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J Am Dent Assoc, Vol 138, No 3, 309-318. © 2007 American Dental Association

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Background. The objective of the authors’ analysis was to investigate the determinants of dental care visits among young, low-income African-American children.

Methods. Trained researchers interviewed a representative sample of low-income black families (caregivers and children aged 0 through 5 years) in Detroit to assess their dental visit history, dental insurance status and oral health behaviors. Dental examinations were conducted using the International Caries Diagnosis Assessment System (ICDAS). Of the 1,021 families who completed an interview and examination, a subset of the 552 children aged 3 to 5 years (and their primary caregivers) was the focus of this analysis.

Results. Children with private dental insurance had four times higher odds of having visited a dentist compared with those who had no dental insurance, and the odds for children receiving Medicaid were about 1.5 times higher. A child’s age and a caregiver’s educational attainment were positive and significant determinants of child dental visits. Caregivers who visited a dentist for preventive reasons were five times more likely to have taken their children to visit the dentist. Visiting a dentist was associated with an increased mean number of filled or missing tooth surfaces, but it was not significantly associated with the mean number of untreated decayed teeth.

Conclusion. Children’s dental insurance status was a significant determinant of their having visited a dentist. Even after the authors accounted for insurance status and other risk indicators, they found that children of caregivers who reported visiting a dentist for preventive care had a higher number of dental care visits. Determinants of caregivers’ preventive dental visits must be identified and encouraged to improve the percentage of low-income children who visit dentists.

Key Words: Behavioral sciences; dental insurance; dental care utilization; access to care

Abbreviations: DDHP: Detroit Dental Health Project • ICDAS: International Caries Diagnosis Assessment System • SCHIP: State Children’s Health Insurance Program

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