Increased Dental Use May Affect Changes in Treated and Untreated Dental Caries in Young Children

Ten-year changes in children's oral health disparities: Findings from the 3rd and 4th oral health surveys in Beijing, China

Objectives

Little is known about children's oral health disparities and their changes in developing countries. This study aimed to measure rural‐urban and maternal education‐related disparities in dental visits and untreated caries among Chinese children, and to describe their changes between 2005 and 2015.

Methods

The 12‐year‐old children's oral health data were from the 3rd (2005) and 4th (2015) oral health surveys in Beijing, China. Rural‐urban disparities and maternal education‐related disparities in dental visits and untreated caries were measured. The slope index of inequality (SII) and a relative index of inequality (RII) were applied to reflect the absolute and relative disparities respectively. These were estimated using a generalized linear regression model.

Results

Data were analysed from 388 children in 2005 and 1926 children in 2015. The proportion of 12‐year‐old schoolchildren who visited the dentist was 24.0% in 2005 and 36.0% in 2015. Untreated caries prevalence in 2005 and 2015 was 20.9% and 16.2% respectively. Rural‐urban disparities in dental visits narrowed between 2005 and 2015 (SII: −10.75 to −3.30, RII: 0.55 to 0.87), and maternal education‐related disparities in dental visits also decreased during this decade (SII: −18.52 to −8.49, RII: 0.38 to 0.65). These changes were statistically significant. For disparities in untreated caries, only maternal education‐related disparities in untreated caries in 2015 were found. The SII and RII were 6.39% (95% CI: 1.65, 11.13) and 1.57 (95% CI: 1.13, 2.20) respectively. The change in disparities in untreated caries was not statistically significant for rural‐urban disparities (P = .319) or maternal education‐related disparities (P = .501).

Conclusions

These findings indicate that in Beijing, China, disparities in children's dental visits narrowed between 2005 and 2015. However, maternal education‐related disparities in dental visits and in untreated caries were still apparent, suggesting that policies to improve children's oral healthcare utilization equality should target the children with less‐educated mothers.

Pediatric dental care use and parent- or caregiver-rated oral health among Alabama children enrolled in Medicaid

BACKGROUND

Reducing caries and improving access to dental care is a public health challenge. Understanding low use of dental care is of critical importance. This study estimated parent- or caregiver-reported prevalence and identified factors associated with children's dental care use, including the association with children's oral health.

METHODS

A cross-sectional analysis of children enrolled in Medicaid in Alabama, using data from the 2017 statewide Consumer Assessment of Healthcare Providers and Systems Health Plan Survey, was conducted. Associations were measured using adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) from logit regression and generalized linear model postestimation of least-squares means.

RESULTS

The 6-month prevalence of children receiving dental care was 70.4%. Children aged 0 through 3 years (aPR, 0.72; 95% CI, 0.53 to 0.91) had lower prevalence of care than other age groups. The prevalence of low-rated oral health was 9.2%. Low-rated oral health was associated with not receiving dental care (aPR, 1.50; 95% CI, 1.12 to 1.87) and parental education of 8th grade or less (aPR, 2.59; 95% CI, 1.20 to 3.98). Falsification tests determined that dental care use was not associated with ratings for overall health (aPR, 1.18; 95% CI, 0.83 to 1.52) or emotional health (aPR, 1.06; 95% CI, 0.79 to 1.33).

CONCLUSIONS

It was observed that children not receiving dental care had low-rated oral health; however, as a cross-sectional study, it was not possible to assess the temporality of this relationship.

PRACTICAL IMPLICATIONS

Oral health care providers should continue to recognize their role in educating parents and providing anticipatory guidance on children's oral health.