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The impact of universal access to dental care on disparities in caries experience in children
- Source :
- The Journal of the American Dental Association. 132:295-303
- Publication Year :
- 2001
- Publisher :
- Elsevier BV, 2001.
-
Abstract
- Background The authors investigated the association between socioeconomic status and the severity of dental caries in 6- and 7-year-old children who had had access to dental care throughout their lives. The children had lived since birth in Nova Scotia, Canada, a province with a universal publicly financed dental care program. Methods The authors selected a representative sample of first-grade children using a stratified multistage sampling method of primary schools (n = 1,614). The response rate was 78.8 percent. Two dentists were trained to diagnose dental caries using modified World Health Organization criteria. Intra-and interexaminer reliability was excellent (κ ≥ 0.88). Of the children who were examined (n = 1,271), 955 were lifelong residents of Nova Scotia, Canada, and so were included in this analysis. Data were weighted and adjusted for clustering (design) effects. Results Only 8.4 percent of the children had visited a dental office before the age of 2 years, and 88.5 percent of the children had their first dental visit between the ages of 2 and 5 years. Children whose parents had completed a university education had a significantly lower mean number of decayed, missing and filled surfaces, or dmfs, in their primary teeth than did children whose parents had a lower education level. A Poisson regression model indicated that parents' high education status, optimal fluoride concentration in schools' water supplies, daily toothbrushing and dental visits for checkup were significantly associated with low dmfs scores. Conclusion Having access to a universal publicly financed dental insurance program since birth did not eliminate the disparities in caries experience. Practice Implications This analysis of a highly utilized universal dental insurance program suggests that disparities in oral health status cannot be reduced solely by providing universal access to dental care. Focused efforts by professional and governmental organizations should be directed toward understanding the socioeconomic, behavioral and community determinants of oral health disparities.
- Subjects :
- Parents
Toothbrushing
Pediatrics
medicine.medical_specialty
Universal design
medicine.medical_treatment
MEDLINE
Dental insurance
Dental Caries
Social class
Health Services Accessibility
symbols.namesake
Universal Health Insurance
Fluoridation
medicine
Cluster Analysis
Humans
Poisson Distribution
Poisson regression
Tooth, Deciduous
Child
Dental Restoration, Permanent
General Dentistry
Socioeconomic status
Dental Care for Children
Observer Variation
Response rate (survey)
Schools
DMF Index
business.industry
Age Factors
stomatognathic diseases
Nova Scotia
Social Class
Family medicine
symbols
Educational Status
Regression Analysis
business
Dental restoration
Subjects
Details
- ISSN :
- 00028177
- Volume :
- 132
- Database :
- OpenAIRE
- Journal :
- The Journal of the American Dental Association
- Accession number :
- edsair.doi.dedup.....7b3a8c3b3124957b0f92dc85ae41d21c