Caregiver-reported Dental Homes in a Community Cohort of Preschool-age Children

Objectives: The dental home for young children plays an important role in oral health promotion and disease prevention, while its absence conveys considerable public health consequences. Our objectives were to: a) identify socio-demographic dental home determinants, b) determine oral health behaviors associated with a dental home, and c) compare caries experience of children with and without dental homes in the context of a community-based genetic epidemiologic study of early childhood oral health.
Methods: We used socio-demographic and oral health behavior questionnaire data from 7,305 preschool-age children (mean age=52 months; range=36-71 months) enrolled in Head Start centers in North Carolina and participating in the ZOE 2.0 study. Our primary outcome, the dental home, was defined as the caregiver reporting her child visits a dentist for regular check-ups rather than for problem-based care. We used clinical examination data obtained by trained and calibrated examiners in community locations using ICDAS criteria to define ECC (at the ICDAS>2 threshold) as well as untreated disease cases. Analyses relied upon descriptive, bivariate and multivariable log-binomial regression modeling.
Results: Eighty-three percent of enrolled children had dental homes. Children with dental homes were approximately 2 months older and more likely to live in urban/suburban areas than those without. Having a dental home had significant positive associations with beneficial oral health behaviors (e.g., use of fluoridated toothpaste, adult supervised brushing), and significant negative associations with detrimental oral health behaviors and reported dental pain. Children without a dental home were 13% more likely to have ECC [95% confidence interval (CI)=6%-20%] and 36% more likely to have untreated disease (95% CI=25%-48%).
Conclusions: Caregiver-reported dental homes were associated with beneficial oral health-related behaviors and lower dental caries prevalence among this group of preschool-aged children. Public health and community-based efforts intended to create and maintain dental homes for low-income children are good investments.