title: Factors associated with dental care utilization in early childhood.
abstract: OBJECTIVE
  To identify sociodemographic, dietary, and biological factors associated with families who do not receive dental care in early childhood and to identify risk factors associated with having cavities among children who receive early dental care.
  
  
  METHODS
  A cross-sectional study of healthy Canadian children seen for primary health care between September 2011 and January 2013 was conducted through the TARGet Kids! practice-based research network in Toronto, Canada. Adjusted logistic regression was used to determine factors associated with children who were not seen by a dentist in early childhood and to determine risk factors associated with having dental cavities among children who received early dental care.
  
  
  RESULTS
  Of the 2505 children included in the analysis, <1% were seen by a dentist by 1 year of age. Older children were less likely to have never been to the dentist (odds ratio [OR], 0.88; 95% confidence interval [CI], 0.87-0.90). Low family income (OR, 2.73; 95% CI, 1.47-5.06), prolonged bottle use (OR, 1.43; 95% CI, 1.03-2.00), and higher intakes of sweetened drinks (OR, 1.20; 95% CI, 1.01-1.42) were associated with increased risk for never having been to the dentist. Among those who had been to the dentist, older children (OR, 1.04; 95% CI, 1.03-1.05), children of low income families (OR, 1.90; 95% CI, 1.17-3.10), and those of East Asian maternal ethnicity (OR, 1.91; 95% CI, 1.10-3.29) were more likely to have dental cavities.
  
  
  CONCLUSIONS
  Among healthy urban children seen by a primary care provider, those most susceptible to cavities were least likely to receive early dental care. These findings support the need for publicly funded universal early preventive dental care and underscore the importance for primary care physicians to promote dental care in early childhood.
authors.affiliation: The Applied Health Research Centre of the Li Ka Shing Knowledge Institute at St Michael's Hospital.
authors.forename: Denise
authors.initials: D
authors.lastname: Darmawikarta
authors.affiliation: The Applied Health Research Centre of the Li Ka Shing Knowledge Institute at St Michael's Hospital.
authors.forename: Yang
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Pediatrics Outcomes Research Team, Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada; and.
authors.forename: Sarah
authors.initials: S
authors.lastname: Carsley
authors.affiliation: Pediatrics Outcomes Research Team, Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada; andPediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Birken
authors.affiliation: Pediatrics Outcomes Research Team, Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada; andPediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Parkin
authors.affiliation: Department of Preventive Dental Science, Faculty of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Schroth
authors.affiliation: Pediatrics Outcomes Research Team, Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada; andPediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;Departments of Pediatrics, St Michael's Hospital, and jonathon.maguire@utoronto.ca.
authors.forename: Jonathon L
authors.initials: JL
authors.lastname: Maguire
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004245:DMF Index; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D003731:Dental Caries / Q000453:epidemiology* / Q000628:therapy*; D003733:Dental Caries Susceptibility; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016017:Odds Ratio; D009864:Ontario; D011320:Primary Health Care / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014600:Utilization Review
keywords: children; dental care; dental caries; oral health; prevention