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

Abstract

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.

Incidence of dental caries in primary dentition and risk factors: a longitudinal study

“…This finding seems to be associated with the difficulty of understanding such measures on the part of parents/caregivers, or else the low priority given to oral health care. 29 In this respect, one must consider the influence of environmental and socioeconomic factors. While families may agree to follow the recommendations of dental professionals for the maintenance of their children's oral health, aspects such as level of comprehension and poor living conditions, as well as limited availability and access to health services may compromise the adoption and success of preventive measures.…”

Emergency Dental Care of Children and Adolescents in Basic Health Unit and Emergency Care Unit

“…As pointed out by two other studies conducted in the USA -one that assessed emergency care at a university health center and one that investigated into Medicaid beneficiaries, first access of children to oral health systems due to a dental emergency shows a remarkable rate [19,20]. Several parents/legal guardians seek first dental care for their children when they spot a problem [21,22] and there have been reports that children with worse oral health have a higher prevalence of first access to the health system during emergency care than those with a better oral health status [20].…”

“…Several parents/legal guardians seek first dental care for their children when they spot a problem [21,22] and there have been reports that children with worse oral health have a higher prevalence of first access to the health system during emergency care than those with a better oral health status [20].…”

Improving Children’s Oral Health

“…This line of research also found oral health literacy associations with oral health status, oral health-related behaviors, knowledge, and quality of life. Importantly, it highlighted that low health literacy among caregivers was associated with children having worse oral health status, deleterious oral health behaviors (e.g., no daily brushing/cleaning and nighttime bottle use), suboptimal use of dental services, and interruptions in children's public insurance coverage (Vann et al, 2010;Lee et al, 2012;Divaris et al, 2014). Self-efficacy and dental neglect are 2 behavioral constructs that have emerged as important mediators between literacy and oral health outcomes (Lee et al, 2012).…”