Methods: Oral health survey and clinical data were collected in 2006-7 from families in Fresno County, California as part of a larger, population-based study. Generalized estimating equation logit regression assessed effects of factors on having a dental visit among children aged 0-17 (n=421). Predisposing factors included child socio-demographics and days caregiver worked in agriculture. Enabling factors included child's dental insurance, child's regular dental care source, and free/reduced price lunch program status, along with family income, household size, caregiver's Anglo/Mexican acculturation level and years of education. Need factors included caregiver's perceptions of child's oral health status and presence of cavities, and dental examiner's clinically-determined treatment urgency.
Results: Half (49%) the children had a past year dental visit, while 22% had never been to a dentist. Children were less likely to have a past year dental visit if they were foreign-born (Odds Ratio [OR]=0.24, 95%Confidence Interval [CI]=0.11-0.53, p=0.0004), if caregiver thought child had cavities (OR=0.37, CI=0.20-0.71, p=0.0026) or not sure about cavities (OR=0.36, CI=0.19-0.68, p=0.0016), and if child should see dentist ‘at earliest convenience' (OR=0.35, CI=0.18-0.67, p=0.0015). Visits were about 2.5-3 times as likely if children were older (OR=2.95, CI=1.59-5.49, p=0.0006 among ages 6-12, OR=2.65, CI=1.19-5.89, p=0.0167 among ages 13-17, relative to children 0-5 years), had a regular source of care (OR=4.44, CI=2.41-8.18, p<0.0001), and if caregivers had Anglo-oriented acculturation scores (OR=1.40, CI 1.05-1.87, p=0.023).
Conclusions: Several unmet dental needs were seen among these children. Many did not obtain care despite caregivers' perceiving cavities and needs. A regular source of dental care was positively associated with past year utilization. Establishing a dental home should be encouraged to promote oral health for this higher risk population. Study supported by: US/DHHS/NIH/NIDCR-U54DE142501