Changes in Children's Oral Health Status and Receipt of Preventive Dental Visits

United States, 2003-2011/2012

Mahua Mandal, MPH, PhD; Burton L. Edelstein, DDS, MPH; Sai Ma, PhD; Cynthia S. Minkovitz, MD, MPP

Disclosures

Prev Chronic Dis. 2013;10 

In This Article

Abstract and Introduction

Abstract

Introduction Oral health represents the largest unmet health care need for children, and geographic variations in children's receipt of oral health services have been noted. However, children's oral health outcomes have not been systematically evaluated over time and across states. This study examined changes in parent-reported children's oral health status and receipt of preventive dental visits in 50 states and the District of Columbia.

Methods We used data from the 2003 and the 2011/2012 National Survey of Children's Health. National and state-level estimates of the adjusted prevalence of oral health status and preventive dental visits were calculated and changes over time examined. Multivariable logistic regression was used to compare outcomes across all states and the District of Columbia for each survey year.

Results The percentage of parents who reported that their children had excellent or very good oral health increased from 67.7% in 2003 to 71.9% in 2011/2012. Parents who reported that their children had preventive dental visits increased from 71.5% in 2003 to 77.0% in 2011/2012. The prevalence of children with excellent or very good oral health status increased in 26 states, and the prevalence of children who received at least 1 preventive care dental visit increased in 45 states. In both years, there was more variation among states for preventive dental visits than for oral health status.

Conclusions State variation in oral health status and receipt of preventive dental services remained after adjusting for demographic characteristics. Understanding these differences is critical to addressing the most common chronic disease of childhood and achieving the oral health objectives of Healthy People 2020.

Introduction

Oral health is critically important to overall health[1] and is the largest unmet health care need for children.[2] Dental caries, a primary indicator of oral health, remains the most common chronic childhood disease.[3] Forty percent of children aged 2 to 11 years experience dental caries,[4] and its prevalence is increasing in the youngest age group: among children aged 2 to 4 years, the prevalence of children with dental caries increased from 19% in 1988–1994 to 24% in 1999–2004.[5] Moreover, parents report their children's oral health status as worse than their general health status.[6]

Children do not receive dental preventive care in accordance with the recommendations of professional organizations. The American Academy of Pediatric Dentistry and the American Academy of Pediatrics recommend that children visit a dentist every 6 months beginning by age 12 months;[7,8] however, according to the 2007 National Survey of Children's Health, 22% of children under age 17 did not visit a dentist in the previous year.[9] Furthermore, although 1 of the goals of Healthy People 2010 was that 66% of low-income children and adolescents receive annual preventive-care dental services, data from Medicaid's Early and Periodic Screening, Diagnostic, and Treatment program indicate only 36% of Medicaid-eligible children under 19 years received any dental preventive care in fiscal year 2010.[10] In 2003 and 2007, publicly insured and uninsured children had lower odds of making preventive care visits to a dentist and higher odds of experiencing delayed dental care than privately insured children.[11] Finally, compared with white, black, and Hispanic children and children of other races/ethnicities are less likely to receive oral health care, including preventive dental visits,[11,12] and more likely to experience delayed care or have unmet dental care needs.[13]

Although geographic variations exist in children's receipt of oral health care,[14] oral health status and receipt of preventive dental care by children have not been systematically evaluated over time and across states. Assessing state-level variations in children's oral health over time is necessary for understanding observed improvements or worsening of outcomes and the potential role of policies and programs in influencing these changes. The objective of this study was to examine changes in parent-reported children's oral health status and recent preventive dental visits in the United States over time and across 50 states and the District of Columbia.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....