Preventive dental care for children in the United States: a national perspective.
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 > or = 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 102,353 children, weighted to represent 72.7 million children, nationally. Our outcome of interest was > or = 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 > or = 200% of the federal poverty level, there is a greater likelihood that near-poor children will receive preventive dental care.
Lewis
Charlotte W
CW
Division of General Pediatrics, Department of Pediatrics, University of Washington, Seattle, Washington, USA. cwlewis@u.washington.edu
Johnston
Brian D
BD
Linsenmeyar
Kristi A
KA
Williams
Alexis
A
Mouradian
Wendy
W
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D016015:Logistic Models; D017057:Medically Uninsured / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D016017:Odds Ratio; D011322:Primary Prevention / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014076:Tooth Diseases / Q000517:prevention & control*; D014481:United States