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BACKGROUND: A substantial number of U.S. children delay obtaining dental care until school-age, despite the pediatric and public health organizations’ recommendations of initiating first dental visit by age one. This study aims to assess if RI young children’s likelihood of dental visit is associated with parent’s receipt of dental care, in accordance with studies that showed parent’s health care utilization behavior is a strong determinant of children’s health care use.
METHODS: As outlined by the RI Oral Health Surveillance System, state-added oral health questions for adults and children were included in the 2008, 2010 and 2012 BRFSS. Three years combined, 3,979 parents of randomly selected children (<18 years) within the household completed the Random Child Selection Optional Module interview. The study examined parent-reported preventive dental visit (for checkup/cleaning) in the past 12 months among children age 1–3 years (n=443 that counted for 95,942 state representative children). Bivariate and multivariate analyses were conducted to assess if children’s preventive dental care is associated with parents’ dental visit and other explanatory variables, using SAS survey procedures (SAS® v9.1.3).
RESULTS: Only about three out of ten children age 1–3 years visited a dentist or dental clinic for preventive dental services in the past year (32.0% [95% CI=26.3–37.7]). Parent’s dental visit was not associated with child’s dental visit, both in unadjusted and adjusted analyses. Child’s age was the only factor that was strongly associated with the likelihood of preventive dental visit: compared with children age 3 years (54.5% [95% CI=43.8–65.2]), children age 1 year and children age 2 years were less likely to have a dental visit (12.3% [95% CI=5.6–19.0]) and 26.9% [95% CI=17.6–36.2], respectively, p<.0001). These associations remained significant in the logistic regression model adjusted for child’s dental insurance, and parent’s attributes of educational attainment, race/ethnicity, marital status and dental visit (AOR for children age 1 vs. 3=0.11 [95% CI=0.05–0.25], AOR for children age 2 vs. 3=0.34 [95% CI=0.17–0.67]).
CONCLUSIONS: The prevalence of early childhood dental visits for RI children is generally quite low, regardless of child’s own dental insurance coverage, and parent’s socioeconomic characteristics and dental utilization. Low oral health care utilization can lead to higher dental disease morbidity, particularly among high-risk, low-income or minority children who would miss opportunities for prevention, early identification and treatment of childhood caries. Public health efforts are needed to educate parents, and medical and dental providers to facilitate establishing dental homes for children at an early age.