Influence of Caregivers and Children's Entry Into the Dental Care System

被引:32
作者
Divaris, Kimon [1 ]
Lee, Jessica Y. [1 ,2 ]
Baker, A. Diane [1 ]
Gizlice, Ziya [3 ]
Rozier, R. Gary [2 ]
DeWalt, Darren A. [4 ]
Vann, William F., Jr. [1 ]
机构
[1] Univ N Carolina, Dept Pediat Dent, Sch Dent, Chapel Hill, NC 27599 USA
[2] Univ N Carolina, Dept Hlth Policy & Management, Gillings Sch Global Publ Hlth, Chapel Hill, NC 27599 USA
[3] Univ N Carolina, Ctr Hlth Promot & Dis Prevent, Chapel Hill, NC 27599 USA
[4] Univ N Carolina, Sch Med, Dept Gen Med & Epidemiol, Chapel Hill, NC 27599 USA
关键词
caregivers; children; dental neglect; dentistry; health literacy; health services; health services use; literacy; oral health; ORAL-HEALTH LITERACY; WORD RECOGNITION INSTRUMENT; VISITS; ACCESS; IMPACT; DISPARITIES; INSURANCE; DENTISTRY; NEGLECT; CARIES;
D O I
10.1542/peds.2013-2932
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVES:Early preventive dental visits are essential in improving children's oral health, especially young children at high risk for dental caries. However, there is scant information on how these children enter the dental care system. Our objectives were as follows: (1) to describe how a population-based cohort of young Medicaid-enrolled children entered dental care; and (2) to investigate the influence of caregiver characteristics on their children's dental care-seeking patterns.METHODS:We relied on Medicaid claims and interview data of caregiver-child dyads who were enrolled in the Carolina Oral Health Literacy study during 2007-2008. The analytical cohort comprised 1000 children who had no dental visits before enrollment. Additional information was collected on sociodemographic characteristics, oral health status, health literacy, dental neglect, and access to care barriers. Our analyses relied on descriptive, bivariate, and multivariate methods.RESULTS:During the 25-month median follow-up period, 39% of the children (mean baseline age: 16 months) entered the dental care system, and 13% of their first encounters were for emergency care. Caregivers' dental neglect emerged as a significant predictor of nonentrance. Children with reported oral health problems at baseline were more likely to enter the dental care system compared with children with better oral health, but they were also more likely to require emergency care.CONCLUSIONS:Caregivers have a pivotal role in children's oral health and care. Interventions aimed at improving children's oral health should involve community outreach to engage caregivers in a culturally appropriate manner when their children are infants or toddlers.
引用
收藏
页码:E1268 / E1276
页数:9
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