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Bas AC, Azogui-Lévy S. Socio-Economic Determinants of Dental Service Expenditure: Findings from a French National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031310. [PMID: 35162334 PMCID: PMC8835070 DOI: 10.3390/ijerph19031310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/12/2022] [Accepted: 01/19/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: This study investigated how individual enabling resources influence (i) their probability of using dental services and (ii) consumers’ expenditure on dental treatment. (2) Methods: Data were derived from a self-administered national health survey questionnaire and from expenditure data from national health insurance. Multiple linear regression methods were used to analyze entry into the dental health system (yes/no) and, independently, the individual expenditure of dental care users. (3) Results: People with the highest incomes were more likely to use dental service (aOR = 1.59; 95% CI = 1.28, 1.97), as were those with complementary health insurance and the lowest deprivation scores. For people using dental services, good dental health status was associated with less expenditure (−70.81 EUR; 95% CI = −116.53, −25.08). For dental service users, the highest deprivation score was associated with EUR +43.61 dental expenditure (95% CI = −0.15; 87.39). (4) Conclusion: Socioeconomic determinants that were especially important for entry into the dental health service system were relatively insignificant for ongoing service utilization. These results are consistent with our hypothesis of a dental care utilization process in two steps. Public policies in countries with private fees for dentistry should improve the clarity of dental fees and insurance payments.
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Affiliation(s)
- Anne-Charlotte Bas
- Dental Public Health Department, Faculty of Dentistry, Paris University, 75006 Paris, France;
- Inserm U1018, Centre de Recherche en Épidémiologie et Santé des Populations, 94807 Villejuif, France
- Correspondence:
| | - Sylvie Azogui-Lévy
- Dental Public Health Department, Faculty of Dentistry, Paris University, 75006 Paris, France;
- Educations and Health Practices Laboratory (LEPS EA 3412), Faculty of Medicine, Paris 13 University, 93017 Bobigny, France
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Chattopadhyay A, Christian B, Masood M, Calache H, Carpenter L, Gibbs L, Gussy M. Natural history of dental caries: Baseline characteristics of the VicGen birth cohort study. Int J Paediatr Dent 2020; 30:334-341. [PMID: 31850608 PMCID: PMC9292657 DOI: 10.1111/ipd.12609] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/04/2019] [Accepted: 12/12/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early-life dental caries is a major global health problem. Children's first dental visit is recommended at 2 years age. The VicGeneration (VicGen) oral health birth cohort study aims to understand the multifactorial nature of early childhood caries. This report describes the baseline characteristics of children in the VicGen study. METHODS We merged data between the first (at birth) and fourth waves (18 month age) to assess dental caries among children (primary outcome) and other oral diseases (secondary outcomes) employing t tests, chi-square tests, Fisher's exact tests, and Cochran-Mantel-Haenszel tests using IBM-SPSS(v25). RESULTS Most children lived in metros with two-parent families. Most guardians were women graduated from high school. Twenty-seven of 389 (6.94%) 18-month-old children experienced dental caries. More children living in rural areas (vs. urban) experienced caries. Females were more likely to experience caries (OR: 2.16). Several children had other oral health problems. In early life, children's oral examination was conducted by midwives, breastfeeding/lactation consultants, hospital nurses, speech pathologists, and breastfeeding clinic staff. CONCLUSION VicGen baseline characteristics show that almost 7% of the 18-month-old children experienced caries. There is a need to advance children's recommended first dental visit date and to train early-life healthcare professionals about oral diseases.
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Affiliation(s)
- Amit Chattopadhyay
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVICAustralia,School of Dental MedicineCase Western Reserve UniversityClevelandOhio,Manipal College of Dental SciencesMangaloreIndia,Quest Arete ScienceOklahoma CityOklahoma
| | | | - Mohd. Masood
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVICAustralia
| | - Hanny Calache
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVICAustralia,Deakin Health EconomicsCentre for Population Health ResearchFaculty of HealthDeakin UniversityBurwoodVICAustralia
| | - Lauren Carpenter
- Jack Brockhoff Child Health and Wellbeing ProgramCentre for Health EquityThe University of MelbourneMelbourneVICAustralia
| | - Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing ProgramCentre for Health EquityThe University of MelbourneMelbourneVICAustralia
| | - Mark Gussy
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVICAustralia
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Bramantoro T, Indrastie N, Hariyani N, Setyowati D. Husband's Support and Wife's Decision to Children's Dental Visit: Is There Any Relationship? Clin Cosmet Investig Dent 2019; 11:367-371. [PMID: 31819658 PMCID: PMC6890517 DOI: 10.2147/ccide.s224336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 11/12/2019] [Indexed: 11/23/2022] Open
Abstract
Background Early childhood caries (ECC) is the most common dental caries in children. The 2013 Indonesian basic health survey showed that there were still many children in developmental age affected by dental caries. Parents’ participation is very necessary in guiding, giving understanding, reminding, and providing facilities so that children can maintain their overall oral hygiene. Hence, parents can prevent plaque accumulation and the occurrence of caries in children. Objective This study aimed to determine the effect of husbands’ support on the decision of mothers to take their children to the dentist. Subjects and methods This study used a cross-sectional method. The samples from this study were 95 mothers from 3 kindergartens in Surabaya. Ninety-five mothers were randomly chosen as research respondents and filled out the research questionnaires. The data obtained were processed using statistical analysis to determine the correlation. Results Research respondents with low husband support (subjective norms) who did not take their children to the dentist had a significant value (p = 0.004) compared to the study respondents with high husband support who did not bring their children to the dentist (p = 0.093). Conclusion Mothers with low support from husbands tend to have the attitude not to take their children to do routine dental and oral examinations.
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Affiliation(s)
- Taufan Bramantoro
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Nuraini Indrastie
- Graduate School of Dental Science, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ninuk Hariyani
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Dini Setyowati
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
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4
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Finlayson TL, Gupta A, Ramos-Gomez FJ. Prenatal Maternal Factors, Intergenerational Transmission of Disease, and Child Oral Health Outcomes. Dent Clin North Am 2018; 61:483-518. [PMID: 28577633 DOI: 10.1016/j.cden.2017.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article reviews maternal prenatal risk factors for caries in children and intergenerational transmission of caries, emphasizing early interventions for pregnant women and mother-infant pairs. A growing body of evidence focuses on maternal interventions. Studies suggest that early prenatal clinical and educational interventions are effective at reducing mother-child mutans streptococci (MS) transmission and delaying colonization and caries in young children. Dental screenings and anticipatory guidance about maternal and infant oral health should be included in prenatal care and pediatric well visits. Dental care during pregnancy is safe and recommended and can reduce maternal MS levels. Infants should visit a dentist by age 1.
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Affiliation(s)
- Tracy L Finlayson
- Division of Health Management and Policy, Graduate School of Public Health, Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Part Court, Suite 221, San Diego, CA 92123, USA.
| | - Aarti Gupta
- Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221, San Diego, CA 92123, USA
| | - Francisco J Ramos-Gomez
- Section of Pediatric Dentistry, University of California Los Angeles (UCLA) School of Dentistry, 10833 Le Conte Avenue, Box 951668, CHS Room 23-020B, Los Angeles, CA 90095-1668, USA
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Statewide Policy Change in Pediatric Dental Care, and the Impact on Pediatric Dental and Physician Visits. Matern Child Health J 2017; 21:1939-1948. [PMID: 28741086 DOI: 10.1007/s10995-017-2310-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Introduction In 2007, the California signed legislation mandating a dental visit for all children entering kindergarten or first grade; no such mandate was made for physician visits. This study examines the impact of this policy change on the risk factors associated with obtaining pediatric dental and physician health care visits. Methods Every 2 years, California Health Interview Survey conducts a statewide survey on a representative community sample. This cross-sectional study took advantage of these data to conduct a "natural experiment" assessing the impact of this policy change on both pediatric physician and dental care visits in the past year. Samples included surveys of adults and children (ages 5-11) on years 2005 (n = 5096), 2007 (n = 4324) and 2009 (n = 4100). Results Although few changes in risk factors were noted in pediatric physician visits, a gradual decrease in risk factors was found in pediatric dental visits from 2005 to 2009. Report of no dental visit was less likely for: younger children (OR -0.81, CI 0.75-0.88), insured children (OR 0.34, CI 0.22-0.53), and children who had a physician's visit last year (OR 0.37, CI 0.25-0.53) in 2005. By 2007, absence of insurance was the only risk factor related to having no dental visit (OR 0.34, CI 0.19-0.61). By 2009, no a priori measured risk factors were associated with not having a dental visit for children aged 5-11 years. Conclusions A statewide policy mandating pediatric dental visits appears to have reduced disparities. A policy for medical care may contribute to similar benefits.
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Heima M, Heaton L, Gunzler D, Morris N. A mediation analysis study: The influence of mothers' dental anxiety on children's dental utilization among low-income African Americans. Community Dent Oral Epidemiol 2017; 45:506-511. [PMID: 28727169 DOI: 10.1111/cdoe.12313] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 05/14/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this study was to test a hypothesized mediation model to explain associations between mothers' dental anxiety and children's dental utilization through the mothers' own dental utilization. METHODS Two hundred and fourteen low-income African American mothers with young children (age 31-59 months) completed a study questionnaire which assessed (i) mothers' dental anxiety; (ii) mothers' dental utilization (seeing a dentist at least once a year) and (iii) children's dental utilization (at least one non-study-related dental visit during the 36-month study period). The hypothesized mediation model consisted of these three elements with both a direct path from mothers' dental anxiety to children's dental utilization and an indirect path from mothers' dental anxiety to children's dental utilization through mothers' dental utilization. Mediation analysis with bootstrapping was conducted to test the hypothesized model. RESULTS The mediation analysis indicated significant total effect of mothers' dental anxiety on children's dental utilization. The standardized total effect of mothers' anxiety on children's dental utilization was -0.172 (SE=.084, P=.041), and the standardized indirect effect of mothers' anxiety on children's dental utilization mediated by mothers' dental utilization was -0.069 (SE=.039, P=.076). The direct effect from mothers' anxiety to children's dental utilization was not statistically significant (P=.261) after adjusting for the mothers' dental utilization. CONCLUSIONS In this low-income African American sample, there was a trend for mothers' dental anxiety to be associated with children's dental utilization indirectly through mothers' own dental utilization, while the direct influence of mothers' dental anxiety on children's dental utilization was not seen. This suggests that mothers' dental utilization might explain how mothers' dental anxiety impacts children's early dental utilization.
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Bellettiere J, Chuang E, Hughes SC, Quintanilla I, Hofstetter CR, Hovell MF. Association Between Parental Barriers to Accessing a Usual Source of Care and Children's Receipt of Preventive Services. Public Health Rep 2017; 132:316-325. [PMID: 28358997 PMCID: PMC5415258 DOI: 10.1177/0033354917699831] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Preventive health services are important for child development, and parents play a key role in facilitating access to services. This study examined how parents' reasons for not having a usual source of care were associated with their children's receipt of preventive services. METHODS We used pooled data from the 2011-2014 National Health Interview Survey (n = 34 843 participants). Parents' reasons for not having a usual source of care were framed within the Penchansky and Thomas model of access and measured through 3 dichotomous indicators: financial barriers (affordability), attitudes and beliefs about health care (acceptability), and all other nonfinancial barriers (accessibility, accommodation, and availability). We used multivariable logistic regression models to test associations between parental barriers and children's receipt of past-year well-child care visits and influenza vaccinations, controlling for other child, family, and contextual factors. RESULTS In 2014, 14.3% (weighted percentage) of children had at least 1 parent without a usual source of care. Children of parents without a usual source of care because they "don't need a doctor and/or haven't had any problems" or they "don't like, trust, or believe in doctors" had 35% lower odds of receiving well-child care (adjusted odds ratio = 0.65; 95% CI, 0.56-0.74) and 23% lower odds of receiving influenza vaccination (adjusted odds ratio = 0.77; 95% CI, 0.69-0.86) than children of parents without those attitudes and beliefs about health care. Financial and other nonfinancial parental barriers were not associated with children's receipt of preventive services. Results were independent of several factors relevant to children's access to preventive health care, including whether the child had a usual source of care. CONCLUSIONS Parents' attitudes and beliefs about having a usual source of care were strongly associated with their children's receipt of recommended preventive health services. Rates of receipt of child preventive services may be improved by addressing parents' attitudes and beliefs about having a usual source of care. Future studies should assess causes of these associations.
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Affiliation(s)
- John Bellettiere
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
- San Diego State University/University of California San Diego Joint Doctoral Program in Public Health (Epidemiology), University of California San Diego, La Jolla, CA, USA
| | - Emmeline Chuang
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Suzanne C. Hughes
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Isaac Quintanilla
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - C. Richard Hofstetter
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Melbourne F. Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
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Askelson NM, Chi DL, Momany ET, Kuthy RA, Carter KD, Field K, Damiano PC. The Importance of Efficacy: Using the Extended Parallel Process Model to Examine Factors Related to Preschool-Age Children Enrolled in Medicaid Receiving Preventive Dental Visits. HEALTH EDUCATION & BEHAVIOR 2015; 42:805-13. [PMID: 25862302 DOI: 10.1177/1090198115580575] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Early preventive dental visits are vital to the oral health of children. Yet many children, especially preschool-age children enrolled in Medicaid, do not receive early visits. This study attempts to uncover factors that can be used to encourage parents to seek preventive dental care for preschool-age children enrolled in Medicaid. The extended parallel process model was used as a theoretical framework for this research. This model suggests that people will act if the perceived threat (severity and susceptibility) is high enough and if efficacy levels (self-efficacy and response efficacy) are likewise high. Following Witte's method of categorizing people's perceptions and emotions into one of four categories based on levels of threat and efficacy, this article describes four groups (high threat/high efficacy, high threat/low efficacy, low threat/high efficacy, and low threat/low efficacy) of parents and how they compare to each other. Using logistic regression to model if a child had a preventive visit, results indicate that parents with low threat/high efficacy and parents with high threat/high efficacy had approximately 2.5 times the odds of having a child with a preventive oral health visit compared to parents with low threat/low efficacy, when controlling for perceived oral health status, health literacy, and child's age. The importance of efficacy needs to be incorporated in interventions aimed at increasing preventive dental visits for young children.
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Kaiser KL, Barry Hultquist T, Chen LW. Maternal Health-Seeking on Behalf of Low-Income Children. Public Health Nurs 2015; 33:21-31. [PMID: 26365293 DOI: 10.1111/phn.12228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Li-Wu Chen
- Department of Health Services Research and Administration; University of Nebraska Medical Center; College of Public Health; Omaha Nebraska
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Riedy CA, Weinstein P, Mancl L, Garson G, Huebner CE, Milgrom P, Grembowski D, Shepherd-Banigan M, Smolen D, Sutherland M. Dental attendance among low-income women and their children following a brief motivational counseling intervention: A community randomized trial. Soc Sci Med 2015; 144:9-18. [PMID: 26372934 DOI: 10.1016/j.socscimed.2015.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 08/19/2015] [Accepted: 09/04/2015] [Indexed: 11/29/2022]
Abstract
UNLABELLED This study tested a behavioral intervention to increase dental attendance among rural Oregonian low-income women and their children. It utilized a multi-site, single-blind, randomized trial design. Four hundred women were randomized into one of four conditions to receive prenatal or postpartum motivational interviewing/counseling (MI) or prenatal or postpartum health education (HE). Counselors also functioned as patient navigators. Primary outcomes were dental attendance during pregnancy for the mother and for the child by age 18 months. Attendance was obtained from the Oregon Division of Medical Assistance Programs and participant self-report. Statewide self-reported utilization data were obtained from the Oregon Pregnancy Risk Assessment Monitoring System (PRAMS). Maternal attendance was 92% in the prenatal MI group and 94% in the prenatal HE group (RR = 0.98; 95% CI = 0.93-1.04). Children's attendance was 54% in postpartum MI group and 52% in the postpartum HE group (RR = 1.03; 95% CI = 0.82-1.28). Compared to statewide PRAMS, attendance was higher during pregnancy for study mothers (45% statewide; 95% CI = 40-50%) and for their children by 24 months (36% statewide; 95% CI = 27-44%). MI did not lead to greater attendance when compared to HE alone and cost more to implement. High attendance may be attributable to the counselors' patient navigator function. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT01120041.
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Affiliation(s)
- Christine A Riedy
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Philip Weinstein
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Lloyd Mancl
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Gayle Garson
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Colleen E Huebner
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Peter Milgrom
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - David Grembowski
- University of Washington School of Public Health, Box 357660, 1959 NE Pacific St, Seattle, WA 98195-7660, USA.
| | - Megan Shepherd-Banigan
- University of Washington School of Public Health, Box 357660, 1959 NE Pacific St, Seattle, WA 98195-7660, USA.
| | - Darlene Smolen
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA.
| | - Marilynn Sutherland
- Klamath County Department of Public Health, 305 Main Street, Klamath Falls, OR 97601, USA.
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Sohn W. Caregiver's Education Level is Associated With a Child's Dental Caries, in Part, Mediated by Dental Care Use Behaviors in Low-income African American Populations. J Evid Based Dent Pract 2015; 15:128-30. [PMID: 26337586 DOI: 10.1016/j.jebdp.2015.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Woosung Sohn
- Associate Professor, Department of Health Policy and Health Services Research, Boston University, Henry M. Goldman School of Dental Medicine, 560 Harrison Ave., 3rd Floor (Rm. 327), Boston, MA 02118, USA, Tel.: +1 617 414 1156; fax: +1 617 638 6381.
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Baker-Ward L, Quinonez R, Milano M, Lee S, Langley H, Brumley B, Ornstein PA. Predicting Children's Recall of a Dental Procedure: Contributions of Stress, Preparation, and Dental History. APPLIED COGNITIVE PSYCHOLOGY 2015. [DOI: 10.1002/acp.3152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Lynne Baker-Ward
- Department of Psychology; North Carolina State University; Raleigh USA
| | - Rocio Quinonez
- Department of Pediatric Dentistry, School of Dentistry; University of North Carolina at Chapel Hill; Chapel Hill USA
| | - Michael Milano
- Department of Pediatric Dentistry, School of Dentistry; University of North Carolina at Chapel Hill; Chapel Hill USA
| | - Seungjin Lee
- Department of Psychology; University of North Carolina at Chapel Hill; Chapel Hill USA
| | - Hillary Langley
- Department of Psychology; University of North Carolina at Chapel Hill; Chapel Hill USA
| | - Benjamin Brumley
- Department of Psychology; University of North Carolina at Chapel Hill; Chapel Hill USA
| | - Peter A. Ornstein
- Department of Psychology; University of North Carolina at Chapel Hill; Chapel Hill USA
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Muirhead V, Levine A, Nicolau B, Landry A, Bedos C. Life course experiences and lay diagnosis explain low-income parents' child dental decisions: a qualitative study. Community Dent Oral Epidemiol 2015; 41:13-21. [PMID: 22934653 DOI: 10.1111/j.1600-0528.2012.00741.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed to better understand low-income parents' child dental care decisions through a life course approach that captured parents' experiences within the social context of poverty. METHODS We conducted 43 qualitative life history interviews with 10 parents, who were long-term social assistance recipients living in Montreal, Canada. Thematic analysis involved interview debriefing, transcript coding, theme identification and data interpretation. RESULTS Our interviews identified two emergent themes: lay diagnosis and parental oral health management. Parents described a process of 'lay diagnosis' that consisted of examining their children's teeth and interpreting their children's oral signs and symptoms based on their observations. These lay diagnoses were also shaped by their own dental crises, care experiences and oral health knowledge gained across a life course of poverty and dental disadvantage. Parents' management strategies included monitoring and managing their children's oral health themselves or by seeking professional recourse. Parents' management strategies were influenced both by their lay diagnoses and their perceived ability to manage their children's oral health. Parents felt responsible for their children's dental care, empowered to manage their oral health and sometimes forgo dental visits for their children because of their own self-management life history. CONCLUSION This original approach revealed insights that help to understand why low-income parents may underutilize free dental services. Further research should consider how dental programs can nurture parental empowerment and capitalize on parents' perceived ability to diagnose and manage their children's oral health.
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15
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Heima M, Lee W, Milgrom P, Nelson S. Caregiver's education level and child's dental caries in African Americans: a path analytic study. Caries Res 2015; 49:177-83. [PMID: 25661111 DOI: 10.1159/000368560] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 09/17/2014] [Indexed: 11/19/2022] Open
Abstract
The objective of this study was to investigate the influence of caregiver education level on children's dental caries mediated by both caregiver and child oral health behaviors. Participants were 423 low-income African American kindergarteners and their caregivers who were part of a school-based randomized clinical trial. Path analysis tested the hypothesis that caregiver education level affected untreated dental caries and cumulative overall caries experience (decayed or filled teeth) through the mediating influence of frequency of dental visits, use of routine care, and frequency of toothbrushing for both the caregiver and the child. The results supported the hypothesis: caregivers who completed high school were 1.76 times more likely to visit dentists compared with those who did not complete high school (e(0.56) = 1.76, 95% CI: 1.03-2.99), which in turn was associated with 5.78 times greater odds of dental visits among their children (e(1.76) = 5.78, 95% CI: 3.53-9.48). Children's dental visits, subsequently, were associated with 26% fewer untreated decayed teeth compared with children without dental visits (e(-0.31) = 0.74, 95% CI: 0.60-0.91). However, this path was not present in the model with overall caries experience. Additionally, caregiver education level was directly associated with 34% less untreated decayed teeth (e(-0.42) = 0.66, 95% CI: 0.54-0.79) and 28% less decayed or filled teeth (e(-0.32) = 0.72, 95% CI: 0.60-0.88) among the children. This study overcomes important conceptual and analytic limitations in the existing literature. The findings confirm the role of caregiver education in child dental caries and indicate that caregiver's behavioral factors are important mediators of child oral health.
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Finlayson TL, Gansky SA, Shain SG, Weintraub JA. Dental utilization by children in Hispanic agricultural worker families in California. JOURNAL OF DENTAL, ORAL AND CRANIOFACIAL EPIDEMIOLOGY 2015; 2:15-24. [PMID: 25621285 PMCID: PMC4301614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Agricultural worker families encounter multiple barriers to accessing all needed dental care. This study investigated predisposing, enabling, and need factors associated with children's past year dental utilization among Hispanic agricultural worker families in central California. METHODS Oral health survey and clinical data were collected from families participating in a larger, population-based study in 2006-7. Generalized estimating equation logit regression assessed effects on a dental visit among children aged 0-17 (n=405). Analyses adjusted for clustering of children in the same household. Predisposing (sociodemographics), enabling (child's dental insurance, usual source of dental care, caregiver past year dental visit, acculturation level, income and education), and need (caregiver's oral health rating, perception of cavities, and clinically-determined treatment urgency) factors were examined. RESULTS Half (51%) the children had a past year dental visit, while 23% had never been to a dentist. In the final model, children were less likely to have a past year dental visit if they were foreign-born, male, had caregivers that thought they had cavities or were unsure, and if the dentist recommended treatment 'at earliest convenience'. Children aged 6-12, with a regular dental care source, and whose caregivers had a recent dentist visit were more likely to have a past year dental visit. CONCLUSIONS Children were more likely to have a past year dental visit if they had a usual source of dental care (OR =4.78, CI=2.51-9.08), and if the caregiver had a past year dental visit (OR=1.88, CI=1.04-3.38). Emphasis should be placed on these two modifiable factors to increase children's dental utilization.
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Affiliation(s)
- Tracy L Finlayson
- Graduate School of Public Health San Diego State University 5500 Campanile Drive San Diego CA 92182-4162
| | - Stuart A Gansky
- University of California San Francisco School of Dentistry John C. Greene Professor of Primary Care Dentistry Associate Director, Center to Address Disparities in Children's Oral Health Assistant Director, CTSI Mentor Development Program Division of Oral Epidemiology & Dental Public Health
| | - Sara G Shain
- University of California San Francisco School of Dentistry
| | - Jane A Weintraub
- The University of North Carolina at Chapel Hill School of Dentistry
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Isong I, Dantas L, Gerard M, Kuhlthau K. Oral Health Disparities and Unmet Dental Needs among Preschool Children in Chelsea, MA: Exploring Mechanisms, Defining Solutions. JOURNAL OF ORAL HYGIENE & HEALTH 2015; 2:1000138. [PMID: 25614878 PMCID: PMC4299657 DOI: 10.4172/2332-0702.1000138] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Significant disparities exist in children's receipt of preventive dental care (PDC) in the United States. Many of the children at greatest risk of dental disease do not receive timely PDC; when they do receive dental care, it is often more for relief of dental pain. Chelsea is a low-income, diverse Massachusetts community with high rates of untreated childhood caries. There are various dental resources available in Chelsea, yet many children do not access dental care at levels equivalent to their needs. OBJECTIVE Using Chelsea as a case-study, to explore factors contributing to forgone PDC (including the age 1 dental visit) in an in-depth way. METHODS We used a qualitative study design that included semi-structured interviews with parents of preschool children residing in Chelsea, and Chelsea-based providers including pediatricians, dentists, a dental hygienist and early childhood care providers. We examined: a) parents' dental attitudes and oral health cultural beliefs; b) parents' and providers' perspectives on facilitators and barriers to PDC, reasons for unmet needs, and proposed solutions to address the problem. We recorded, transcribed and independently coded all interviews. Using rigorous, iterative qualitative data analyses procedures, we identified emergent themes. RESULTS Factors perceived to facilitate receipt of PDC included Head-Start oral health policies, strong pediatric primary care/dental linkages, community outreach and advertising, and parents' own oral health experiences. Most parents and providers perceived there to be an adequate number of accessible dental services and resources in Chelsea, including for Medicaid enrollees. However, several barriers impeded children from receiving timely PDC, the most frequently cited being insurance related problems for children and adults. Other barriers included limited dental services for children <2 years, perceived poor quality of some dental practices, lack of emphasis on prevention-based dental care, poor care-coordination, and insufficient culturally-appropriate care. Important family-level barriers included parental oral health literacy, cultural factors, limited English proficiency and competing priorities. Several solutions were proposed to address identified barriers. CONCLUSION Even in a community with a considerable number of dental resources, various factors may preclude access to these services by preschool-aged children. Opportunities exist to address modifiable factors through strategic oral health policies, community outreach and improved care coordination between physicians, dentists and early childhood care providers.
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Affiliation(s)
- Inyang Isong
- Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Laila Dantas
- Cambridge Health Alliance, Cambridge, MA, USA
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Macda Gerard
- Department of Public Health, Brown University, Providence, RI, USA
| | - Karen Kuhlthau
- Harvard Medical School, Boston, MA, USA
- Center for Child & Adolescent Health Research and Policy, MGHfC, Boston, MA, USA
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Casamassimo PS, Lee JY, Marazita ML, Milgrom P, Chi DL, Divaris K. Improving children's oral health: an interdisciplinary research framework. J Dent Res 2014; 93:938-42. [PMID: 25122218 DOI: 10.1177/0022034514547273] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Despite the concerted efforts of research and professional and advocacy stakeholders, recent evidence suggests that improvements in the oral health of young children in the United States has not followed the prevailing trend of oral health improvement in other age groups. In fact, oral health disparities in the youngest children may be widening, yet efforts to translate advances in science and technology into meaningful improvements in populations' health have had limited success. Nevertheless, the great strides in genomics, biological, behavioral, social, and health services research in the past decade have strengthened the evidence base available to support initiatives and translational efforts. Concerted actions to accelerate this translation and implementation process are warranted; at the same time, policies that can help tackle the upstream determinants of oral health disparities are imperative. This article summarizes the proceedings from the symposium on the interdisciplinary continuum of pediatric oral health that was held during the 43rd annual meeting of the American Association for Dental Research, Charlotte, North Carolina, USA. This report showcases the latest contributions across the interdisciplinary continuum of pediatric oral health research and provides insights into future research priorities and necessary intersectoral synergies. Issues are discussed as related to the overwhelming dominance of social determinants on oral disease and the difficulty of translating science into action.
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Affiliation(s)
- P S Casamassimo
- Division of Pediatric Dentistry and Community Oral Health, The Ohio State University College of Dentistry, Columbus, OH, USA Department of Dentistry, Columbus Nationwide Children's Hospital, Columbus, OH, USA
| | - J Y Lee
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - M L Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA Clinical and Translational Science Institute, and Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - P Milgrom
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - D L Chi
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - K Divaris
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
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Oredugba F, Agbaje M, Ayedun O, Onajole A. Assessment of Mothers’ Oral Health Knowledge: Towards Oral Health Promotion for Infants and Children. Health (London) 2014. [DOI: 10.4236/health.2014.610114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Milgrom P, Riedy CA, Weinstein P, Mancl LA, Garson G, Huebner CE, Smolen D, Sutherland M. Design of a community-based intergenerational oral health study: "Baby Smiles". BMC Oral Health 2013; 13:38. [PMID: 23914908 PMCID: PMC3751087 DOI: 10.1186/1472-6831-13-38] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 08/02/2013] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Rural, low-income pregnant women and their children are at high risk for poor oral health and have low utilization rates of dental care. The Baby Smiles study was designed to increase low-income pregnant women's utilization of dental care, increase young children's dental care utilization, and improve home oral health care practices. METHODS/DESIGN Baby Smiles was a five-year, four-site randomized intervention trial with a 2 × 2 factorial design. Four hundred participants were randomly assigned to one of four treatment arms in which they received either brief Motivational Interviewing (MI) or health education (HE) delivered during pregnancy and after the baby was born. In the prenatal study phase, the interventions were designed to encourage dental utilization during pregnancy. After childbirth, the focus was to utilize dental care for the infant by age one. The two primary outcome measures were dental utilization during pregnancy or up to two months postpartum for the mother, and preventive dental utilization by 18 months of age for the child. Medicaid claims data will be used to assess the primary outcomes. Questionnaires were administered at enrollment and 3, 9 and 18 months postpartum (study end) to assess mediating and moderating factors. DISCUSSION This trial can help define the most effective way to provide one-on-one counseling to pregnant women and new mothers regarding visits to the dentist during pregnancy and after the child is born. It supports previous work demonstrating the potential of reducing mother-to-child transmission of Streptococcus mutans and the initiation of dental caries prevention in early childhood. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT01120041.
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Affiliation(s)
- Peter Milgrom
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, University of Washington, Box 357475, 98195-7475 Seattle, WA, USA
| | - Christine A Riedy
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, University of Washington, Box 357475, 98195-7475 Seattle, WA, USA
| | - Philip Weinstein
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, University of Washington, Box 357475, 98195-7475 Seattle, WA, USA
| | - Lloyd A Mancl
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, University of Washington, Box 357475, 98195-7475 Seattle, WA, USA
| | - Gayle Garson
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, University of Washington, Box 357475, 98195-7475 Seattle, WA, USA
| | - Colleen E Huebner
- Northwest Center to Reduce Oral Health Disparities, Department of Health Services, University of Washington, Box 357230, 98195-7230 Seattle, WA, USA
| | - Darlene Smolen
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, University of Washington, Box 357475, 98195-7475 Seattle, WA, USA
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Leroy R, Bogaerts K, Hoppenbrouwers K, Martens LC, Declerck D. Dental attendance in preschool children - a prospective study. Int J Paediatr Dent 2013; 23:84-93. [PMID: 22356279 DOI: 10.1111/j.1365-263x.2012.01227.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND At present, our understanding of the use of dental care services is incomplete, certainly where preschool children are concerned. OBJECTIVES To investigate what proportion of 3- and 5-year-olds living in Flanders (Belgium) have already visited the dentist, to describe parents' experience about their child's dental visit, and to explore factors that may have an impact on children's early dental visit. DESIGN Data were collected from 1057 children; validated questionnaires were completed, and children were examined by trained dentist at ages 3 and 5. Logistic regression analyses were performed to explain dental attendance. RESULTS At the age of 3, 62% and by 5 years, 21% had never visited the dentist. The first dental visit was considered a pleasant experience for the majority of children. Multivariable regression analyses revealed that children who were not first born, whose mothers had a higher educational level and whose parents had recently visited the dentist, had significantly higher odds for having visited the dentist at young age. CONCLUSIONS Parents of young children need to be informed about and motivated for an early dental visit. Promotion campaigns should focus on firstborn children, children from less educated parents, and parents who do not regularly see a dentist.
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Affiliation(s)
- Roos Leroy
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.
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Chi DL, Momany ET, Jones MP, Kuthy RA, Askelson NM, Wehby GL, Damiano PC. Relationship between medical well baby visits and first dental examinations for young children in Medicaid. Am J Public Health 2013; 103:347-54. [PMID: 23237163 PMCID: PMC3558774 DOI: 10.2105/ajph.2012.300899] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2012] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the relationship between preventive well baby visits (WBVs) and the timing of first dental examinations for young Medicaid-enrolled children. METHODS The study focused on children born in 2000 and enrolled continuously in the Iowa Medicaid Program from birth to age 41 months (n = 6322). The main predictor variables were number and timing of WBVs. The outcome variable was timing of first dental examination. We used survival analysis to evaluate these relationships. RESULTS Children with more WBVs between ages 1 and 2 years and ages 2 and 3 years were 2.96 and 1.25 times as likely, respectively, to have earlier first dental examinations as children with fewer WBVs. The number of WBVs before age 1 year and the timing of the WBVs were not significantly related to the outcome. CONCLUSIONS The number of WBVs from ages 1 to 3 years was significantly related to earlier first dental examinations, whereas the number of WBVs before age 1 year and the timing of WBVs were not. Future interventions and policies should actively promote first dental examinations by age 12 months at WBVs that take place during the first year of life.
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Affiliation(s)
- Donald L Chi
- Department of Oral Health Sciences, University of Washington, Seattle, WA 98195-7475, USA.
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Milgrom P, Huebner CE, Mancl L, Garson G, Grembowski D. Counseling on Early Childhood Caries transmission by dentists. J Public Health Dent 2012; 73:151-7. [PMID: 22970775 DOI: 10.1111/j.1752-7325.2012.00356.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE High levels of Streptococcus mutans on teeth of young children are predictive of Early Childhood Caries (ECC). Transmission from mother-to-child is common and studies have demonstrated treatment of the mother results in less ECC. The objective of this study was to determine how dentists have adopted the practice of counseling about ECC. METHODS In 2006 as part of a larger study on dental care for pregnant women, we surveyed 829 general dentists in Oregon. The questionnaire contained questions to capture the extent to which general dentists have adopted counseling pregnant women about ECC transmission, to describe personal and practice characteristics, and examine how dentists' views on the ease of adopting of new procedures related to ECC counseling. Multivariate logistic regression was used to identify separate and additive effects of demographic and practice characteristics, attitudes, and beliefs. RESULTS The adjusted odds of a dentist who strongly believed in the link between mothers and babies and provided ECC counseling were 1.60 (95% CI 1.3-2.0, P<0.01). The odds of a dentist who reported discussing ECC with staff members and provided counseling were 2.7 (95% CI 1.7-4.3, P<0.01). Male dentists were less likely to counsel patients than female dentists (Adjusted OR=0.5, 95% CI 0.3-1.0, p<0.05). CONCLUSIONS The strongest predictors of counseling patients about ECC were dentists' belief in the evidence of caries transmission and dentists' discussion of ECC during staff meetings.
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Affiliation(s)
- Peter Milgrom
- Northwest Center to Reduce Oral Health Disparities, University of Washington, Seattle, WA 98195-7475, USA.
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Isong IA, Soobader MJ, Fisher-Owens SA, Weintraub JA, Gansky SA, Platt LJ, Newacheck PW. Racial disparity trends in children's dental visits: US National Health Interview Survey, 1964-2010. Pediatrics 2012; 130:306-14. [PMID: 22753556 PMCID: PMC3408679 DOI: 10.1542/peds.2011-0838] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Research that has repeatedly documented marked racial/ethnic disparities in US children's receipt of dental care at single time points or brief periods has lacked a historical policy perspective, which provides insight into how these disparities have evolved over time. Our objective was to examine the im-pact of national health policies on African American and white children's receipt of dental care from 1964 to 2010. METHODS We analyzed data on race and dental care utilization for children aged 2 to 17 years from the 1964, 1976, 1989, 1999, and 2010 National Health Interview Survey. Dependent variables were as follows: child's receipt of a dental visit in the previous 12 months and child's history of never having had a dental visit. Primary independent variable was race (African American/white). We calculated sample prevalences, and χ(2) tests compared African American/white prevalences by year. We age-standardized estimates to the 2000 US Census. RESULTS The percentage of African American and white children in the United States without a dental visit in the previous 12 months declined significantly from 52.4% in 1964 to 21.7% in 2010, whereas the percentage of children who had never had a dental visit declined significantly (P < .01) from 33.6% to 10.6%. Pronounced African American/white disparities in children's dental utilization rates, whereas large and statistically significant in 1964, attenuated and became nonsignificant by 2010. CONCLUSIONS We demonstrate a dramatic narrowing of African American/white disparities in 2 measures of children's receipt of dental services from 1964 to 2010. Yet, much more needs to be done before persistent racial disparities in children's oral health status are eliminated.
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Affiliation(s)
- Inyang A. Isong
- MassGeneral Hospital Center for Child and Adolescent Health Research and Policy, Harvard Medical School, Boston, Massachusetts
| | | | | | - Jane A. Weintraub
- The University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, North Carolina; and
| | - Stuart A. Gansky
- Center to Address Disparities in Children’s Oral Health, School of Dentistry, University of California, San Francisco, California
| | - Larry J. Platt
- Philip R. Lee Institute for Health Policy, School of Medicine, University of California, San Francisco, California
| | - Paul W. Newacheck
- Department of Pediatrics and,Philip R. Lee Institute for Health Policy, School of Medicine, University of California, San Francisco, California
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Valencia A, Damiano P, Qian F, Warren JJ, Weber-Gasparoni K, Jones M. Racial and ethnic disparities in utilization of dental services among children in Iowa: the Latino experience. Am J Public Health 2012; 102:2352-9. [PMID: 22698039 DOI: 10.2105/ajph.2011.300471] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to understand the role of Latino acculturation in dental care utilization in Iowa children. METHODS We used logistic regression to evaluate factors associated with having a previous-year dental check-up with 2005 Iowa Child and Family Household Health Survey data. We constructed models to examine the association with race/ethnicity and used chosen interview language to measure Latino acculturation. RESULTS After we controlled for several factors, having a regular dental care source, having a dental need, dental insurance status, family income, children's dental health rating, children's age, and brushing habits were associated with having a previous-year dental check-up. Race/ethnicity was indirectly associated with use of dental services through other related factors with significant differences for less-acculturated Latinos. CONCLUSIONS Policymakers and health planners should implement strategies to address individual, community, and system factors affecting racial/ethnic minorities. A regular source of dental care for Latino children that will enhance their access to services should be ensured. Ignoring the needs of the fastest growing segment of children with the poorest oral health and the least access to care will lead to future increase of oral diseases in this population.
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Affiliation(s)
- Alejandra Valencia
- Department of Preventive and Community Dentistry, University of Iowa, Iowa City, USA.
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Kawaguchi M, Hoshino T, Ooshima T, Fujiwara T. Establishment of Streptococcus mutans in infants induces decrease in the proportion of salivary α-haemolytic bacteria. Int J Paediatr Dent 2012; 22:139-45. [PMID: 21923689 DOI: 10.1111/j.1365-263x.2011.01183.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE For paediatric dentists, an indicator to assess caries risk of infants is very important. Conventionally, the number and/or proportions of Streptococcus mutans have been employed as risk indicator; however, because such figures reflect the existing situation, they are not suitable for assessing caries risk of infants that have not yet been infected with S. mutans. Thus, we searched for an indicator for the establishment of S. mutans. METHODS To evaluate the changes caused by the establishment of S. mutans in the microbiota of the infant oral cavity, we monitored changes in the oral microbiota of two pre-dentate infants over a 3-year period and in a cross-sectional study of 40 nursery school-aged children by cultivation of saliva on nonselective blood agar, Mitis-Salivarius agar, and Mitis-Salivarius agar supplemented with bacitracin combined with identification of selected isolates. RESULTS Two longitudinal observations suggested that the establishment of S. mutans would induce a decrease in α-haemolytic bacteria in the microbial population of the oral cavity. This suggestion was compensated with the results of cross-sectional study, and it was revealed that the establishment of 10(3) CFU/mL of mutans streptococci in saliva might be predicted by a microbiota comprising less than approximately 55% of α-haemolytic. CONCLUSION Decrease in the proportion of α-haemolytic bacteria in saliva of infant was found to be applicable as an indicator to predict the establishment of S. mutans and to assess dental caries risk as a background for planning of dental care and treatment in the infants before infection with S. mutans.
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Affiliation(s)
- Mamoru Kawaguchi
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
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Chi DL, Momany ET, Jones MP, Kuthy R, Damiano PC. Timing of first dental checkup for newly Medicaid-enrolled children with an intellectual or developmental disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2012; 50:2-15. [PMID: 22316222 PMCID: PMC3586286 DOI: 10.1352/1934-9556-50.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
We compared the extent to which having an intellectual or developmental disability was associated with rates at which Iowa Medicaid-enrolled children ages 3 to 8 had first dental checkups after an initial dental examination. We hypothesized that these children would have later first dental checkups than would children without an intellectual or developmental disability. Findings suggest no significant difference in the time to first dental checkup for children by intellectual or developmental disability status. Those who took over 12 months to see a dentist for their initial dental examination were 1.68 times as likely to have an earlier first dental checkup as children whose initial dental examination occurred within 4 months of being enrolled. Results suggest that having an intellectual or developmental disability is not associated with later first dental checkups for this population.
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Affiliation(s)
- Donald L Chi
- Oral Health Sciences, University of Washington, Seattle, WA 98195, USA.
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Assessing the relationship between children's oral health status and that of their mothers. J Am Dent Assoc 2011; 142:173-83. [PMID: 21282684 DOI: 10.14219/jada.archive.2011.0061] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The authors conducted a study to describe the relationship between the oral health of young children and that of their mothers. METHODS Using data from the Third National Health and Nutrition Examination Survey and a related birth certificate-linked file, the authors compiled a sample of 1,184 mother/child pairs for children aged 2 through 6 years. The authors performed logistic and cumulative logistic regression analyses by using children's caries experience and untreated caries status as dependent variables. They evaluated the mothers' untreated caries status and tooth loss status along with other covariates, including age, race/ethnicity and poverty status. RESULTS Children of mothers who had high levels of untreated caries were more than three times as likely (odds ratio [OR], 3.5; 95 percent confidence interval [CI], 2.0-6.2) to have higher levels of caries experience (treated or untreated dental caries) compared with children whose mothers had no untreated caries. A similar relationship was observed between mothers' tooth loss and caries experience among their children. The children of mothers with high levels of tooth loss were more than three times as likely (OR, 3.3; 95 percent CI, 1.8-6.4) to have higher levels of caries experience compared with children of mothers with no tooth loss; for mothers with moderate tooth loss, the OR was 2.3 (95 percent CI, 1.5-3.5). CONCLUSIONS Mothers' oral health status is a strong predictor of the oral health status of their children.
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Nelson S, Mandelaris J, Ferretti G, Heima M, Spiekerman C, Milgrom P. School screening and parental reminders in increasing dental care for children in need: a retrospective cohort study. J Public Health Dent 2011; 72:45-52. [PMID: 22316214 PMCID: PMC3737569 DOI: 10.1111/j.1752-7325.2011.00282.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study is to assess follow-up dental care received by children given baseline screening and referrals as part of an ongoing clinical trial. METHODS A retrospective study with two cohorts of kindergarten children who had baseline and follow-up (9 months later) dental exams was used. The parents/caregivers of children with routine restorative or urgent needs at baseline received a referral letter and telephone reminders to seek care for their child. Children with referrals were evaluated at follow-up exam for the receipt of care. A baseline caregiver questionnaire provided information on the individual and family characteristics of the children. RESULTS A total of 303 children had dental exams at both time periods. At baseline, 42 percent (126/303) received referrals and among the referred group19 percent (24/126) received follow-up care. A greater proportion with urgent referrals (10/30, 33 percent) received care than those with routine referrals (14/96, 15 percent). Baseline dmft decayed, missing, filled primary teeth and DMFT decayed, missing, filled permanent teeth was similar between children who did/did not receive follow-up care (P = 0.178 and 0.491, respectively). Children receiving referrals had caregivers with less education, higher Medicaid participation, fewer routine care visits, poorer self-rating of teeth, and a higher proportion of children reporting tooth pain. Children without receipt of follow-up care had caregivers who were more likely to report not visiting a dentist within the last 5 years and a greater number of missed days from work because of tooth problems. CONCLUSION The rate of dental utilization was low even with school screening, referral and parental reminders among poor, largely minority inner-city kindergarten children.
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Affiliation(s)
- Suchitra Nelson
- Department of Community Dentistry, Case Western Reserve University, Cleveland, OH, USA.
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Dye BA, Ogden CL. The relationship between birth weight and growth with caries development in young children remains uncertain. J Evid Based Dent Pract 2011; 11:156-9. [PMID: 21855820 DOI: 10.1016/j.jebdp.2011.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Bruce A Dye
- Centers for Disease Control and Prevention, National Center for Health Statistics, 3311 Toledo Road, Room 4416, Hyattsville, MD 20782, USA.
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Bisgaier J, Cutts DB, Edelstein BL, Rhodes KV. Disparities in child access to emergency care for acute oral injury. Pediatrics 2011; 127:e1428-35. [PMID: 21606154 DOI: 10.1542/peds.2011-0011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We examined the impact of insurance status on dental practices' willingness to schedule an appointment for a child with a symptomatic fractured permanent front tooth. PATIENTS AND METHODS Between February and May 2010, 6 research assistants posed as mothers of a 10-year-old boy seeking an urgent dental appointment. Two calls 4 weeks apart, with the same clinical scenario, were made by the same caller to a stratified random sample of dental practices, one-half of which were enrolled in the state's combined Medicaid and Children's Health Insurance Program (CHIP) dental program. The only difference in the calls was the child's insurance coverage (Medicaid/CHIP versus private Blue Cross dental coverage). We estimated differences in the log-odds probability of scheduling an appointment for a child with public versus private insurance by using exact conditional (fixed-effects) logistic regression, which accounts for paired data. RESULTS Of 170 paired calls to 85 dental practices (41 participating in the Medicaid program), only 36.5% of Medicaid beneficiaries obtained any appointment compared with 95.4% of Blue Cross-insured children with the same oral injury. Among dental providers enrolled in the Medicaid program, children with Medicaid were still 18.2 times more likely to be denied an appointment than privately insured counterparts (95% confidence interval: 3.1 to ∞; P < .001). CONCLUSIONS Illinois dentists, including those participating in Medicaid, are less likely to see a child for an urgent dental complaint if the child has public versus private dental coverage. These results have implications for developing policies that improve access to oral health care.
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Affiliation(s)
- Joanna Bisgaier
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA 19104, USA
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Beil HA, Rozier RG. Primary health care providers' advice for a dental checkup and dental use in children. Pediatrics 2010; 126:e435-41. [PMID: 20660547 DOI: 10.1542/peds.2009-2311] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE In this study we estimated factors associated with children being advised to see the dentist by a doctor or other health provider; tested for an association between the advisement on the likelihood that the child would visit the dentist; and estimated the effect of the advisement on dental costs. METHODS We identified a sample of 5268 children aged 2 to 11 years in the 2004 Medical Expenditures Panel Survey. A cross-sectional analysis with logistic regression models was conducted to estimate the likelihood of the child receiving a recommendation for a dental checkup, and to determine its effect on the likelihood of having a dental visit. Differences in cost for children who received a recommendation were assessed by using a linear regression model. All analyses were conducted separately on children aged 2 to 5 (n = 2031) and aged 6 to 11 (n = 3237) years. RESULTS Forty-seven percent of 2- to 5-year-olds and 37% of 6- to 11-year-olds had been advised to see the dentist. Children aged 2 to 5 who received a recommendation were more likely to have a dental visit (odds ratio: 2.89 [95% confidence interval: 2.16-3.87]), but no difference was observed among older children. Advice had no effect on dental costs in either age group. CONCLUSIONS Health providers' recommendation that pediatric patients visit the dentist was associated with an increase in dental visits among young children. Providers have the potential to play an important role in establishing a dental home for children at an early age. Future research should examine potential interventions to increase effective dental referrals by health providers.
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Affiliation(s)
- Heather A Beil
- Department of Health Policy and Management, UNC Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC 27599, USA.
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Racial/Ethnic Disparities in Maternal Oral Health Experiences in 10 States, Pregnancy Risk Assessment Monitoring System, 2004–2006. Matern Child Health J 2010; 15:722-9. [DOI: 10.1007/s10995-010-0643-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Binkley CJ, Garrett B, Johnson KW. Increasing dental care utilization by Medicaid-eligible children: a dental care coordinator intervention. J Public Health Dent 2010; 70:76-84. [PMID: 19765202 DOI: 10.1111/j.1752-7325.2009.00146.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to determine the effect of a dental care coordinator intervention on increasing dental utilization by Medicaid-eligible children compared with a control group. METHODS One hundred and thirty-six children enrolled in Medicaid aged 4 to 15 years at baseline in 2004 who had not had Medicaid claims for 2 years, were randomly assigned to intervention or control groups for 12 months. Children and caregivers in the intervention group received education, assistance in finding a dentist if the child did not have one, and assistance and support in scheduling and keeping dental appointments. All children continued to receive routine member services from the dental plan administrator, including newsletters and benefit updates during the study. RESULTS Dental utilization during the study period was significantly higher in the intervention group (43 percent) than in the control group (26 percent). The effect was even more significant among children living in households well below the Federal Poverty Level. The intervention was effective regardless of whether the coordinator was able to provide services in person or via telephone and mail. CONCLUSION The dental care coordinator intervention significantly increased dental utilization compared with similar children who received routine Medicaid member services. Public health programs and communities endeavoring to reduce oral health disparities may want to consider incorporating a dental care coordinator along with other initiatives to increase dental utilization by disadvantaged children.
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Affiliation(s)
- Catherine J Binkley
- Department of Surgical and Hospital Dentistry, School of Dentistry, University of Louisville, KY 40292, USA.
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Isong IA, Zuckerman KE, Rao SR, Kuhlthau KA, Winickoff JP, Perrin JM. Association between parents' and children's use of oral health services. Pediatrics 2010; 125:502-8. [PMID: 20123775 DOI: 10.1542/peds.2009-1417] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
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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Affiliation(s)
- Inyang A Isong
- Massachusetts General Hospital for Children, Center for Child and Adolescent Health Policy, 50 Staniford St, Suite 901, Boston, MA 02114, USA.
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Children's tooth decay in a public health program to encourage low-income pregnant women to utilize dental care. BMC Public Health 2010; 10:76. [PMID: 20163743 PMCID: PMC2830171 DOI: 10.1186/1471-2458-10-76] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 02/18/2010] [Indexed: 11/10/2022] Open
Abstract
Background A community-based public health program to provide a dental home for women covered by the Oregon Health Plan (Medicaid) in Klamath County, Oregon USA was instituted with the long-term goal to promote preventive oral care for both mothers and their new infants provided by dental managed care companies. Methods As part of the evaluation of the program, children in Klamath and comparable non-program counties were examined in their 2nd year of life to begin to determine if benefits accrued to the offspring of the mothers in Klamath County. Results Eighty-five and 58.9% of the children were caries free in the Klamath and comparison county samples, respectively (RR = 1.48, 95% CI 1.13, 1.93). The mean (SD) number of teeth with any decay was .75 (2.5) in the test population and 1.6 (2.5) in the comparison population (t = 2.08, p = .04). Conclusions The assessment showed that children of mothers in the Klamath County program were about one and a half times more likely to be caries free than children in the comparison counties. Additional controlled studies are being undertaken.
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Abstract
OBJECTIVES The authors examined whether low-income mothers, who have a regular source of dental care (RSDC), rate the dental health of their young children higher than mothers without an RSDC. METHODS From a population of 108,151 children enrolled in Medicaid aged 3 to 6 years and their low-income mothers in Washington state, a disproportionate stratified random sample of 11,305 children aged 3 to 6 years was selected from enrollment records in four racial/ethnic groups: 3791 Black; 2806 Hispanic; 1902 White; and 2806 other racial/ethnic groups. A mixed-mode survey was conducted to measure mother RSDC and mother ratings of child's dental health and pain. The unadjusted response rate was 44%, yielding the following eligible mothers: 816 Black, 1309 Hispanic, 1379 White, 237 Asian, and 133 American-Indian. Separate regression models for Black, Hispanic, and White mothers estimated associations between the mothers having an RSDC and ratings of child dental health. RESULTS Across racial/ethnic groups, mothers with an RSDC consistently rated their children's dental health 0.15 higher on a 1-to-5 scale (where '1' means 'poor' and '5' means 'excellent') than mothers without an RSDC, controlling for child and mother characteristics and the mothers' propensity to have an RSDC. This difference can be interpreted as a net movement of one level up the scale by 15% of the population. CONCLUSIONS Across racial/ethnic groups, low-income mothers who have a regular source of dental care rate the dental health of their young children higher than mothers without an RSDC.
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Affiliation(s)
- David Grembowski
- Department of Dental Public Health Sciences, University of Washington, Box 357660, 1959 NE Pacific Street, Seattle, WA 98195-7660
- Department of Health Services, University of Washington, Box 357660, 1959 NE Pacific Street, Seattle, WA 98195-7660
| | - Charles Spiekerman
- Department of Dental Public Health Sciences, University of Washington, Box 357660, 1959 NE Pacific Street, Seattle, WA 98195-7660
| | - Peter Milgrom
- Department of Dental Public Health Sciences, University of Washington, Box 357660, 1959 NE Pacific Street, Seattle, WA 98195-7660
- Department of Health Services, University of Washington, Box 357660, 1959 NE Pacific Street, Seattle, WA 98195-7660
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