental visit when their parents also had a dental visit (adjusted odds ratio: 3.36 [95% confidence interval: 2.71–4.18]), compared with children of parents who did not have a dental visit. In addition, compared with children of parents who did not defer seeking dental care, children of parents who deferred their dental care because of cost were more likely to have care deferred because of cost as well (adjusted odds ratio: 12.47 [95% confidence interval: 9.09–17.11]). CONCLUSIONS: Parental oral health–seeking behaviors for themselves may have an important effect on oral health–seeking behaviors on behalf of their children, regardless of the child's insurance status. Comprehensive strategies to eliminate barriers that target parents and not just children may help to address children's underuse of oral health services.

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Preventive Dental Care for Children in the United States: A National Perspective

Cited by 61 publications

References 16 publications

Influence of Caregivers and Children’s Entry Into the Dental Care System

Influence of Caregivers and Children’s Entry Into the Dental Care System

State of Dental Care Among Medicaid-Enrolled Children in the United States

Association Between Parents' and Children's Use of Oral Health Services

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