Published online June 22, 2007
PEDIATRICS Vol. 119 No. 3 March 2007, pp. e544-e553 (doi:10.1542/peds.2006-1958)
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ARTICLE

Preventive Dental Care for Children in the United States: A National Perspective

Charlotte W. Lewis, MD, MPHa,b,c,d, Brian D. Johnston, MD, MPHa,b,e, Kristi A. Linsenmeyar, DDSd, Alexis Williams, BSc and Wendy Mouradian, MDa,b,d

a Division of General Pediatrics, Department of Pediatrics
c Child Health Institute
d Department of Pediatric Dentistry, University of Washington, Seattle, Washington
b Children's Hospital and Regional Medical Center, Seattle, Washington
e Department of Pediatrics, Harborview Medical Center, Seattle, Washington

OBJECTIVE. Preventive dental care is a cornerstone of optimal oral health. However, in 1996, only 38% of US children received preventive dental care. We used the National Survey of Children's Health to (1) describe the proportion of US children with ≥1 preventive dental visit within the previous year, (2) identify factors that were associated with preventive dental care use, and (3) test the hypothesis that preventive dental care use by near-poor children is associated with State Child Health Insurance Program policies for covering dental care.

METHODS. The National Survey of Children's Health includes data from 102353 children, weighted to represent 72.7 million children, nationally. Our outcome of interest was ≥1 preventive dental visit in the past year. We conducted multivariate regression analysis to identify factors that were associated significantly with this outcome using Stata survey capabilities.

RESULTS. In 2003, 72% of US children had a reported preventive dental care visit in the previous year. On multivariable analysis, we found that being young, black or multiracial relative to white, lower income, and lacking a personal doctor were variables with a significantly lower likelihood of a preventive dental visit. Children in states with State Child Health Insurance Program dental coverage and broadest income eligibility had a 24% higher likelihood of a preventive dental visit when compared with children in states with limited or no State Child Health Insurance Program coverage for dental services, on adjusted analysis.

CONCLUSIONS. Although the proportion of US children with a preventive dental visit now is higher than previously reported, children who are at highest risk for dental problems still are those who are least likely to receive preventive dental care. When states cover preventive dental care at income eligibility levels ≥200% of the federal poverty level, there is a greater likelihood that near-poor children will receive preventive dental care.

Key Words: dental care • prevention • oral health

Abbreviations: MEPS—Medical Expenditure Panel Survey • NSCH—National Survey of Children's Health • SCHIP—State Child Health Insurance Program • EPSDT—Early Periodic Screening, Diagnosis, and Treatment • FPL—federal poverty level • MSA—metropolitan statistical area • OR—odds ratio

Accepted Oct 10, 2006.




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