Date of Graduation

2016

Document Type

Thesis

Degree Type

MS

College

School of Public Health

Department

Social and Behavioral Sciences

Committee Chair

Ranjita Misra

Committee Co-Chair

Ranjita Misra

Committee Member

R Constance Wiener

Committee Member

Keith Zullig

Abstract

Background and objectives: Early dental visits provide the opportunity to reduce the prevalence of early childhood caries through risk assessment, counseling, and provision of specific preventive measures. Despite the American Academy of Pediatric Dentistry's recommendation that the first dental visit should occur by 1 year of age, many children are not receiving care until much later. Evidence that early dental visits improve dental outcomes is vital to educate parents and health care providers. Hence, this study examined the association between a child's age at the first dental visit and dental outcomes, parents' awareness of the recommendation for the first dental visit, and perceived barriers to dental care. A secondary aim examined pediatric dentists' perceived barriers to children's early dental care in West Virginia.;Methods: A cross-sectional survey was used to collect data from parents of children ≤ 6 years of age, and under the care of a pediatric dentist. Pearson correlation was used to examine the association between age at first dental visit and age at caries onset. Chi-square analyses were used to test the association between (1) age at first dental visit and history of caries, (2) age at first dental visit and history of an adverse dental outcome, and (3) reason for the first dental visit and history of an adverse dental outcome. A binary logistic regression model was used to evaluate the extent to which age at the first dental visit explained caries history. For the qualitative study component, pediatric dentists responded to questions regarding barriers to the establishment of a dental home for West Virginia children.;Results: A significant association was noted between a child's age at the first dental visit and age at caries onset, r (29) = 0.65, p <.0001 [95% CI=0.39, 0.82]. No significant association was noted between age at the first dental visit and history of caries, or between age at first visit and history of adverse outcome (p >.05). However, children whose first visit was for a problem with the teeth or mouth were significantly more likely to have had an adverse outcome, chi2 (1, n = 160) = 7.60, p = .0058. The adjusted odds ratio for age at first dental visit in the logistic regression model predicting caries history was 1.10, [95% CI= 1.04, 1.17], p =.0013. Pediatric dentists perceived the limited dental workforce in West Virginia to be the greatest barrier to early dental visits for children.;Conclusions: This pilot study demonstrates that parent reported dental outcomes may be useful in studies evaluating the association between early dental visits and dental outcomes. There remains a need to educate parents about the recommended first dental visit by age 1 year.

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