title: The dental care of U.S. children: access, use and referrals by nondentist providers, 2003.
abstract: BACKGROUND
  Improvements in oral health care services have not reached evenly across every segment of American society. The authors examine the role of nondentist practitioners in referring child patients for dental care by analyzing data from the 2003 Medical Expenditure Panel Survey conducted by the Agency for Healthcare Research and Quality and the National Center for Health Statistics.
  
  
  METHODS
  The authors provide national estimates of the percentage of the civilian noninstitutionalized population of the United States aged 2 through 17 years who had a dental visit, who had a dental checkup and who received advice from a nondentist health care provider to have a dental checkup.
  
  
  RESULTS
  Overall, 38 percent of all poor, near-poor or low-income children and 60 percent of all middle- or high-income children aged 2 through 17 years reported having had a dental checkup during 2003. The authors observed no significant differences between poor, near-poor and low-income children and higher-income children in terms of having been advised by a nondentist health care provider to have a dental checkup.
  
  
  CONCLUSIONS
  Although income may not predict the likelihood of patients' receiving advice from a nondentist health care provider to have a dental checkup, children from families with higher levels of income were more likely to seek dental care than were children from families with lower levels of income. Practice Implications. Efforts to increase access to dental care should aim to maximize the benefit of advice provided by nondentist health care practitioners to receive a dental checkup, so that children from families with limited income are as likely to receive a dental checkup as are children from families with higher levels of income.
authors.affiliation: Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, 540 Gaither, Rockville, MD 20850, USA. may.chu@ahrq.hhs.gov
authors.forename: May
authors.initials: M
authors.lastname: Chu
authors.forename: Luciana E
authors.initials: LE
authors.lastname: Sweis
authors.forename: Albert H
authors.initials: AH
authors.lastname: Guay
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Manski
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D003731:Dental Caries / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007347:Insurance, Dental / Q000706:statistics & numerical data; D008297:Male; D054525:Minority Health; D010372:Pediatrics; D011203:Poverty; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology