title: Primary health care providers' advice for a dental checkup and dental use in children.
abstract: OBJECTIVE
  In this study we estimated factors associated with children being advised to see the dentist by a doctor or other health provider; tested for an association between the advisement on the likelihood that the child would visit the dentist; and estimated the effect of the advisement on dental costs.
  
  
  METHODS
  We identified a sample of 5268 children aged 2 to 11 years in the 2004 Medical Expenditures Panel Survey. A cross-sectional analysis with logistic regression models was conducted to estimate the likelihood of the child receiving a recommendation for a dental checkup, and to determine its effect on the likelihood of having a dental visit. Differences in cost for children who received a recommendation were assessed by using a linear regression model. All analyses were conducted separately on children aged 2 to 5 (n = 2031) and aged 6 to 11 (n = 3237) years.
  
  
  RESULTS
  Forty-seven percent of 2- to 5-year-olds and 37% of 6- to 11-year-olds had been advised to see the dentist. Children aged 2 to 5 who received a recommendation were more likely to have a dental visit (odds ratio: 2.89 [95% confidence interval: 2.16-3.87]), but no difference was observed among older children. Advice had no effect on dental costs in either age group.
  
  
  CONCLUSIONS
  Health providers' recommendation that pediatric patients visit the dentist was associated with an increase in dental visits among young children. Providers have the potential to play an important role in establishing a dental home for children at an early age. Future research should examine potential interventions to increase effective dental referrals by health providers.
authors.affiliation: Department of Health Policy and Management, UNC Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC 27599, USA. hbeil@email.unc.edu
authors.forename: Heather A
authors.initials: HA
authors.lastname: Beil
authors.forename: R Gary
authors.initials: RG
authors.lastname: Rozier
mesh_terms: D001291:Attitude of Health Personnel; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D003731:Dental Caries / Q000517:prevention & control*; D003752:Dental Health Services / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures; D006282:Health Personnel; D006293:Health Promotion; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards*; D011795:Surveys and Questionnaires; D014481:United States